The University of Southampton
University of Southampton Institutional Repository

How can the orthopedic surgeon ensure optimal Vitamin D status in patients operated for an osteoporotic fracture?

How can the orthopedic surgeon ensure optimal Vitamin D status in patients operated for an osteoporotic fracture?
How can the orthopedic surgeon ensure optimal Vitamin D status in patients operated for an osteoporotic fracture?

In this narrative review, the role of vitamin D deficiency in the pathophysiology, healing of fragility fractures, and rehabilitation is discussed. Vitamin D status can be assessed by measuring serum 25(OH)-vitamin D level with standardized assays. There is a high prevalence of vitamin D insufficiency (25(OH)D < 50 nmol/l (i.e., 20 ng/mL)) or deficiency (25(OH)D < 25 nmol/l (i.e., 10 ng/mL)) in patients with fragility fractures and especially in those with a hip fracture. The evidence on the effects of vitamin D deficiency and/or vitamin D supplementation on fracture healing and material osseointegration is still limited. However, it appears that vitamin D have a rather positive influence on these processes. The fracture liaison service (FLS) model can help to inform orthopedic surgeons, all caregivers, and fractured patients about the importance of optimal vitamin D status in the management of patients with fragility fractures. Therefore, vitamin D status should be included in Capture the Fracture® program as an outcome of FLS in addition to dual-energy X-ray absorptiometry (DXA) and specific antiosteoporosis medication. Vitamin D plays a significant role in the pathophysiology and healing of fragility fractures and in rehabilitation after fracture. Correction of vitamin D deficiency should be one of the main outcomes in fracture liaison services.

Fracture healing, Fracture liaison service, Fragility fracture, Rehabilitation, Vitamin D
0937-941X
1921-1935
Chevalley, Thierry
6ee10580-2048-4dd2-bff0-26a2b2950dc9
Brandi, Maria Luisa
5828a1bf-dd91-4cfb-b362-e345cc65020f
Cavalier, Etienne
bc312308-1b70-4434-ab15-28860479d2e9
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Iolascon, Giovanni
d4c5e844-8f3e-4964-8b97-6b22e3efac2a
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Hannouche, Didier
2bdfac8a-622e-4f03-89af-a4250ea0e8c0
Kaux, Jean-Francois
a69c85d7-28b1-410d-90f6-e3977445f817
Kurth, Andreas
5681eee6-8950-41bd-9fda-9b503b2a4e99
Maggi, Stefania
269c4058-6259-4392-a884-4fca4ffe5c68
Maier, Gerrit
55665bad-9061-444d-8f7e-c899f81313a7
Papavasiliou, Kyriakos
e05862ec-0fd8-4d70-9e6c-95e36b5ae030
Al-Daghri, Nasser M.
0bf1023c-a104-4f74-8b06-87780dfbd8b4
Sosa-Henríquez, Manuel
0fc0aafb-8d24-487f-8f9f-1ca18d12da18
Suhm, Norbert
7534ced5-7a42-4552-b736-5c26807f9293
Tarantino, Umberto
881aa033-d5f5-4a6f-a692-13077c03b435
Reginster, Jean-Yves
db56b103-184d-46e1-9600-f47f7a09a492
Rizzoli, Rene
e02c0d92-6da1-430c-a669-0c20e94a850a
Chevalley, Thierry
6ee10580-2048-4dd2-bff0-26a2b2950dc9
Brandi, Maria Luisa
5828a1bf-dd91-4cfb-b362-e345cc65020f
Cavalier, Etienne
bc312308-1b70-4434-ab15-28860479d2e9
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Iolascon, Giovanni
d4c5e844-8f3e-4964-8b97-6b22e3efac2a
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Hannouche, Didier
2bdfac8a-622e-4f03-89af-a4250ea0e8c0
Kaux, Jean-Francois
a69c85d7-28b1-410d-90f6-e3977445f817
Kurth, Andreas
5681eee6-8950-41bd-9fda-9b503b2a4e99
Maggi, Stefania
269c4058-6259-4392-a884-4fca4ffe5c68
Maier, Gerrit
55665bad-9061-444d-8f7e-c899f81313a7
Papavasiliou, Kyriakos
e05862ec-0fd8-4d70-9e6c-95e36b5ae030
Al-Daghri, Nasser M.
0bf1023c-a104-4f74-8b06-87780dfbd8b4
Sosa-Henríquez, Manuel
0fc0aafb-8d24-487f-8f9f-1ca18d12da18
Suhm, Norbert
7534ced5-7a42-4552-b736-5c26807f9293
Tarantino, Umberto
881aa033-d5f5-4a6f-a692-13077c03b435
Reginster, Jean-Yves
db56b103-184d-46e1-9600-f47f7a09a492
Rizzoli, Rene
e02c0d92-6da1-430c-a669-0c20e94a850a

Chevalley, Thierry, Brandi, Maria Luisa, Cavalier, Etienne, Harvey, Nicholas, Iolascon, Giovanni, Cooper, Cyrus, Hannouche, Didier, Kaux, Jean-Francois, Kurth, Andreas, Maggi, Stefania, Maier, Gerrit, Papavasiliou, Kyriakos, Al-Daghri, Nasser M., Sosa-Henríquez, Manuel, Suhm, Norbert, Tarantino, Umberto, Reginster, Jean-Yves and Rizzoli, Rene (2021) How can the orthopedic surgeon ensure optimal Vitamin D status in patients operated for an osteoporotic fracture? Osteoporosis International, 32 (10), 1921-1935. (doi:10.1007/s00198-021-05957-9).

Record type: Review

Abstract

In this narrative review, the role of vitamin D deficiency in the pathophysiology, healing of fragility fractures, and rehabilitation is discussed. Vitamin D status can be assessed by measuring serum 25(OH)-vitamin D level with standardized assays. There is a high prevalence of vitamin D insufficiency (25(OH)D < 50 nmol/l (i.e., 20 ng/mL)) or deficiency (25(OH)D < 25 nmol/l (i.e., 10 ng/mL)) in patients with fragility fractures and especially in those with a hip fracture. The evidence on the effects of vitamin D deficiency and/or vitamin D supplementation on fracture healing and material osseointegration is still limited. However, it appears that vitamin D have a rather positive influence on these processes. The fracture liaison service (FLS) model can help to inform orthopedic surgeons, all caregivers, and fractured patients about the importance of optimal vitamin D status in the management of patients with fragility fractures. Therefore, vitamin D status should be included in Capture the Fracture® program as an outcome of FLS in addition to dual-energy X-ray absorptiometry (DXA) and specific antiosteoporosis medication. Vitamin D plays a significant role in the pathophysiology and healing of fragility fractures and in rehabilitation after fracture. Correction of vitamin D deficiency should be one of the main outcomes in fracture liaison services.

Text
Manuscript-R1-clean version - Accepted Manuscript
Download (252kB)

More information

Accepted/In Press date: 9 April 2021
e-pub ahead of print date: 20 May 2021
Published date: October 2021
Additional Information: Funding Information: MLB has received consultancy, lecture fees, and honoraria from Abiogen, Alexion, Amgen, Bruno Farmaceutici, Kyowa Kirin, Servier, and SPA. EC is consultant for DiaSorin, Fujirebio, IDS, Menarini, Nittobo and bioMérieux. NCH has received consultancy, lecture fees, and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, UCS, Shire, Consilient Healthcare, Kyowa Kirin and Internis Pharma. CC has received consultancy, lecture fees, and honoraria from AMGEN, GSK, Alliance for Better Bone Health, MSD, Eli Lilly, Pfizer, Novartis, Servier, Medtronic and Roche. SM reports grants from SANOFI, MSD, GSK, PFIZER, TAKEDA, MYLAN through institution as organizer of meetings/congresses and as principal investigator of epidemiological studies, for taking part to advisory boards and expert meetings. NS has received fees for lectures or scientific advisory boards from AgNovos, EliLilly, Amgen, AO Foundation, UCB Pharma, Roche, Labatec. JYR reports consulting fees or advisory board participation for IBSA-Genevrier, Mylan, Radius Health and Pierre Fabre, lecturing fees for IBSA-Genevrier, Mylan, Cniel and Dairy Research Council (DRC) and grant support from IBSA-Genevrier, Mylan, Cniel and Radius Health. RR has received fees for lectures or scientific advisory boards from Abiogen, Danone, Echolight, European Milk Forum, Mithra, ObsEva, Pfizer Consumer Health and Theramex. The Working Group was entirely funded by the ESCEO. The ESCEO receives Unrestricted Educational Grants, to support its educational and scientific activities, from non-governmental organizations, not-for-profit organizations, non-commercial and corporate partners. The choice of topics, participants, content and agenda of the Working Groups, as well as the writing, editing, submission and reviewing of the manuscript are under the sole responsibility of the ESCEO, without any influence from third parties. Publisher Copyright: © 2021, The Author(s).
Keywords: Fracture healing, Fracture liaison service, Fragility fracture, Rehabilitation, Vitamin D

Identifiers

Local EPrints ID: 449628
URI: http://eprints.soton.ac.uk/id/eprint/449628
ISSN: 0937-941X
PURE UUID: a4c13698-0930-44f1-8755-5db7cc55f03e
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 09 Jun 2021 16:31
Last modified: 18 Mar 2024 05:04

Export record

Altmetrics

Contributors

Author: Thierry Chevalley
Author: Maria Luisa Brandi
Author: Etienne Cavalier
Author: Nicholas Harvey ORCID iD
Author: Giovanni Iolascon
Author: Cyrus Cooper ORCID iD
Author: Didier Hannouche
Author: Jean-Francois Kaux
Author: Andreas Kurth
Author: Stefania Maggi
Author: Gerrit Maier
Author: Kyriakos Papavasiliou
Author: Nasser M. Al-Daghri
Author: Manuel Sosa-Henríquez
Author: Norbert Suhm
Author: Umberto Tarantino
Author: Jean-Yves Reginster
Author: Rene Rizzoli

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×