Pre-Operative Vitamin D Optimization and Osseointegration in Cementless THR

Author(s): Anil Kumar Sahu, Alok Prusty, Gopabandhu Patra

Background: Vitamin D is crucial in musculoskeletal health, bone metabolism, and implant integration. Deficiency is common among patients undergoing total hip arthroplasty and may affect functional outcomes and osseointegration. Optimizing preoperative vitamin D could improve recovery and implant success in cementless THR.

Methods: A retrospective multicenter cohort study was carried out across SCB Medical college and IMS & SUM hospital in Odisha, India, from January 2024 to August 2025, including 258 patients undergoing cementless THR. Preoperative vitamin D levels were measured, and supplementation was provided for deficient or insufficient patients. Functional outcomes, radiographic osseointegration, and post-operative complications were assessed at 6 weeks and 3 months.

Results: Vitamin D deficiency was observed in 38% of patients, with only 27.1% being sufficient. Patients with sufficient vitamin D had higher baseline functional scores and better osseointegration (94.3%) compared to deficient patients (81.6%). Deficient patients also showed a higher trend of post-operative complications such as delayed healing and implant loosening.

Conclusion: Preoperative vitamin D deficiency is more common in patients undergoing cementless THR and is associated with lower baseline function, suboptimal osseointegration, and increased complication risk.