RT Journal Article
SR Electronic
T1 Recovery after unilateral knee replacement due to severe osteoarthritis and progression in the contralateral knee: a randomised clinical trial comparing daily 2000 IU versus 800 IU vitamin D
JF RMD Open
JO RMD Open
FD EULAR
SP e000678
DO 10.1136/rmdopen-2018-000678
VO 4
IS 2
A1 Heike A Bischoff-Ferrari
A1 E John Orav
A1 Andreas Egli
A1 Bess Dawson-Hughes
A1 Karina Fischer
A1 Hannes B Staehelin
A1 Rene Rizzoli
A1 Juerg Hodler
A1 Arnold von Eckardstein
A1 Gregor Freystaetter
A1 Ursina Meyer
A1 Thomas Guggi
A1 Peter Burckhardt
A1 Simeon Schietzel
A1 Patricia Chocano-Bedoya
A1 Robert Theiler
A1 Walter C Willett
A1 David Felson
YR 2018
UL http://rmdopen.bmj.com/content/4/2/e000678.abstract
AB Objective To test whether daily high-dose vitamin D improves recovery after unilateral total knee replacement.Methods Data come from a 24-month randomised, double-blind clinical trial. Adults aged 60 and older undergoing unilateral joint replacement due to severe knee osteoarthritis were 6–8 weeks after surgery randomly assigned to receive daily high-dose (2000 IU) or standard-dose (800 IU) vitamin D3. The primary endpoints were symptoms (Western Ontario and McMaster Universities Arthritis Index pain and function scores) assessed at baseline, 6, 12, 18 and 24 months in both knees, and the rate of falls over 24 months. The secondary outcomes were sit-to-stand performance, gait speed, physical activity and radiographic progression in the contralateral knee.Results We recruited 273 participants, 137 were randomised to receive 2000 IU and 136 were randomised to receive 800 IU vitamin D per day. 2000 IU vitamin D increased 25-hydroxyvitamin D levels to 45.6 ng/mL and 800 IU vitamin D to 37.1 ng/mL at month 24 (p<0.0001). While symptoms improved significantly in the operated knee and remained stable in the contralateral knee over time, none of the primary or secondary endpoints differed by treatment group over time. The rate of falls over 24 months was 1.05 with 2000 IU and 1.07 with 800 IU (p=0.84). 30.5% of participants in the 2000 IU and 31.3% of participants in the 800 IU group had radiographic progression in the contralateral knee over 24 months (p=0.88).Conclusions Our findings suggest that a 24-month treatment with daily 2000 IU vitamin D did not show greater benefits or harm than a daily standard dose of 800 IU among older adults undergoing unilateral total knee replacement.