Nearly half of persons undergoing orthopedic surgery go into the operating room with deficient vitamin D levels — a condition that should be corrected ahead of time to improve outcomes.

Internal-medicine specialists cleared 723 patients for elective orthopedic surgery to repair such conditions as distal radial or ulnar fracture of the hand, vertebral compression fracture, and knee or hip replacement. However, a retrospective chart review revealed that although 57% of the patients had normal vitamin D levels (≥32 ng/mL), 28% had insufficient levels (<32 ng/mL) and the remaining 15% were vitamin D-deficient (<20 ng/mL).

“Nearly half of the patients who were considered ‘healthy’ enough for surgery had significantly low levels of vitamin D, placing them at risk for poor bone healing, osteomalacia, or even secondary hyperparathyroidism in the most severe cases,” observed the authors in a statement describing the findings.

The statement also noted that putting people on 2,000 to 4,000 IU of vitamin D (depending on their deficient value) could usually correct levels in four to six weeks. Very aggressive treatment right before surgery also can bring deficient vitamin D levels into the normal range.