The Relationship Between Serum 25[OH]D Concentration and Orthopaedic Infection: A Case-Control Study

Area of Science:

• Orthopaedic Surgery
• Immunology
• Endocrinology

Background:

• Vitamin D deficiency (low 25[OH]D) is prevalent, affecting up to 50% of UK adults.
• The role of vitamin D in immune response is known, but its specific impact on orthopaedic infections requires further investigation.

Purpose of the Study:

• To assess the relationship between serum 25[OH]D concentration and the occurrence of orthopaedic infection.
• To determine if vitamin D levels correlate with the incidence of bone and joint infections.

Main Methods:

• A cohort of 205 patients with orthopaedic infections was studied at a tertiary referral centre.
• Patients were grouped by infection status and matched for age and gender.
• Statistical analysis was employed to identify relationships between serum 25[OH]D levels and infection.

Main Results:

• 114 patients had an orthopaedic infection; no significant age or gender differences were found between groups.
• Mean serum 25[OH]D was significantly lower in infected patients (39 nmol/L) compared to non-infected patients (59 nmol/L).
• Low serum 25[OH]D concentration correlated with increased orthopaedic infection rates (OR 5.94, p<0.01).

Conclusions:

• An association exists between low serum 25[OH]D levels and a higher incidence of orthopaedic infection.
• Vitamin D insufficiency was common in orthopaedic inpatients, with higher vitamin D levels correlating with lower infection rates.
• Prophylactic vitamin D supplementation may enhance patient outcomes, supporting the need for clinical trials.