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Significant Association between a Diagnosis of Hypovitaminosis D and Rotator Cuff Tear, Independent of Age and Sex: A Retrospective Database Study.

PURPOSE: As high rates of vitamin D deficiency have been demonstrated in orthopaedic patient cohorts, this study aims to characterize the association between a diagnosis of hypovitaminosis D and primary rotator cuff tear (RCT), primary rotator cuff repair (RCR), and postoperative complications in different sex and age cohorts.

METHODS: In this retrospective cohort study using PearlDiver, a nationwide administrative claims database, records for all patients aged 30 to 89 who received a diagnosis of hypovitaminosis D between January 1st, 2011 to October 31st, 2018 were queried. Rates of primary RCT, primary RCR, and postoperative complications including subsequent surgery were calculated within sex- and age-specific cohorts and compared to matched control cohorts using multivariable logistic regression.

RESULTS: Among the 336,320 patients included in the hypovitaminosis D cohort, these patients were significantly more likely to experience a RCT (OR = 2.70, 95% CI, 2.55 - 2.85) as well as a full-thickness RCT (OR 2.36, 95% CI, 2.17 - 2.56) specifically within 2 years of their diagnosis. Females with hypovitaminosis D were more likely to undergo surgery to address their full-thickness tears (OR = 1.37, 95% CI, 1.09 - 1.74). There was no difference in the rates of revision RCR or irrigation and debridement. However, female with hypovitaminosis D were significantly more likely to undergo manipulation under anesthesia (OR = 1.16, 95% CI, 1.03 - 1.31).

CONCLUSIONS: Patients diagnosed with hypovitaminosis D were significantly more likely to suffer a primary RCT and to undergo manipulation under anesthesia within a year of their rotator cuff repair. While many risk factors for RCT are unmodifiable, vitamin D deficiency is a readily modifiable risk factor with several treatment regimens demonstrating positive effects on musculoskeletal health.

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