2025 ISAKOS Biennial Congress ePoster
Effect Of Insulin Dependence On Complications Following Total Shoulder Arthroplasty In Patients With Diabetes Mellitus
Stephen C. Weber, MD, San Diego, CA UNITED STATES
Eve R. Glenn, ScB, Baltimore, Maryland UNITED STATES
Alexander R. Zhu, BA, Baltimore, Maryland UNITED STATES
James H. Padley, BS, Baltimore, Maryland UNITED STATES
Henry Fox, MD, Baltimore, MD UNITED STATES
Laurence Okeke, BA, Washington, D.C. UNITED STATES
Edward G McFarland, MD, FAAOS, Baltimore, Maryland UNITED STATES
The Johns Hopkins School of Medicine, Baltimore, Maryland, UNITED STATES
FDA Status Cleared
Summary
Insulin dependence does not significantly impact short term outcomes undergoing TSA
ePosters will be available shortly before Congress
Abstract
Introduction
Diabetes mellitus (DM) is a common metabolic disorder that significantly impacts total shoulder arthroplasty (TSA) outcomes. Osteoarthritis (OA) is a primary indication for TSA, and DM is recognized as a significant risk factor for developing OA. However, the influence of insulin dependence on TSA outcomes in diabetic patients remains uncertain. This study aims to evaluate the demographics, baseline characteristics on admission, and perioperative outcomes of TSA in patients with DM.
Methods
This retrospective study analyzed data from the National Surgical Quality Improvement Program (NSQIP) from 2006 to 2022. A total of 8,430 adult diabetic patients who underwent TSA were included and stratified by insulin-dependent (IDDM) or non-insulin-dependent DM (NIDDM). Demographic variables, baseline characteristics on admission, and 30-day perioperative outcomes were compared between cohorts using univariate and multivariate analyses. A subanalysis focused on 3,940 patients who underwent TSA specifically for OA, stratified by insulin dependence.
Results
Among TSA patients, 2,431 (28.84%) had IDDM, and 5,999 (71.16%) had NIDDM. Significant differences in perioperative complications were observed between IDDM and NIDDM patients, including operation time, length of stay, discharge timing, and complications such as septic shock and blood transfusion. However, multivariate analysis showed no significant differences between the groups in any perioperative outcomes. Similar findings were observed in the OA TSA subgroup.
Discussion
Despite demographic differences, insulin dependence did not significantly impact short-term outcomes in diabetic patients undergoing TSA. These findings suggest that factors beyond insulin dependence should be considered when managing diabetic patients undergoing TSA.