advertising
-
1.
Norman AW: From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr 88 : 491S, 2008.
-
2.
Curtis L: Nutritional research may be useful in treating tendon injuries. Nutrition 32 : 617, 2016.
-
3.
Holick MF: “Vitamin D,” in Modern Nutrition in Health and Disease, edited by Shils, ME , Shike, M , Ross, AC et al., p 376, Lippincott Williams & Wilkins, Philadelphia, 2006.
-
4.
Pojednic RM & Ceglia L: The emerging biomolecular role of vitamin D in skeletal muscle. Exerc Sport Sci Rev 42 : 76, 2014.
-
5.
Hayes CE , Nashold FE & Spach KM et al.: The immunological functions of the vitamin D endocrine system. Cell Mol Biol (Noisy-le-grand) 49 : 277, 2003.
-
6.
Soderstrom LH , Johnson SP & Diaz VA et al.: Association between vitamin D and diabetic neuropathy in a nationally representative sample: results from 2001-2004 NHANES. Diabet Med 29 : 50, 2012.
-
7.
Tiwari S , Pratyush DD & Gupta SK et al.: Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection. Br J Nutr 112 : 1938, 2014.
-
8.
Bischoff-Ferrari HA , Dietrich T & Orav EJ et al.: Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr 80 : 752, 2004.
-
9.
Brumbaugh PF & Speer DP Pitt MJ: 1 alpha, 25-Dihydroxyvitamin D3 a metabolite of vitamin D that promotes bone repair. Am J Pathol 106 : 171, 1982.
-
10.
Skaria J , Katiyar BC & Srivastava TP et al.: Myopathy and neuropathy associated with osteomalacia. Acta Neurol Scand 51 : 37, 1975.
-
11.
Ceglia L: Vitamin D and skeletal muscle tissue and function. Mol Aspects Med 29 : 407, 2008.
-
12.
Pearce SH & Cheetham TD: Diagnosis and management of vitamin D deficiency. BMJ 340 : b5664, 2010.
-
13.
Holick MF: Vitamin D deficiency. N Engl J Med 357 : 266, 2007.
-
14.
Munns CF , Shaw N & Kiely M et al.: Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab 101 : 394, 2016.
-
15.
Ross AC , Taylor CL & Yaktine AL et al.: “Dietary Reference Intakes for Calcium and Vitamin D,” in The National Academies Collection: Reports Funded by National Institutes of Health , National Academies Press, Washington, DC, 2011.
-
16.
Vitamin D: supplement use in specific population groups. National Institute for Health and Care Excellence Web site. Available at: https://www.nice.org.uk/guidance/ph56. Updated August 30, 2017. Accessed January 2, 2018.
-
17.
Ziambaras K & Dagogo-Jack S: Reversible muscle weakness in patients with vitamin D deficiency. West J Med 167 : 435, 1997.
-
18.
Sprague S , Petrisor B & Scott T et al.: What is the role of vitamin D supplementation in acute fracture patients? a systematic review and meta-analysis of the prevalence of hypovitaminosis D and supplementation efficacy. J Orthop Trauma 30 : 53, 2016.
-
19.
McBeth J , Pye SR & O'Neill TW et al.: Musculoskeletal pain is associated with very low levels of vitamin D in men: results from the European Male Ageing Study. Ann Rheum Dis 69 : 1448, 2010.
-
20.
Haining SA , Atkins RM & Guilland-Cumming DF et al.: Vitamin D metabolites in patients with established non-union of fracture. Bone Miner 1 : 205, 1986.
-
21.
Boszczyk AM , Zakrzewski P & Pomianowski S: Vitamin D concentration in patients with normal and impaired bone union. Pol Orthop Traumatol 78 : 1, 2013.
-
22.
Bischoff-Ferrari HA , Willett WC & Orav EJ et al.: A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367 : 40, 2012.
-
23.
Danczak A: Aches and pains in primary care. Br J Gen Pract 60 : 374, 2010.
-
24.
Patton CM , Powell AP & Patel AA: Vitamin D in orthopaedics. J Am Acad Orthop Surg 20 : 123, 2012.
-
25.
Levis S , Gomez A & Jimenez C et al.: Vitamin D deficiency and seasonal variation in an adult South Florida population. J Clin Endocrinol Metab 90 : 1557, 2005.
-
26.
Scientific Advisory Committee on Nutrition: SACN vitamin D and health report. Available at: https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report Published July 21, 2016. Accessed May 2, 2018.
-
27.
Holick MF: Vitamin D: evolutionary, physiological and health perspectives. Curr Drug Targets 12 : 4, 2011.
-
28.
Adams JS & Hewison M: Update in vitamin D. J Clin Endocrinol Metab 95 : 471, 2010.
-
29.
Goula T , Kouskoukis A & Drosos G et al.: Vitamin D status in patients with knee or hip osteoarthritis in a Mediterranean country. J Orthop Traumatol 16 : 35, 2015.
-
30.
Bogunovic L , Kim AD & Beamer BS et al.: Hypovitaminosis D in patients scheduled to undergo orthopaedic surgery: a single-center analysis. J Bone Joint Surg Am 92 : 2300, 2010.
-
31.
Michelson JD & Charlson MD: Vitamin D status in an elective orthopedic surgical population. Foot Ankle Int 37 : 186, 2016.
-
32.
Aujla RS , Allen PE & Ribbans WJ: Vitamin D levels in 577 consecutive elective foot & ankle surgery patients. Foot Ankle Surg 25 : 310, 2019.
-
33.
White JH: Vitamin D signaling, infectious diseases, and regulation of innate immunity. Infect Immun 76 : 3837, 2008.
-
34.
Afarideh M , Ghanbari P & Noshad S et al.: Raised serum 25-hydroxyvitamin D levels in patients with active diabetic foot ulcers. Br J Nutr 115 : 1938, 2016.
-
35.
Martineau AR , Jolliffe DA & Hooper RL et al.: Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 356 : i6583, 2017.
-
36.
Abrams GD , Feldman D & Safran MR: Effects of vitamin D on skeletal muscle and athletic performance. J Am Acad Orthop Surg 26 : 278, 2018.
-
37.
Bischoff-Ferrari HA , Willett WC & Wong JB et al.: Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293 : 2257, 2005.
-
38.
Bischoff-Ferrari HA , Dawson-Hughes B & Willett WC et al.: Effect of vitamin D on falls: a meta-analysis. JAMA 291 : 1999, 2004.
-
39.
Mahmoodzadeh H , Nasimfar A & Sadeghi E et al.: Study of vitamin D Level in children with non-specific musculoskeletal pain. Int J Pediatr 5 : 4533, 2017.
-
40.
Metzger MF , Kanim LE & Zhao L et al.: The relationship between serum vitamin D levels and spinal fusion success: a quantitative analysis. Spine (Phila Pa 1976) 40 : E458, 2015.
-
41.
Doetsch AM , Faber J & Lynnerup N et al.: The effect of calcium and vitamin D3 supplementation on the healing of the proximal humerus fracture: a randomized placebo-controlled study. Calcif Tissue Int 75 : 183, 2004.
-
42.
Ravindra VM , Godzik J & Dailey AT et al.: Vitamin D levels and 1-year fusion outcomes in elective spine surgery: a prospective observational study. Spine (Phila Pa 1976) 40 : 1536, 2015.
-
43.
Brinker MR , O'Connor DP & Monla YT et al.: Metabolic and endocrine abnormalities in patients with nonunions. J Orthop Trauma 21 : 557, 2007.
-
44.
Sonneville KR , Gordon CM & Kocher MS et al.: Vitamin D, calcium, and dairy intakes and stress fractures among female adolescents. Arch Pediatr Adolesc Med 166 : 595, 2012.
-
45.
Avenell A , Mak JC & O'Connell D: Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev 4 : CD000227, 2014.
-
46.
Lappe J , Cullen D & Haynatzki G et al.: Calcium and vitamin D supplementation decreases incidence of stress fractures in female Navy recruits. J Bone Miner Res 23 : 741, 2008.
-
47.
Dao D , Sodhi S & Tabasinejad R et al.: Serum 25-hydroxyvitamin D levels and stress fractures in military personnel: a systematic review and meta-analysis. Am J Sports Med 43 : 2064, 2015.
-
48.
Iglar PJ & Hogan KJ: Vitamin D status and surgical outcomes: a systematic review. Patient Saf Surg 9 : 14, 2015.
-
49.
Chiu KC , Chu A & Go VL et al.: Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 79 : 820, 2004.
-
50.
Yoho RM , Frerichs J & Dodson NB et al.: A comparison of vitamin D levels in nondiabetic and diabetic patient populations. JAPMA 99 : 35, 2009.
-
51.
Tiwari S , Pratyush DD & Gupta B et al.: Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Br J Nutr 109 : 99, 2013.
-
52.
Zubair M , Malik A & Meerza D et al.: 25-Hydroxyvitamin D [25(OH)D] levels and diabetic foot ulcer: is there any relationship? Diabetes Metab Syndr 7 : 148, 2013.
-
53.
Smith JT , Halim K & Palms DA et al.: Prevalence of vitamin D deficiency in patients with foot and ankle injuries. Foot Ankle Int 35 : 8, 2014.
-
54.
Williams BR , Thomas AJ & Collier RC et al.: Vitamin D levels do not predict risk of metatarsal fractures. Foot Ankle Spec 11 : 37, 2018.
-
55.
Clutton J & Perera A: Vitamin D insufficiency and deficiency in patients with fractures of the fifth metatarsal. Foot (Edinb) 27 : 50, 2016.
-
56.
Shimasaki Y , Nagao M & Miyamori T et al.: Evaluating the risk of a fifth metatarsal stress fracture by measuring the serum 25-hydroxyvitamin D levels. Foot Ankle Int 37 : 307, 2016.
-
57.
Hechtman KS , Quintero LC & San Giovanni TP et al.: Vitamin D deficiency in an athlete sustaining refracture after intramedullary screw fixation of a Jones fracture: coincidence or contributing factor? Curr Orthop Pract 24 : 98, 2013.
-
58.
Bernhard A & Matuk J: Vitamin D in foot and ankle fracture healing: a literature review and research design. Foot Ankle Spec 8 : 397, 2015.
-
59.
Telleria JJM , Ready LV & Bluman EM et al.: Prevalence of vitamin D deficiency in patients with talar osteochondral lesions. Foot Ankle Int 39 : 471, 2018.
-
60.
Bird ML , Hill KD & Robertson IK et al.: Serum [25(OH)D] status, ankle strength and activity show seasonal variation in older adults: relevance for winter falls in higher latitudes. Age Ageing 42 : 181, 2013.
-
61.
Almurdhi MM , Reeves ND & Bowling FL et al.: Reduced lower-limb muscle strength and volume in patients with type 2 diabetes in relation to neuropathy, intramuscular fat, and vitamin D levels. Diabetes Care 39 : 441, 2016.
-
62.
Gao MF , Yang HL & Shi WD: Simultaneous bilateral quadriceps tendon rupture in a patient with hyperparathyroidism undergoing long-term haemodialysis: a case report and literature review. J Int Med Res 41 : 1378, 2013.
-
63.
Uzer G , Elmadag M & Yildiz F et al.: Simultaneous spontaneous bilateral quadriceps tendon rupture related with hyperparathyroidism secondary to vitamin D deficiency: a case report. Bezmialem Sci 1 : 33, 2013.
-
64.
Abogamal A , Mahmoud E & Abdelaziz A et al.: Prevalence of lower limb traction apophysitis among children with low vitamin D and secondary hyperparathyroidism: ultra sonographic study. J Med Sci Clin Res 5 : 17222, 2017.
-
65.
Kimyon G , Tekir D & Kısacık B et al.: The frequency of subclinical Achilles enthesopathy in inflammatory bowel disease and its relation with vitamin D. Ann Rheum Dis 74 : 1154, 2015.
-
66.
Moore KR , Howell MA & Saltrick KR et al.: Risk factors associated with nonunion after elective foot and ankle reconstruction: a case-control study. J Foot Ankle Surg 56 : 457, 2017.
-
67.
Warner SJ , Garner MR & Nguyen JT et al.: Perioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation. Arch Orthop Trauma Surg 136 : 339, 2016.
-
68.
Tsugawa N , Uenishi K & Ishida H et al.: Association between vitamin D status and serum parathyroid hormone concentration and calcaneal stiffness in Japanese adolescents: sex differences in susceptibility to vitamin D deficiency. J Bone Miner Metab 34 : 464, 2016.
-
69.
Grahn Kronhed AC , Knutsson I & Lofman O et al.: Is calcaneal stiffness more sensitive to physical activity than forearm bone mineral density? a population-based study of persons aged 20-79 years. Scand J Public Health 32 : 333, 2004.
-
70.
Horas K , Fraissler L & Maier G et al.: High prevalence of vitamin D deficiency in patients with bone marrow edema syndrome of the foot and ankle. Foot Ankle Int 38 : 760, 2017.
-
71.
Sprinchorn AE , O'Sullivan R & Beischer AD: Transient bone marrow edema of the foot and ankle and its association with reduced systemic bone mineral density. Foot Ankle Int 32 : S508, 2011.
-
72.
Vitamin D: Fact sheet for health professionals. National Institutes of Health: Office of Dietary Supplements Web site. Available at: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed May 13, 2018.
-
73.
Vitamins, supplements and nutrition in pregnancy. NHS Choices Web site. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/. Accessed April 10, 2018.
-
74.
Sanders KM , Stuart AL & Williamson EJ et al.: Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303 : 1815, 2010.
-
75.
Vieth R: Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 69 : 842, 1999.
-
76.
Compston J , Cooper A & Cooper C et al.: UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12 : 43, 2017.
-
77.
Sunyecz JA: The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag 4 : 827, 2008.
-
78.
Webb AR , Kline L & Holick MF: Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67 : 373, 1988.
-
79.
McCabe MP , Smyth MP & Richardson DR: Current concept review: vitamin D and stress fractures. Foot Ankle Int 33 : 526, 2012.
-
80.
Costing statement: vitamin D: increasing supplement use among at-risk groups. National Institute for Health and Care Excellence Web site. Available at: https://www.nice.org.uk/guidance/ph56/resources/costing-statement-69288013. Published November 2014. Accessed May 13, 2018.
-
81.
Most people don't need vitamin D testing. BlueCross BlueShield Web site. Available at: https://www.bcbs.com/news/press-releases/most-people-dont-need-vitamin-d-testing. Accessed May 13, 2018.
-
82.
Meyr AJ , Mirmiran R & Naldo J et al.: American College of Foot and Ankle Surgeons((R)) Clinical Consensus Statement: perioperative management. J Foot Ankle Surg 56 : 336, 2017.
-
83.
Malhotra K , Wright S & Luckshmana J et al.: Consensus of the 7th round table: aspects of foot and ankle surgery. Ortho Solutions Web site. Available at: http://orthosol.com/wp-content/uploads/2018/02/7th-Consensus-of-Round-Table-2017-CARDIFF.pdf. Accessed February 15, 2018.
Vitamin D in the Foot and Ankle: A Review of the Literature
Search for other papers by Karan Malhotra in
Current site
Google Scholar
PubMed
Search for other papers by Paul J. Baggott in
Current site
Google Scholar
PubMed
Search for other papers by Julian Livingstone in
Current site
Google Scholar
PubMed
Background
Vitamin D is an essential vitamin that targets several tissues and organs and plays an important role in calcium homeostasis. Vitamin D deficiency is common, particularly at higher latitudes, where there is reduced exposure to ultraviolet B radiation. We reviewed the role of vitamin D and its deficiency in foot and ankle pathology.
Methods
The effects of vitamin D deficiency have been extensively studied, but only a small portion of the literature has focused on the foot and ankle. Most evidence regarding the foot and ankle consists of retrospective studies, which cannot determine whether vitamin D deficiency is, in fact, the cause of the pathologies being investigated.
Results
The available evidence suggests that insufficient vitamin D levels may result in an increased incidence of foot and ankle fractures. The effects of vitamin D deficiency on fracture healing, bone marrow edema syndrome, osteochondral lesions of the talus, strength around the foot and ankle, tendon disorders, elective foot and ankle surgery, and other foot and ankle conditions are less clear.
Conclusions
Based on the available evidence, we cannot recommend routine testing or supplementation of vitamin D in patients with foot and ankle pathology. However, supplementation is cheap, safe, and may be of benefit in patients at high risk for deficiency. When vitamin D is supplemented, the evidence suggests that calcium should be co-supplemented. Further high-quality research is needed into the effect of vitamin D in the foot and ankle. Cost-benefit analyses of routine testing and supplementation of vitamin D for foot and ankle pathology are also required.
Foot and Ankle Unit, Barnet and Chase Farm Hospitals, Royal Free London NHS Foundation Trust, Barnet, United Kingdom. Dr. Malhotra is now with Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
advertising
