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Evaluating Vitamin D3 Supplement on Post-Op Outcomes

A Prospective, Tripled-Blinded, Randomized Controlled Trial Evaluating Vitamin D3 Supplementation on Post-Operative Functional and Clinical Outcomes Following Total Knee Arthroplasty

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04177758
Enrollment
137
Registered
2019-11-26
Start date
2020-02-01
Completion date
2022-03-01
Last updated
2023-04-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Knee Osteoarthritis

Brief summary

The aim of this study is to determine if vitamin D supplementation is associated with differences in short-term recovery in patients following total knee arthroplasty compared to patients who do not receive supplementation. If so, vitamin D supplementation has the potential to become widely incorporated into the routine care for patients undergoing knee replacements.

Detailed description

Patients will be enrolled from the clinics of Dr. Denis Nam and Dr. Craig Della Valle, two fellowship-trained orthopedic surgeons in the division of Adult Reconstruction at Midwest Orthopedics at Rush University Medical Center. Study staff will screen the clinic schedule of each surgeon and will discuss the purposes of the investigation at the time of their visit. If the patient is willing to participate in the investigation, verbal and written consent will be obtained by the study staff. At the time of consenting, patients will also be asked to perform a TUG test and will be asked to complete the questions that comprise the functional component of the KSS score. This study will be tripled-blinded, thus, the patients, clinicians, and research staff involved will be unaware of patient allocation during this study. Each patient will receive a study ID, and a computer randomization system will be used to allocate patients to receive either vitamin D3 or placebo based on their study ID. Only members of the Rush pharmacy staff will possess the list matching the study ID to the study group assignment, ensuring that the study remains triple-blinded and that study coordinators are unaware of a patient's assignment when he or she picks up the study medication from the pharmacy. Patients randomized to the experimental arm of the study will receive 50,000IU of vitamin D3 following surgery and asked to take the medication orally following surgery. Vitamin D3 was selected over vitamin D2 as the former is less expensive and is more effective at raising serum 25-OH vitamin D levels than the latter. The regimen of 50,000IU given once was selected as this regimen has been previously used without side effects in previous studies and has been shown to be as effective as other regimens that utilize more frequent dosing with smaller doses. Patients randomized to the control arm will receive placebo tablets and advised to consume their medication similar to the treatment arm. Both groups of patients will receive their medications from the pharmacy at Rush Medical Center, which will be responsible for providing patients with the appropriate regimen. All patients will receive the same postoperative multimodal analgesic regimen that is normally administered to patients undergoing THA and TKA at Rush University Medical Center. In accordance with current standard post-operative care, patients will be asked to follow-up with their surgeon in clinic at 3 weeks and 6 weeks following surgery. At these post-operative visits, patients will be asked to repeat the TUG test and the 17-questions of the functional component of the KSS score.

Interventions

DRUGVitamin D

Patients randomized to the experimental arm of the study will receive 50,000IU of vitamin D3 following surgery and asked to take the medication orally following surgery.

DRUGControl

Patients randomized to the control will receive a placebo

Sponsors

Rush University Medical Center
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

* Any patient undergoing primary total knee arthroplasty for osteoarthritis * Age ≥ 18 years old * Willingness to undergo randomization and return for all scheduled visits

Exclusion criteria

* Age \> 80 years old * American Society of Anesthesiologists (ASA) Score ≥ 4 * Other supplemental vitamin D or Calcium use including their analogs: ergocalciferol, calcitriol, dihydrotachysterol, and paricalcitol * Current cancer * Malabsorption syndromes * Inability to take medications orally * Renal impairment defined as a glomerular filtration rate (GFR) \< 30 mL/minute or creatinine \>1.3 mg/dL * History of hypercalcemia defined as albumin-corrected hypercalcemia \>12 mg/dL

Design outcomes

Primary

MeasureTime frameDescription
Knee Society Score (KSS), Functional Component (2012) at 3 Weeks Post OperativeAssessed at 3 weeks following surgeryThe functional component of the 2012 version of the knee society score at 3 weeks following surgery. Range 0-100. Assessed at 3 weeks following surgery, 3 weeks following surgery reported. For the 0-100 scale, Zero represents a worse outcome, deductions are taken away for using an assistive device and other physical exam factors. 100 would be the best score possible.
Knee Society Score (KSS) at 6 Weeks Following SurgeryAssessed at 6 weeks following surgery reportedThe functional component of the 2012 version of the knee society score at 6 weeks following surgery. Range 0-100. Assessed at 6 weeks following surgery, 6 weeks following surgery reported. For the 0-100 scale, Zero represents a worse outcome, deductions are taken away for using an assistive device and other physical exam factors. 100 would be the best score possible.

Secondary

MeasureTime frameDescription
Timed up and go Test at 3 Weeks Post SurgeryAssessed at 3 weeks following surgeryA timed up and go (TUG) test at 3 weeks following surgery. The TUG test consists of measuring the time it takes for an individual to rise from a seated position in a chair, walk to a mark 3 meters away, turn around, come back, and sit in the same chair from which they started. Patients will be asked to perform the test twice at each of the aforementioned encounters. The use of any assistive devices such as cane or a walker) will also be noted.
Timed up and go Test Difference From Baseline to 6 Weeks After Surgeryvalue at 6 weeks minus value at baselineA timed up and go (TUG) test difference from baseline and at 6 weeks following surgery. The TUG test consists of measuring the time it takes for an individual to rise from a seated position in a chair, walk to a mark 3 meters away, turn around, come back, and sit in the same chair from which they started. Patients will be asked to perform the test twice at each of the aforementioned encounters. The use of any assistive devices such as cane or a walker) will also be noted.
Number of Participants With Complications6 weeks following surgeryOccurrence of any of the Knee Society's Standardized List of Complications

Countries

United States

Participant flow

Recruitment details

Any patient undergoing primary total knee arthroplasty for osteoarthritis Age ≥ 18 years old Willingness to undergo randomization and return for all scheduled visits

Participants by arm

ArmCount
Control
Patients randomized to the control arm will receive placebo tablets and advised to consume their medication similar to the treatment arm. Control: Patients randomized to the control will receive a placebo
50
Treatment
Patients randomized to the experimental arm of the study will receive 50,000IU of vitamin D3 following surgery and asked to take the medication orally following surgery. Vitamin D: Patients randomized to the experimental arm of the study will receive 50,000IU of vitamin D3 following surgery and asked to take the medication orally following surgery.
57
Total107

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up1911

Baseline characteristics

CharacteristicTreatmentTotalControl
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
27 Participants53 Participants26 Participants
Age, Categorical
Between 18 and 65 years
30 Participants54 Participants24 Participants
Age, Continuous63.7 years
STANDARD_DEVIATION 9.5
64.1 years
STANDARD_DEVIATION 9
64.5 years
STANDARD_DEVIATION 8.5
Race and Ethnicity Not Collected0 Participants
Region of Enrollment
United States
57 Participants107 Participants50 Participants
Sex: Female, Male
Female
29 Participants56 Participants27 Participants
Sex: Female, Male
Male
28 Participants51 Participants23 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 500 / 57
other
Total, other adverse events
0 / 500 / 57
serious
Total, serious adverse events
0 / 500 / 57

Outcome results

Primary

Knee Society Score (KSS) at 6 Weeks Following Surgery

The functional component of the 2012 version of the knee society score at 6 weeks following surgery. Range 0-100. Assessed at 6 weeks following surgery, 6 weeks following surgery reported. For the 0-100 scale, Zero represents a worse outcome, deductions are taken away for using an assistive device and other physical exam factors. 100 would be the best score possible.

Time frame: Assessed at 6 weeks following surgery reported

ArmMeasureValue (MEAN)
ControlKnee Society Score (KSS) at 6 Weeks Following Surgery55.43 score on a scale
TreatmentKnee Society Score (KSS) at 6 Weeks Following Surgery60.38 score on a scale
Primary

Knee Society Score (KSS), Functional Component (2012) at 3 Weeks Post Operative

The functional component of the 2012 version of the knee society score at 3 weeks following surgery. Range 0-100. Assessed at 3 weeks following surgery, 3 weeks following surgery reported. For the 0-100 scale, Zero represents a worse outcome, deductions are taken away for using an assistive device and other physical exam factors. 100 would be the best score possible.

Time frame: Assessed at 3 weeks following surgery

ArmMeasureValue (MEAN)
ControlKnee Society Score (KSS), Functional Component (2012) at 3 Weeks Post Operative46.94 score on a scale
TreatmentKnee Society Score (KSS), Functional Component (2012) at 3 Weeks Post Operative50.89 score on a scale
Secondary

Number of Participants With Complications

Occurrence of any of the Knee Society's Standardized List of Complications

Time frame: 6 weeks following surgery

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
ControlNumber of Participants With Complications4 Participants
TreatmentNumber of Participants With Complications5 Participants
Secondary

Timed up and go Test at 3 Weeks Post Surgery

A timed up and go (TUG) test at 3 weeks following surgery. The TUG test consists of measuring the time it takes for an individual to rise from a seated position in a chair, walk to a mark 3 meters away, turn around, come back, and sit in the same chair from which they started. Patients will be asked to perform the test twice at each of the aforementioned encounters. The use of any assistive devices such as cane or a walker) will also be noted.

Time frame: Assessed at 3 weeks following surgery

ArmMeasureValue (MEAN)
ControlTimed up and go Test at 3 Weeks Post Surgery13.35 seconds
TreatmentTimed up and go Test at 3 Weeks Post Surgery13.46 seconds
Secondary

Timed up and go Test Difference From Baseline to 6 Weeks After Surgery

A timed up and go (TUG) test difference from baseline and at 6 weeks following surgery. The TUG test consists of measuring the time it takes for an individual to rise from a seated position in a chair, walk to a mark 3 meters away, turn around, come back, and sit in the same chair from which they started. Patients will be asked to perform the test twice at each of the aforementioned encounters. The use of any assistive devices such as cane or a walker) will also be noted.

Time frame: value at 6 weeks minus value at baseline

ArmMeasureValue (MEAN)
ControlTimed up and go Test Difference From Baseline to 6 Weeks After Surgery-0.9 seconds
TreatmentTimed up and go Test Difference From Baseline to 6 Weeks After Surgery-0.3 seconds

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026