The Outcome of Total Knee Arthroplasty in Diabetics

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Abstract

To analyze the results of total knee arthroplasty (TKA) in patients with diabetes mellitus (DM). Materials and Methods: Between 1996 and 2001, 601 TKAs in 373 patients were performed by a single surgeon. From this series, 45 patients (74 knees) were diagnosed as type Il DM and osteoarthritis of the knee. The mean follow-up was 49 months (6-108 months), and the mean age was 68.6 years (54-83 years). The clinical outcome of the diabetic and non diabetic group was compared using the Hospital for special surgery score (HSS) and the Knee society clinical and radiological scoring system. The radiological loosening and perioperative complications were evaluated. The plasma Hemoglobin A1c (HbA1c) level of the diabetes patients was examined pre and postoperatively. Results: The knee and pain scores were higher in the diabetes group postoperatively (p=0.040, p=0.039, respectively), whereas the HSS scores and overall function scores were lower in the diabetes group postoperatively (p=0.021, p=0.016, respectively). The rate of superficial wound problems was greater in the diabetes group (8.1 % versus 2.4%, p=0.032). However the incidence of a deep infection was similar in the diabetic and non diabetic group (2.7% versus 0.9%). The mean HbA1c level was significantly higher in the diabetic patients with a superficial and deep infection than in the remaining diabetic patients (p=0.033). Conclusion: The HbA1c level might be a valuable predictor of superficial wound complications and deep infection. Although the clinical results were similar in the diabetes and non diabetes groups, special precautions should be taken for diabetic patients undergoing TKA to minimize complications.
Original languageAmerican English
Pages (from-to)737-742
JournalJournal of the Korean Orthopaedic Association
Volume42
StatePublished - 2007

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Knee Replacement Arthroplasties
Special Hospital
Knee
Hemoglobins
Diabetes Mellitus
Infection
Knee Osteoarthritis
Wounds and Injuries
Pain
Incidence

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@article{fe8133ed8a6d49e1842d65c9c34fadd4,
title = "The Outcome of Total Knee Arthroplasty in Diabetics",
abstract = "To analyze the results of total knee arthroplasty (TKA) in patients with diabetes mellitus (DM). Materials and Methods: Between 1996 and 2001, 601 TKAs in 373 patients were performed by a single surgeon. From this series, 45 patients (74 knees) were diagnosed as type Il DM and osteoarthritis of the knee. The mean follow-up was 49 months (6-108 months), and the mean age was 68.6 years (54-83 years). The clinical outcome of the diabetic and non diabetic group was compared using the Hospital for special surgery score (HSS) and the Knee society clinical and radiological scoring system. The radiological loosening and perioperative complications were evaluated. The plasma Hemoglobin A1c (HbA1c) level of the diabetes patients was examined pre and postoperatively. Results: The knee and pain scores were higher in the diabetes group postoperatively (p=0.040, p=0.039, respectively), whereas the HSS scores and overall function scores were lower in the diabetes group postoperatively (p=0.021, p=0.016, respectively). The rate of superficial wound problems was greater in the diabetes group (8.1 {\%} versus 2.4{\%}, p=0.032). However the incidence of a deep infection was similar in the diabetic and non diabetic group (2.7{\%} versus 0.9{\%}). The mean HbA1c level was significantly higher in the diabetic patients with a superficial and deep infection than in the remaining diabetic patients (p=0.033). Conclusion: The HbA1c level might be a valuable predictor of superficial wound complications and deep infection. Although the clinical results were similar in the diabetes and non diabetes groups, special precautions should be taken for diabetic patients undergoing TKA to minimize complications.",
author = "Seung-Baik Kang and Cho, {Young Jae} and Yoon, {Kang Sup} and Lee, {Ji Ho} and Jo, {Chris Hyunchul} and Lee, {Jae Hyup} and Han, {Hyuk Soo}",
year = "2007",
language = "American English",
volume = "42",
pages = "737--742",
journal = "Journal of the Korean Orthopaedic Association",
issn = "1226-2102",

}

TY - JOUR

T1 - The Outcome of Total Knee Arthroplasty in Diabetics

AU - Kang, Seung-Baik

AU - Cho, Young Jae

AU - Yoon, Kang Sup

AU - Lee, Ji Ho

AU - Jo, Chris Hyunchul

AU - Lee, Jae Hyup

AU - Han, Hyuk Soo

PY - 2007

Y1 - 2007

N2 - To analyze the results of total knee arthroplasty (TKA) in patients with diabetes mellitus (DM). Materials and Methods: Between 1996 and 2001, 601 TKAs in 373 patients were performed by a single surgeon. From this series, 45 patients (74 knees) were diagnosed as type Il DM and osteoarthritis of the knee. The mean follow-up was 49 months (6-108 months), and the mean age was 68.6 years (54-83 years). The clinical outcome of the diabetic and non diabetic group was compared using the Hospital for special surgery score (HSS) and the Knee society clinical and radiological scoring system. The radiological loosening and perioperative complications were evaluated. The plasma Hemoglobin A1c (HbA1c) level of the diabetes patients was examined pre and postoperatively. Results: The knee and pain scores were higher in the diabetes group postoperatively (p=0.040, p=0.039, respectively), whereas the HSS scores and overall function scores were lower in the diabetes group postoperatively (p=0.021, p=0.016, respectively). The rate of superficial wound problems was greater in the diabetes group (8.1 % versus 2.4%, p=0.032). However the incidence of a deep infection was similar in the diabetic and non diabetic group (2.7% versus 0.9%). The mean HbA1c level was significantly higher in the diabetic patients with a superficial and deep infection than in the remaining diabetic patients (p=0.033). Conclusion: The HbA1c level might be a valuable predictor of superficial wound complications and deep infection. Although the clinical results were similar in the diabetes and non diabetes groups, special precautions should be taken for diabetic patients undergoing TKA to minimize complications.

AB - To analyze the results of total knee arthroplasty (TKA) in patients with diabetes mellitus (DM). Materials and Methods: Between 1996 and 2001, 601 TKAs in 373 patients were performed by a single surgeon. From this series, 45 patients (74 knees) were diagnosed as type Il DM and osteoarthritis of the knee. The mean follow-up was 49 months (6-108 months), and the mean age was 68.6 years (54-83 years). The clinical outcome of the diabetic and non diabetic group was compared using the Hospital for special surgery score (HSS) and the Knee society clinical and radiological scoring system. The radiological loosening and perioperative complications were evaluated. The plasma Hemoglobin A1c (HbA1c) level of the diabetes patients was examined pre and postoperatively. Results: The knee and pain scores were higher in the diabetes group postoperatively (p=0.040, p=0.039, respectively), whereas the HSS scores and overall function scores were lower in the diabetes group postoperatively (p=0.021, p=0.016, respectively). The rate of superficial wound problems was greater in the diabetes group (8.1 % versus 2.4%, p=0.032). However the incidence of a deep infection was similar in the diabetic and non diabetic group (2.7% versus 0.9%). The mean HbA1c level was significantly higher in the diabetic patients with a superficial and deep infection than in the remaining diabetic patients (p=0.033). Conclusion: The HbA1c level might be a valuable predictor of superficial wound complications and deep infection. Although the clinical results were similar in the diabetes and non diabetes groups, special precautions should be taken for diabetic patients undergoing TKA to minimize complications.

M3 - Article

VL - 42

SP - 737

EP - 742

JO - Journal of the Korean Orthopaedic Association

JF - Journal of the Korean Orthopaedic Association

SN - 1226-2102

ER -