Background: Orthopaedic infection is a potentially serious complication of elective and emergency trauma and orthopaedic procedures, with a high associated burden of morbidity and cost. Optimisation of vitamin D levels has been postulated to be beneficial in prevention of orthopaedic infection. This study explores the role of vitamin D in orthopaedic infection through a systematic review of available evidence
Methods: A comprehensive search was conducted on databases including Medline and Embase, as well as grey literature such as Google Scholar and The World Health Organization Database. Pooled analysis with weighted means was undertaken.
Results: Pooled analysis of four studies including 651 patients found the mean 25[OH]D level to be 50.7 nmol/L with a mean incidence of infection of 70%. There was a paucity of literature exploring prophylactic 25[OH]D supplementation on reducing orthopaedic infection, however, there was evidence of association between low 25[OH]D levels and increased incidence of orthopaedic infection.
Conclusion: The results indicate a significant proportion of orthopaedic patients have low 25[OH]D levels, as well as an association between low 25[OH]D levels and orthopaedic infection, but more RCTs need to be conducted to establish the benefit of prophylactic supplementation and the optimum regimen by dose and time.