Diabetes Mellitus Related to Clinical Outcomes and Postoperative Bleeding of Total Knee Arthroplasty
Journal of Surgery
Volume 5, Issue 2, April 2017, Pages: 33-36
Received: Mar. 23, 2017;
Accepted: Apr. 5, 2017;
Published: Apr. 29, 2017
Views 1939 Downloads 74
Houge Hou, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Huajun Wang, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
To investigate the effect of diabetes mellitus (DM) on the postoperative clinical outcomes and perioperative bleeding volume in patients with primary total knee arthroplasty. Clinical data of 49 patients with osteoarthritis underwent primary total knee arthroplasty (TKA) were collected and retrospectively analyzed from October 2015 and September 2016. Patients were set to two groups with (A) or without DM (B). Data were compared between 2 groups, including postoperative hemoglobin, hematocrit (Hct), Hb, dominant blood loss, hidden blood loss, theoretical total blood loss, range of joint motion, VAS score, increasing rate of circumference length above 10 cm of the knee, HSS score, the operation time and hospitalization days. The results showed that the Hb and Hct of A group was significantly less than the B group (P<0.05). The dominant blood loss, the hidden blood loss and theoretical total blood loss of A group was significantly higher than B group (P<0.05). The hospitalization days of A group was significantly longer than B group (P<0.05). The VAS score and the increasing rate of circumference length above 10 cm of the knee of A group was significantly higher than B group at 3 days (P<0.05). The patients were all followed up 12 weeks. The HSS score of A group was significantly lower than B group at 4 weeks (P<0.05). There was no significant difference in the HSS score between 2 groups at 12 weeks after operation (P>0.05). The prosthesis was in good position, without loosening, subsidence, or osteolysis. In general, patients with DM got TKA have a higher bleeding and longer hospitalization days. DM acts as an adverse impact on recent functional recovery after TKA.
Diabetes Mellitus Related to Clinical Outcomes and Postoperative Bleeding of Total Knee Arthroplasty, Journal of Surgery.
Vol. 5, No. 2,
2017, pp. 33-36.
Glyn-Jones, S., A. J. Palmer, R. Agricola, A. J. Price, T. L. Vincent, H. Weinans, and A. J. Carr, Osteoarthritis. Lancet, 2015, 386(9991):376-87.
Chang, A. H., J. S. Chmiel, O. Almagor, A. Guermazi, P. V. Prasad, K. C. Moisio, L. Belisle, Y. Zhang, K. Hayes, and L. Sharma, Association of baseline knee sagittal dynamic joint stiffness during gait and 2-year patellofemoral cartilage damage worsening in knee osteoarthritis. Osteoarthritis Cartilage, 2017, 25(2):242-248.
King, K. B. and A. K. Rosenthal, The adverse effects of diabetes on osteoarthritis: update on clinical evidence and molecular mechanisms. Osteoarthritis Cartilage, 2015, 23(6):841-50.
Kharroubi, A. T. and H. M. Darwish, Diabetes mellitus: The epidemic of the century. World J Diabetes, 2015, 6(6):850-67.
Courties, A., O. Gualillo, F. Berenbaum, and J. Sellam, Metabolic stress-induced joint inflammation and osteoarthritis. Osteoarthritis Cartilage, 2015, 23(11):1955-65.
Nieves-Plaza, M., L. E. Castro-Santana, Y. M. Font, A. M. Mayor, and L. M. Vila, Association of hand or knee osteoarthritis with diabetes mellitus in a population of Hispanics from Puerto Rico. J Clin Rheumatol, 2013, 19(1):1-6.
Schett, G., A. Kleyer, C. Perricone, E. Sahinbegovic, A. Iagnocco, J. Zwerina, R. Lorenzini, F. Aschenbrenner, F. Berenbaum, M. A. D'Agostino, J. Willeit, and S. Kiechl, Diabetes is an independent predictor for severe osteoarthritis: results from a longitudinal cohort study. Diabetes Care, 2013, 36(2):403-9.
Yang, Z., H. Liu, X. Xie, Z. Tan, T. Qin, and P. Kang, The influence of diabetes mellitus on the post-operative outcome of elective primary total knee replacement: a systematic review and meta-analysis. Bone Joint J, 2014, 96-B(12):1637-43.
Amusat, N., L. Beaupre, G. S. Jhangri, S. L. Pohar, S. Simpson, S. Warren, and C. A. Jones, Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study. J Physiother, 2014, 60(4):217-23.
Bolognesi, M. P., M. H. Marchant, Jr., N. A. Viens, C. Cook, R. Pietrobon, and T. P. Vail, The impact of diabetes on perioperative patient outcomes after total hip and total knee arthroplasty in the United States. J Arthroplasty, 2008, 23(6 Suppl 1):92-8.
Viens, N. A., K. T. Hug, M. H. Marchant, C. Cook, T. P. Vail, and M. P. Bolognesi, Role of diabetes type in perioperative outcomes after hip and knee arthroplasty in the United States. J Surg Orthop Adv, 2012, 21(4):253-60.
King, K. B., T. W. Findley, A. E. Williams, and A. L. Bucknell, Veterans with diabetes receive arthroplasty more frequently and at a younger age. Clin Orthop Relat Res, 2013, 471(9):3049-54.
Robertson, F., J. Geddes, D. Ridley, G. McLeod, and K. Cheng, Patients with Type 2 diabetes mellitus have a worse functional outcome post knee arthroplasty: a matched cohort study. Knee, 2012, 19(4):286-9.
Meding, J. B., K. Reddleman, M. E. Keating, A. Klay, M. A. Ritter, P. M. Faris, and M. E. Berend, Total knee replacement in patients with diabetes mellitus. Clin Orthop Relat Res, 2003(416):208-16.