Vitamin D and Functional Outcomes After Total Hip Arthroplasty (THA)

NCT ID: NCT01397383

Last Updated: 2017-03-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

219 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-03-31

Study Completion Date

2014-02-03

Brief Summary

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The investigators would like to evaluate the effect of serum 25-hydroxy vitamin D level on post-operative short-term functional outcomes after total hip arthroplasty (THA).

Hypothesis: Patients with low serum vitamin D level will have less within-patient improvement in pre- to 6 week, 1 year, 2 year and 5 year post THA WOMAC scores, SF-36 scores, and performance-based tests(get up and go test and 2 minute walking test) compared to patients who do not have a low vitamin D levels.

Also, Patients with low serum vitamin D level will have a higher rate of postoperative thigh pain or periprosthetic fracture.

Detailed Description

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Vitamin D is an important nutrient to maintain both skeletal and non-skeletal function. In this study, we have 4 specific aims:

The primary aim of this prospective observational study is to compare the pre- to 6 week, 1 year, 2 year and 5 year post-THA within-patient change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between patients who have a low preoperative serum vitamin D level and patients who do not have a low serum vitamin D level. Low serum vitamin D will be defined as serum 25-hydroxy vitamin D level less than 32 ng/ml.

The secondary aim is to compare the pre- to 6 week, 1 year, 2 year and 5 year post-THA within-patient change in performance-based tests (get up and go test, 2 minute walking test) between patients who have a low preoperative serum vitamin D level and patients who do not have a low serum vitamin D level.

The third aim is to compare the pre- to 6 week, 1 year, 2 year and 5 year post-THA within-patient change in Short-form 36 health survey (SF-36) scores between patients who have a low preoperative serum vitamin D level and patients who do not have a low serum vitamin D level.

The fourth aim is to compare the rate of postoperative fracture or thigh pain between patients who have a low preoperative serum vitamin D level and patients who do not have a low serum vitamin D level.

Postoperative thigh pain is defined as pain at the anterolateral aspect of mid thigh which corresponds to the level of the prosthetic stem tip. Thigh pain is characterized by pain in the start-up phase, diminishes during movement and is absent at rest.

Conditions

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Vitamin D Deficiency

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Vitamin D deficiency

Patients with low serum vitamin D (25-hydroxy vitamin D \< 32 ng/ml)

No interventions assigned to this group

Control group

Patients with normal serum vitamin D level (serum 25-hydroxy vitamin D \> 32 ng/ml)

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patients between the ages of 40 and 100 years old, and are scheduled for primary total hip arthroplasty with two surgeons (Drs. Sculco and Cornell) at Hospital for Special Surgery.
* Patients who have a serum 25-OH vitamin D drawn as part of their preoperative work-up.

Exclusion Criteria

* Bilateral one-stage total hip replacements
* Patients who required a complex surgical procedure including extensive bone grafting, osteotomy, extensive soft tissue release, or a need of adjunctive internal fixation with cables, wires or plate
* Those with serious medical co-morbidities that need adjusted rehabilitation protocol due to their medical problems
* Those who require immediate postoperative revision due to dislocation, infection or component malalignment
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Hospital for Special Surgery, New York

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joseph M Lane, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital for Special Surgery, New York

Aasis Unnanuntana, MD

Role: STUDY_DIRECTOR

Hospital for speicial surgery

Locations

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Hospital for Special Surgery

New York, New York, United States

Site Status

Countries

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United States

References

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Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81. doi: 10.1056/NEJMra070553. No abstract available.

Reference Type BACKGROUND
PMID: 17634462 (View on PubMed)

Janssen HC, Samson MM, Verhaar HJ. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr. 2002 Apr;75(4):611-5. doi: 10.1093/ajcn/75.4.611.

Reference Type BACKGROUND
PMID: 11916748 (View on PubMed)

Stein MS, Wark JD, Scherer SC, Walton SL, Chick P, Di Carlantonio M, Zajac JD, Flicker L. Falls relate to vitamin D and parathyroid hormone in an Australian nursing home and hostel. J Am Geriatr Soc. 1999 Oct;47(10):1195-201. doi: 10.1111/j.1532-5415.1999.tb05199.x.

Reference Type BACKGROUND
PMID: 10522952 (View on PubMed)

Birge SJ. Can falls and hip fracture be prevented in frail older adults? J Am Geriatr Soc. 1999 Oct;47(10):1265-6. doi: 10.1111/j.1532-5415.1999.tb05212.x. No abstract available.

Reference Type BACKGROUND
PMID: 10522964 (View on PubMed)

Bischoff HA, Stahelin HB, Urscheler N, Ehrsam R, Vonthein R, Perrig-Chiello P, Tyndall A, Theiler R. Muscle strength in the elderly: its relation to vitamin D metabolites. Arch Phys Med Rehabil. 1999 Jan;80(1):54-8. doi: 10.1016/s0003-9993(99)90307-6.

Reference Type BACKGROUND
PMID: 9915372 (View on PubMed)

Mowe M, Haug E, Bohmer T. Low serum calcidiol concentration in older adults with reduced muscular function. J Am Geriatr Soc. 1999 Feb;47(2):220-6. doi: 10.1111/j.1532-5415.1999.tb04581.x.

Reference Type BACKGROUND
PMID: 9988294 (View on PubMed)

Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B. Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med. 2004 May 1;116(9):634-9. doi: 10.1016/j.amjmed.2003.12.029. No abstract available.

Reference Type BACKGROUND
PMID: 15093761 (View on PubMed)

Gloth FM 3rd, Smith CE, Hollis BW, Tobin JD. Functional improvement with vitamin D replenishment in a cohort of frail, vitamin D-deficient older people. J Am Geriatr Soc. 1995 Nov;43(11):1269-71. doi: 10.1111/j.1532-5415.1995.tb07404.x.

Reference Type BACKGROUND
PMID: 7594162 (View on PubMed)

Verhaar HJ, Samson MM, Jansen PA, de Vreede PL, Manten JW, Duursma SA. Muscle strength, functional mobility and vitamin D in older women. Aging (Milano). 2000 Dec;12(6):455-60. doi: 10.1007/BF03339877.

Reference Type BACKGROUND
PMID: 11211956 (View on PubMed)

Other Identifiers

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10014

Identifier Type: -

Identifier Source: org_study_id

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