SERIAL CHANGES IN SERUM VITAMIN-K-1, TRIGLYCERIDE, CHOLESTEROL, OSTEOCALCIN AND 25-HYDROXYVITAMIN-D-3 IN PATIENTS AFTER HIP-REPLACEMENT FORFRACTURED NECK OF FEMUR OR OSTEOARTHRITIS

Serum vitamin K-1 concentrations were measured at presentation (just b efore surgery) and then at weekly intervals for 3 weeks in two groups of elderly patients requiring either hemiarthroplasty for fractured ne ck of femur (FON, n = 13) or total hip replacement for osteoarthritis of the hip (OA, n = 16). In comparison with healthy elderly volunteers (n = 25), serum vitamin K-1 concentrations were significantly lower i n both groups at presentation, and fell significantly within 24 h afte r surgery to concentrations approaching non-detectable, subsequently r eturning to pre-operative values within 3 weeks. Serum vitamin K-1 ten ded to be lower in the fracture group both before and after operation, although calculation of a vitamin K-1-triglyceride ratio reduced the apparent difference as triglyceride concentrations were lower in the f racture group. Osteocalcin concentrations were similar and fell signif icantly after operation in both groups, returning to pre-operative lev els within 7 days. No differences in the two forms of osteocalcin (car boxylated and undercarboxylated) were observed either before or after operation in either group. 25-Hydroxyvitamin D-3 concentrations were n ot significantly different between the two groups at any time. Vitamin K-1 status may be lower than desirable in certain groups of the elder ly population, and supplementation should be considered as prophylacti c therapy.