Summary
patients with HbA1c =6.5%, have lower risk of complications. Patients with diabetes, regardless of glycemic control status, had a higher risk of re-hospitalization than those without diabetes
Abstract
Introduction
Hip and Knee arthroplasty constitute a growing proportion of orthopaedic
surgeries. However, relationship between diabetes control and outcomes of orthopaedic
surgeries are controversial. This study examined an intervention that was conducted in
the orthopaedic department at Soroka University Medical Centre (SUMC). Policy for
diabetes patients were changed, and surgeries were performed on patients with HbA1c
values below a threshold of 7.5%. we assessed the effects of this intervention and examined
the impact of glycaemic control on postoperative complications.
Methods
We conducted a retrospective cohort study that analysed all patients who
underwent total hip or knee arthroplasty at SUMC from 2015 to 2022.The study group
included all diabetes patients who had arthroplasty between January 2018 to January 2022.
Patients were divided into three groups, before and after intervention and a control group
without diabetes. Data was obtained from the computerized database system.
Results
This study involved 1366 patients, 685 of whom had diabetes mellitus. The
diabetes group was split into two subgroups and compared, based on whether they were
operated before (DM1 group) or after (DM2 group) the intervention. The results of the
multivariate model showed that Patients with a BMI greater than 25, those
undergoing total knee arthroplasty, and those with HbA1c levels above 6.5% had a
significantly higher risk of developing complications.
Conclusions: In summary, our results showed that patients with HbA1c =6.5%, had a
lower risk of complications. Patients with diabetes, regardless of glycaemic control status,
had a higher risk of re-hospitalization than those without diabetes. In addition, we
found that patients with a BMI greater than 25 were at an increased risk of complications.