Current Evidence on and Clinical Implications of Vitamin D Levels in Pain and Functional Management of Knee Osteoarthritis: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Risk of Bias | |||||||||
---|---|---|---|---|---|---|---|---|---|
D1 | D2 | D3 | D4 | D5 | D6 | D7 | Overall | ||
Study | Heidari et al. [43] | ||||||||
Arden et al. [44] | |||||||||
Jin et al. [45] | |||||||||
Manoy et al. [46] | |||||||||
Wang et al. [47] | |||||||||
Zheng et al. [48] | |||||||||
Perry et al. [49] | |||||||||
Divjak et al. [50] | |||||||||
Saengsiwaritt et al. [51] | |||||||||
D1: Random sequence generation D2: Allocation concealment D3: Blinding of participants and personnel D4: Blinding of outcome assessment D5: Incomplete outcome data D6: Selective reporting D7: Other source of bias | Judgement: High Unclear Low |
PubMed | Scopus | Web of Science | Cochrane | Total | |
---|---|---|---|---|---|
Vitamin D AND knee osteoarthritis | 193 | 76 | 109 | 54 | 432 |
Vitamin D AND knee pain | 129 | 20 | 22 | 6 | 177 |
Cholecalciferol AND knee osteoarthritis | 25 | 0 | 0 | 0 | 25 |
Cholecalciferol AND knee pain | 20 | 0 | 0 | 0 | 20 |
25-(OH)D AND knee osteoarthritis | 37 | 0 | 3 | 0 | 40 |
25-(OH)D AND knee pain | 18 | 0 | 0 | 0 | 18 |
25-Hydroxyvitamin D AND knee osteoarthritis | 56 | 3 | 3 | 0 | 62 |
25-Hydroxyvitamin D AND knee pain | 31 | 3 | 4 | 0 | 38 |
TOTAL | 509 | 102 | 141 | 60 | 812 |
Authors | Study Design | No. of Patients | Gender | Age (Years) | Dosage | Type of Vitamin | Timing of Treatment | Treatment Duration |
---|---|---|---|---|---|---|---|---|
Heidari et al. [43] | Prospective double-blind, placebo-controlled, randomized trial | 67 | 86.5% female | 50 ± 6.6 | 50,000 IU | D3 cholecalciferol | Weekly | 2 moths |
Arden et al. [44] | Randomized double-blind, placebo-controlled trial | 474 | 61% female | 64.0 ± 8.0 | 800 IU | D3 cholecalciferol | Daily | 3 years |
Jin et al. [45] | Randomized double-blind, placebo-controlled trial | 413 | 50% female | 63.2 | 50,000 IU | D3 cholecalciferol | Monthly | 2 years |
Manoy et al. [46] | Controlled before–after study | 175 | 90% female | 64.58 ± 0.55 | 40,000 IU | D2 ergocalciferol | Weekly | 6 months |
Wang et al. [47] | Post hoc analysis of a randomized double-blind, placebo-controlled trial | 413 | 50% female | 63 ± 7 | 50,000 IU | D3 cholecalfiferol | Monthly | 2 years |
Zheng et al. [48] | Post hoc analysis of a randomized double-blind, placebo-controlled trial | 340 | 50% female | 63.2 | 50,000 IU | D3 cholecalciferol | Monthly | 2 years |
Perry et al. [49] | Randomized double-blind, placebo-controlled trial | 50 | 74% female | 63.3 | 800 IU | D3 cholecalciferol | Daily | 2 years |
Divjak et al. [50] | Open-label clinical trial | 80 | 58% female | 57.1 | 4000 IU | D3 cholecalciferol | Daily | 3 months |
Saengsiwaritt et al. [51] | Prospective single-site, single-arm, nonrandomized interventional trial | 175 | 90.3% female | 65 | 40,000 IU | D2 ergocalciferol | Weekly | 6 months |
Authors | Outcomes Measured | Results after Treatment |
---|---|---|
Heidari et al. (2014) [43] | - 25-Hydroxyvitamin D level - Knee pain: VAS, WOMAC pain scale - QMS: dynamometer | - 25-Hydroxyvitamin D level increased - WOMAC and VAS decreased - QMS increased |
Arden et al. (2016) [44] | - Knee pain: VAS, WOMAC - JSN (X-rays) - 25-Hydroxyvitamin D level | - WOMAC pain decreased in vitamin D group and increased in placebo group - WOMAC stiffness decreased in both groups and WOMAC function increased in both groups - No significant change in JSN - 25-Hydroxyvitamin D level increased in vitamin D group and decreased in placebo group |
Jin et al. (2016) [45] | - WOMAC pain score - Tibial cartilage volume (MRI) - Cartilage defects and BML (MRI) - 25-Hydroxyvitamin D level | - No significant differences in WOMAC pain score - No significant differences in change in tibial cartilage volume and BML - 25-Hydroxyvitamin D level increased more in the vitamin D group |
Manoy et al. (2017) [46] | - WOMAC and VAS - Quality of life (SF-12) - Physical activity (PAQ-EJ) - Muscle strength (dynamometer) - Physical performance (4 m gait speed test, TUGT, STS, 6MWT); - 25-Hydroxyvitamin D level | - No significant change in WOMAC; VAS decreased - SF-12 improved significantly - No significant change in PAQ-EJ score - No significant improvement in knee extension force - Gait speed, TUGT, STS, and 6MWT improved - 25-Hydroxyvitamin D level increased significantly |
Wang et al. (2017) [47] | - Volume of knee effusion synovitis (MRI) - 25-Hydroxyvitamin D level | - Clinical improvements in effusion synovitis volume - Serum 25-hydroxyvitamin D level increased in vitamin D group |
Zheng et al. (2017) [48] | - WOMAC score - Structural changes in knee (MRI) | - No differences in WOMAC pain and stiffness - Significant differences in WOMAC physical function - Less loss of total tibial cartilage volume in participants with consistently sufficient vitamin D compared with participants with consistently insufficient vitamin D [33] |
Perry et al. (2019) [49] | - STV and BML - 25-Hydroxyvitamin D level | - No significant changes in STV and subchondral BML - Serum vitamin D3 levels increased significantly in the vitamin D group and decreased significantly in placebo group |
Divjak et al. (2023) [50] | - WOMAC and VAS - Measurement of cytokine levels - 25-Hydroxyvitamin D level | - In the vitamin D supplementation group, the VAS and WOMAC pain score decreased; the WOMAC pain score increased in the no-supplementation group; the WOMAC stiffness score increased in the vitamin D group and decreased in the no-supplementation group; the WOMAC function score decreased in the vitamin D group and decreased in the no-supplementation group; VAS decreased in the vitamin D group and in the no-supplementation group - IL-1β, IL-23, and IL-33 increased; TNF-α, IL-13, and IL-17 decreased - 25-Hydroxivitamin D level increased in the vitamin D supplementation group |
Saengsiwaritt et al. (2023) [51] | - VAS and WOMAC - Muscle strength (dynamometer) - Physical performance - 25-Hydroxyvitamin D level | - VAS decreased significantly - Significant improvements in muscle strength (grip strength and knee extension force) - Physical performance increased (gait speed, TUGT, STS, and 6MWT) - 25-Hydroxyvitamin D level increased |
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Georgescu, B.; Cristea, A.E.; Oprea, D.; Lupu, A.A.; Stanciu, L.-E.; Borgazi, E.; Caraban, B.M.; Ciortea, V.M.; Irsay, L.; Iliescu, M.G. Current Evidence on and Clinical Implications of Vitamin D Levels in Pain and Functional Management of Knee Osteoarthritis: A Systematic Review. Clin. Pract. 2024, 14, 1997-2012. https://doi.org/10.3390/clinpract14050158
Georgescu B, Cristea AE, Oprea D, Lupu AA, Stanciu L-E, Borgazi E, Caraban BM, Ciortea VM, Irsay L, Iliescu MG. Current Evidence on and Clinical Implications of Vitamin D Levels in Pain and Functional Management of Knee Osteoarthritis: A Systematic Review. Clinics and Practice. 2024; 14(5):1997-2012. https://doi.org/10.3390/clinpract14050158
Chicago/Turabian StyleGeorgescu, Bianca, Adelina Elena Cristea, Doinița Oprea, Andreea Alexandra Lupu, Liliana-Elena Stanciu, Erdin Borgazi, Bogdan Marian Caraban, Viorela Mihaela Ciortea, Laszlo Irsay, and Mădălina Gabriela Iliescu. 2024. "Current Evidence on and Clinical Implications of Vitamin D Levels in Pain and Functional Management of Knee Osteoarthritis: A Systematic Review" Clinics and Practice 14, no. 5: 1997-2012. https://doi.org/10.3390/clinpract14050158