Prevalence of Vitamin D Deficiency and Osteoporosis Among Patients Undergoing Elective Joint Replacement at a High-Volume Centre in Malaysia

BackgroundBone health optimisation (BHO) is increasingly recognised as an important strategy for improving patient outcomes in orthopaedic surgery.Vitamin D plays a vital role in bone health, but the burden of vitamin D deficiency and osteoporosis among elective joint replacement candidates in Malaysia's multi-ethnic population remains poorly characterised. MethodsIn this prospective observational cohort study, 204 patients aged ≥50 years who were listed for elective primary or revision arthroplasty at Hospital Kuala Lumpur between May 2025 and April 2026 underwent preoperative assessment of serum vitamin D, calcium, and albumin levels, together with a bone mineral density (BMD) scan. ResultsVitamin D deficiency (<50 nmol/L) was present in 43.6% (n = 89) of patients, insufficiency (50-74 nmol/L) in 32.8% (n = 67), and sufficiency (≥75 nmol/L) in 23.5% (n = 48).Osteoporosis and osteopenia were present in 28.9% (n = 59) and 59.3% (n = 121) of patients, respectively.Hypoalbuminemia was present in 91 patients (44.6%).Malay patients had a significantly higher prevalence of vitamin D deficiency than Indian and Chinese patients (χ² = 28.559,p < 0.001), while Indian patients had significantly lower albumin levels (χ² = 12.192, p = 0.002). ConclusionVitamin D deficiency, osteoporosis, and malnutrition were highly prevalent among elective arthroplasty candidates in this Malaysian cohort.These findings support the routine incorporation of serum vitamin D assessment and BMD screening into the preoperative workup.