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The Association of Calcium and Vitamin D Use With Implant Survival of Total Knee Arthroplasty: A Nationwide Population-Based Cohort Study

 Youngho Kong  ;  Minkyung Han  ;  Minyoung Lee  ;  Eun Hwa Kim  ;  Inkyung Jung  ;  Kwan Kyu Park 
 JOURNAL OF ARTHROPLASTY, Vol.36(2) : 542-549.e.3, 2021-02 
Journal Title
Issue Date
calcium ; implant survival ; revision ; total knee arthroplasty ; vitamin D
Background: Calcium and vitamin D have been regarded as beneficial nutrients for bone metabolism that may affect survival of arthroplasties. However, the relationship between their use and revision rate of knee arthroplasty has not been evaluated. Thus, we investigated an association between calcium and vitamin D use and the revision rate after primary total knee arthroplasty. Methods: A nationwide population-based cohort study was conducted using the Korean National Health Insurance database. We included patients diagnosed with knee osteoarthritis and underwent primary total knee arthroplasty between 2009 and 2018. Risk for arthroplasty revision was estimated using a Cox proportional hazards model with time-dependent covariates. Log-rank test was used to assess survival of knee arthroplasty. Results: Out of 142,147 subjects, 28,403 were calcium and vitamin D users and 113,744 were never users. Calcium and vitamin D significantly reduced the revision risk with a 6-month drug use lag period (adjusted hazard ratio [aHR] 0.56, 95% confidence interval [CI] 0.45-0.70). Calcium and vitamin D combination use for more than 1 year was associated with reduced revision risks in both patients with periprosthetic joint infection (aHR 0.63, 95% CI 0.42-0.95) and patients without infection (aHR 0.70, 95% CI 0.54-0.91). Implant survival was significantly improved in calcium and vitamin D combination users for more than 1 year compared with never users (log-rank P < .001). Conclusion: Combination use of calcium and vitamin D with a dose of 800 IU or greater for more than 1 year was associated with the greatest reduction in the risks for revision surgery after total knee arthroplasty.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kong, Youngho(공영호) ORCID logo https://orcid.org/0000-0002-4931-3628
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Lee, Minyoung(이민영) ORCID logo https://orcid.org/0000-0002-9333-7512
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
Han, Minkyung(한민경) ORCID logo https://orcid.org/0000-0002-5011-5557
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