Association of Preoperative Vitamin D Deficiency With Retear Rate and Early Pain After Arthroscopic Rotator Cuff Repair: A Retrospective Cohort Study

• Published in: Orthopaedic journal of sports medicine Vol. 10; no. 10; p. 23259671221130315
• Main Authors: Chen, Jun, Lou, Juexiang, Wang, Weikai, Xu, Guohong
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-10-2022; Sage Publications Ltd
• Subjects: Cohort analysis; Orthopedics; Pain; Rotator cuff; Sports medicine; Vitamin D; Vitamin deficiency; arthroscopy; shoulder; rotator cuff; vitamin D; outcome
• ISSN: 2325-9671; 2325-9671
• DOI: 10.1177/23259671221130315

Background:
Although the function of vitamin D in bone metabolism has been well studied, the question remains whether vitamin D deficiency impairs tendon healing after rotator cuff repair.
Purpose:
To investigate the correlation between preoperative vitamin D deficiency and the retear rate and pain after arthroscopic rotator cuff repair.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients with full-thickness rotator cuff tears who underwent arthroscopic rotator cuff repair between January 2018 and August 2019 were enrolled. Included patients were divided into a control group (vitamin D level ≥20 μg/L) and a deficiency group (vitamin D level <20 μg/L). We investigated the association between preoperative vitamin D level and patient characteristics, MRI findings, pain and function scores (visual analog scale [VAS] for pain; Constant-Murley; University of California, Los Angeles; and American Shoulder and Elbow Surgeons scores), and healing status using the Pearson or Spearman correlation coefficient. The clinical characteristics were compared between the groups using the chi-square test or Fisher exact test.
Results:
Included were 89 patients (control group, 44 patients; deficiency group, 45 patients). The mean vitamin D levels were 25.07 ± 5.38 and 14.61 ± 3.43 μg/L in the control and deficiency groups, respectively (P < .001); otherwise, there were no significant differences between the groups in the variables under study. Vitamin D levels were not related to age, symptom duration, tear size, extent of retraction, VAS pain score preoperatively and at 6 and 24 months postoperatively, or any function scores. Supraspinatus fatty infiltration and VAS scores at 1 and 3 months postoperatively were significantly associated with vitamin D level (r = –0.360, –0.362, and –0.316, respectively; P < .05 for all). VAS scores were significantly lower in the control group than in the deficiency group at postoperative 1 month (1.09 ± 0.56 vs 1.47 ± 0.66, respectively) and 3 months (1.14 ± 0.77 vs 1.44 ± 0.66) (P < .05 for both). The retear rate was significantly lower in the control group than in the deficiency group (9.09% vs 26.67%, respectively; P < .05).
Conclusion:
Our study revealed that preoperative vitamin D deficiency was associated with a higher retear rate and early pain (1 and 3 months) after arthroscopic rotator cuff repair.