Related Experiment Video
Updated: Sep 10, 2025

Isolation of Mesenchymal Stem Cells from Human Alveolar Periosteum and Effects of Vitamin D on Osteogenic Activity of Periosteum-derived Cells
Published on: May 4, 2018
Vitamin D deficiency and periprosthetic fractures
Emily M Pilc1, Amy Y Zhao2, Sanjay Kubsad3
1Eastern Virginia Medical School at Old Dominion University, 825 Fairfax Ave, Norfolk, VA, 23507, USA.
Background:
Post-operative periprosthetic fractures (PPF) are a serious complication following total hip (THA) and knee (TKA) arthroplasty. As vitamin D is involved in the pathogenesis of osteoporosis, a risk factor for PPF, it has been assumed that the incidence of vitamin D deficiency is high among patients who experience PPF. The purpose of this study was to evaluate the cumulative incidence and risk of PPF within 10 years after THA or TKA in patients with vitamin D deficiency.
Methods:
The Research Network of TriNetX was used to perform the retrospective cohort analysis. Current Procedural Terminology, International Classification of Diseases, and RxNorm codes were used to identify patients who underwent primary THA or TKA between January 2010 and April 2021, had previous testing for serum or plasma calcidiol levels, and had at least 2 years of follow up data. Propensity score matching between patients with and without vitamin D deficiency at a 1:1 ratio was conducted.
Results:
A total of 15,226 patients were included. Compared to the control cohort, the vitamin D deficient cohort had a lower cumulative incidence of PPF after THA (0.60 % vs 1.68 %) and TKA (0.26 vs 0.47 %). Risk of PPF was not associated with vitamin D deficiency after THA (HR:0.69; 95 % CI:0.25-1.91; p = 0.38) or TKA (HR:0.80; 95 % CI:0.39-2.76; p = 0.22).
Conclusion:
Incidence or risk of revision due to PPF were not associated with vitamin D deficiency.
Related Concept Videos
Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Role of Skin in Vitamin D Synthesis
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin...
Skeleton and Calcium Homeostasis
Essential Minerals for Bone Health
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
Connective Tissue Cell Types
Fat cells (adipocytes), smooth muscle cells (myoblasts), and bone cells (osteoblasts) are some connective tissue cell types. Some immune system cells...

