Diabetics who have undergone total knee replacement (TKR) surgery are at no greater risk of post-operative complications compared to diabetes-free patients.
This is the conclusion drawn by a research team from the Kaiser Permanente Southern California Department of Research & Evaluation. The findings of the study have been published in the March issue of the Journal of Bone and Joint Surgery.
The researchers set out to establish whether blood sugar levels (glycaemic control) had any influence on TKR surgery outcomes. It is estimated that 52% of diabetics suffer from arthritis and previous studies have indicated that poor glycaemic control may lead to post-operative complications such as infection and deep vein thrombosis.
This study involved a review of over 40,000 patient records at Kaiser Permanente. The records belonged to people who had undergone TKR between January 2001 and December 2009. Among them, 7,567 had diabetes, 464 required revision surgery and 287 developed a deep infection. Within the entire group, 12.5% of patients had controlled diabetes, while 6.2% had uncontrolled diabetes.
The researchers established low rates of deep infection, deep vein thrombosis and pulmonary embolism and the results were comparable for the diabetic group (both controlled and uncontrolled) and the non-diabetic group. There was also no indication that uncontrolled diabetics run a greater risk of myocardial infarction or rehospitalisation. According to Annette L. Adams, a member of the Kaiser Permanente research team, the study suggests that poor surgical outcomes are not linked to the presence of diabetes and multiple factors should be evaluated when TKR surgery is being considered.