The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients

Dirk Zajonz,1,2,* Florian Prager,1,* Melanie Edel,1,2 Robert Möbius,1,2 Alexandros Daikos,1 Johannes KM Fakler,1 Christoph Josten,1,2 Jürgen Kratzsch,3 Andreas Roth1,2 1Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany; 2ZESBO &a...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Zajonz D, Prager F, Edel M, Möbius R, Daikos A, Fakler JKM, Josten C, Kratzsch J, Roth A
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2018
Materias:
THA
TKA
Acceso en línea:https://doaj.org/article/bffa22c498574390bfc5527229d28431
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:bffa22c498574390bfc5527229d28431
record_format dspace
spelling oai:doaj.org-article:bffa22c498574390bfc5527229d284312021-12-02T02:41:09ZThe significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients1178-1998https://doaj.org/article/bffa22c498574390bfc5527229d284312018-08-01T00:00:00Zhttps://www.dovepress.com/the-significance-of-the-vitamin-d-metabolism-in-the-development-of-per-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Dirk Zajonz,1,2,* Florian Prager,1,* Melanie Edel,1,2 Robert Möbius,1,2 Alexandros Daikos,1 Johannes KM Fakler,1 Christoph Josten,1,2 Jürgen Kratzsch,3 Andreas Roth1,2 1Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany; 2ZESBO – Zentrum zur Erforschung der Stuetz- und Bewegungsorgane, Leipzig, Germany; 3Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany *These authors contributed equally to this work Background: The importance of the vitamin D homeostasis in infections is already known. However, its significance in periprosthetic infections (PPIs) after total hip arthroplasty and total knee arthroplasty is largely unexplored. The aim of the study is to precisely analyze the vitamin D balance in patients with PPIs after total hip arthroplasty and total knee arthroplasty. Here, cases with primary endoprosthesis implants and aseptic loosening are used as comparison groups.Materials and methods: In this prospective matched-pair analysis, patients with PPI at the hip and knee joints were included in the study group (SG). The control groups (CGs) consisted of patients with primary implants (CG I) and who underwent replacement surgery due to aseptic loosening (CG II). In addition to 25 OH vitamin D3 and calcium, bone mineral and protein parameters were determined. An osteoporosis-specific questionnaire was collected.Results: There are no significant differences in the 25 OH-vitamin D levels between the SG (17.9±8.9) and both CGs (CG I: 16.8±6.90; CG II: 19.7±7.90). However, compared with the SG, significantly higher levels of calcium (Ca) and bone-specific alkaline phosphatase were found in both CGs in comparison with the SG. Significantly lower values concerning the protein balance in PPI were conspicuous. Acute PPI showed a significant reduction in 25 OH vitamin D3 compared with chronic infections (8.3±5.98 vs 21.6±8.40, P=0.002). Calcium and protein balance were also significantly reduced in acute PPIs.Conclusion: Acute PPIs of the hip and knee joints show a significantly reduced calcium and 25 OH vitamin D3 levels as well as lowered proteins (albumin and total protein) compared with chronic infections as well as primary endoprostheses and aseptic replacement operations. Substitution of vitamin D3 and calcium with simultaneous adaptation of the protein balance is recommended in all PPIs, especially in the acute PPI. Keywords: periprosthetic infection, protein deficiency, THA, TKA, vitamin D deficiency Zajonz DPrager FEdel MMöbius RDaikos AFakler JKMJosten CKratzsch JRoth ADove Medical Pressarticleperiprosthetic infectionprotein deficiencyTHATKAvitamin D deficiencyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1429-1435 (2018)
institution DOAJ
collection DOAJ
language EN
topic periprosthetic infection
protein deficiency
THA
TKA
vitamin D deficiency
Geriatrics
RC952-954.6
spellingShingle periprosthetic infection
protein deficiency
THA
TKA
vitamin D deficiency
Geriatrics
RC952-954.6
Zajonz D
Prager F
Edel M
Möbius R
Daikos A
Fakler JKM
Josten C
Kratzsch J
Roth A
The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients
description Dirk Zajonz,1,2,* Florian Prager,1,* Melanie Edel,1,2 Robert Möbius,1,2 Alexandros Daikos,1 Johannes KM Fakler,1 Christoph Josten,1,2 Jürgen Kratzsch,3 Andreas Roth1,2 1Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany; 2ZESBO – Zentrum zur Erforschung der Stuetz- und Bewegungsorgane, Leipzig, Germany; 3Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany *These authors contributed equally to this work Background: The importance of the vitamin D homeostasis in infections is already known. However, its significance in periprosthetic infections (PPIs) after total hip arthroplasty and total knee arthroplasty is largely unexplored. The aim of the study is to precisely analyze the vitamin D balance in patients with PPIs after total hip arthroplasty and total knee arthroplasty. Here, cases with primary endoprosthesis implants and aseptic loosening are used as comparison groups.Materials and methods: In this prospective matched-pair analysis, patients with PPI at the hip and knee joints were included in the study group (SG). The control groups (CGs) consisted of patients with primary implants (CG I) and who underwent replacement surgery due to aseptic loosening (CG II). In addition to 25 OH vitamin D3 and calcium, bone mineral and protein parameters were determined. An osteoporosis-specific questionnaire was collected.Results: There are no significant differences in the 25 OH-vitamin D levels between the SG (17.9±8.9) and both CGs (CG I: 16.8±6.90; CG II: 19.7±7.90). However, compared with the SG, significantly higher levels of calcium (Ca) and bone-specific alkaline phosphatase were found in both CGs in comparison with the SG. Significantly lower values concerning the protein balance in PPI were conspicuous. Acute PPI showed a significant reduction in 25 OH vitamin D3 compared with chronic infections (8.3±5.98 vs 21.6±8.40, P=0.002). Calcium and protein balance were also significantly reduced in acute PPIs.Conclusion: Acute PPIs of the hip and knee joints show a significantly reduced calcium and 25 OH vitamin D3 levels as well as lowered proteins (albumin and total protein) compared with chronic infections as well as primary endoprostheses and aseptic replacement operations. Substitution of vitamin D3 and calcium with simultaneous adaptation of the protein balance is recommended in all PPIs, especially in the acute PPI. Keywords: periprosthetic infection, protein deficiency, THA, TKA, vitamin D deficiency 
format article
author Zajonz D
Prager F
Edel M
Möbius R
Daikos A
Fakler JKM
Josten C
Kratzsch J
Roth A
author_facet Zajonz D
Prager F
Edel M
Möbius R
Daikos A
Fakler JKM
Josten C
Kratzsch J
Roth A
author_sort Zajonz D
title The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients
title_short The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients
title_full The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients
title_fullStr The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients
title_full_unstemmed The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients
title_sort significance of the vitamin d metabolism in the development of periprosthetic infections after tha and tka: a prospective matched-pair analysis of 240 patients
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/bffa22c498574390bfc5527229d28431
work_keys_str_mv AT zajonzd thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT pragerf thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT edelm thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT mobiusr thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT daikosa thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT faklerjkm thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT jostenc thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT kratzschj thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT rotha thesignificanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT zajonzd significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT pragerf significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT edelm significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT mobiusr significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT daikosa significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT faklerjkm significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT jostenc significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT kratzschj significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
AT rotha significanceofthevitamindmetabolisminthedevelopmentofperiprostheticinfectionsafterthaandtkaaprospectivematchedpairanalysisof240patients
_version_ 1718402315020402688