Juergen Bruns1, Mathias Werner2, Matthias Soyka3. 1. Department of Orthopaedic Surgery, Agaplesion Diakonieklinikum, Hohe Weide 17, 20259, Hamburg, Germany. Juergen.bruns@d-k-h.de. 2. Department of Pathology, HELIOS Klinikum Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. 3. "Activion"Medizinisches Versorgungszentrum, Alte Holstenstrasse 2, 21031, Hamburg, Germany.
Abstract
PURPOSE: The aetiology of osteochondritis dissecans is still unclear. The aim of this prospective pilot study was to analyse whether vitamin D insufficiency, or deficiency, might be a contributing etiological factor in the development of an OCD lesion. METHODS: The serum level of vitamin D3 in 23 consecutive patients (12 male and 11 female) suffering from a stage III, or stages III and IV, OCD lesion (mostly stage III) admitted for surgery was measured. RESULTS: The patients' mean age was 31.3 years and most of them already exhibited closed epiphyseal plates. In the majority of patients (18/23), a distinct vitamin D3 deficiency was found, two patients were vitamin D3-insufficient and, in three patients, the vitamin D3 level reached the lowest normal value. CONCLUSION: These first data show that a vitamin D3 deficiency rather than an insufficiency may be involved in the development of OCD lesions. Probably, with a vitamin D3 substitution, the development of an advanced OCD stage could be avoided. Further analyses, including morphological analyses regarding a possible osteomalacia, and examination of the PTH and other determinants of the bone metabolism, should be undertaken to either confirm or refute these data. LEVEL OF EVIDENCE: IV.
PURPOSE: The aetiology of osteochondritis dissecans is still unclear. The aim of this prospective pilot study was to analyse whether vitamin Dinsufficiency, or deficiency, might be a contributing etiological factor in the development of an OCD lesion. METHODS: The serum level of vitamin D3 in 23 consecutive patients (12 male and 11 female) suffering from a stage III, or stages III and IV, OCD lesion (mostly stage III) admitted for surgery was measured. RESULTS: The patients' mean age was 31.3 years and most of them already exhibited closed epiphyseal plates. In the majority of patients (18/23), a distinct vitamin D3deficiency was found, two patients were vitamin D3-insufficient and, in three patients, the vitamin D3 level reached the lowest normal value. CONCLUSION: These first data show that a vitamin D3deficiency rather than an insufficiency may be involved in the development of OCD lesions. Probably, with a vitamin D3 substitution, the development of an advanced OCD stage could be avoided. Further analyses, including morphological analyses regarding a possible osteomalacia, and examination of the PTH and other determinants of the bone metabolism, should be undertaken to either confirm or refute these data. LEVEL OF EVIDENCE: IV.
Entities:
Keywords:
Aetiology; Deficiency; Insufficiency; Osteochondritis dissecans; Vitamin D
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