Insulin dependence increases the risk of postoperative complications and inferior outcome but not the survivorship of total joint arthroplasty among diabetic population: a systematic review and meta-analysis.
Arthroplasty, Replacement, Hip
/ adverse effects
Arthroplasty, Replacement, Knee
/ adverse effects
Diabetes Mellitus, Type 1
/ complications
Diabetes Mellitus, Type 2
/ complications
Humans
Insulin
Postoperative Complications
/ epidemiology
Reoperation
/ methods
Retrospective Studies
Risk Factors
Survivorship
Diabetes mellitus
Functional outcome
Pain
Periprosthetic joint Infection
Total hip arthroplasty
Total knee arthroplasty
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
19
03
2021
accepted:
29
05
2021
pubmed:
8
6
2021
medline:
14
4
2022
entrez:
7
6
2021
Statut:
ppublish
Résumé
Diabetes mellitus (DM) has been associated with poorer outcomes in total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, it is not clear if insulin-dependent diabetes mellitus (IDDM) patients display more perioperative complications and a worse clinical outcome compared to patients with non-insulin-dependent diabetes mellitus (NIDDM). Medline, Scopus, and the Cochrane library were systematically searched from inception to December 2020 to identify studies evaluating the results of THA and TKA in IDDM and NIDDM patients. The primary outcomes of the review were the surgical and systemic complications, 30-day mortality and readmission, and revision arthroplasty. Secondary outcomes were the survival of the prosthetic joints and the Knee Society Score (KSS). Thirteen studies with 54,215 patients were included in the review. IDDM patients showed a greater risk for developing periprosthetic joint infection (p = 0.02), wound complications (p = 0.01), 30-day readmission (p < 0.01) and mortality (p < 0.01), reoperation (p < 0.01), revision joint surgery (p = 0.02), and systemic complications (p < 0.01) than NIDDM patients. The KSS-knee score was similar in IDDM and NIDDM patients, but the KSS-function score was lower in IDDM patients (p = 0.002). The overall survival rates of the prosthetic joints were similar between the groups. Among diabetic population who undergo THA and TKA, insulin dependence is a risk factor for postoperative complications, and inferior functional outcome but not for shorter survivorship of the prosthetic joints.
Identifiants
pubmed: 34097155
doi: 10.1007/s00590-021-03027-8
pii: 10.1007/s00590-021-03027-8
doi:
Substances chimiques
Insulin
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
701-709Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Martinez-Huedo MA, Villanueva M, De Andres AL et al (2013) Trends 2001–2008 in incidence and immediate postoperative outcomes for major joint replacement among Spanish adults suffering diabetes. Eur J Orthop Surg Traumatol 23:53–59. https://doi.org/10.1007/s00590-011-0915-6
doi: 10.1007/s00590-011-0915-6
pubmed: 23412408
Jain RK, Shukla R, Singh P, Kumar R (2015) Epidemiology and risk factors for surgical site infections in patients requiring orthopedic surgery. Eur J Orthop Surg Traumatol 25:251–254. https://doi.org/10.1007/s00590-014-1475-3
doi: 10.1007/s00590-014-1475-3
pubmed: 24806395
Ackerman GP, McHugh MP, Bharam S (2015) The impact of preoperative planning software on arthroscopic correction of femoroacetabular impingement. Orthop J Sport Med 3:1. https://doi.org/10.1177/2325967115S00056
doi: 10.1177/2325967115S00056
Smith TO, Penny F, Fleetcroft R (2016) Medical morbidities in people following hip and knee arthroplasty: data from the osteoarthritis initiative. Eur J Orthop Surg Traumatol 26:99–106. https://doi.org/10.1007/s00590-015-1713-3
doi: 10.1007/s00590-015-1713-3
pubmed: 26474996
Kebaish KJ, Puvanesarajah V, Rao S et al (2020) Diabetes status affects odds of body mass index-dependent adverse outcomes after total hip arthroplasty. J Am Acad Orthop Surg. https://doi.org/10.5435/JAAOS-D-20-00028
doi: 10.5435/JAAOS-D-20-00028
pubmed: 31567615
Lovecchio F, Beal M, Kwasny M, Manning D (2014) Do patients with insulin-dependent and noninsulin-dependent diabetes have different risks for complications after arthroplasty? Clin Orthop Relat Res 472:3570–3575. https://doi.org/10.1007/s11999-014-3891-4
doi: 10.1007/s11999-014-3891-4
pubmed: 25138473
pmcid: 4182386
Denaro V, Gulino G, Giuffrida N (1994) Infections in orthopaedic surgery–risk factors and prophylaxis. Eur J Orthop Surg Traumatol 4:73–78. https://doi.org/10.1007/BF01803638
doi: 10.1007/BF01803638
Gu A, Wei C, Robinson HN et al (2020) Postoperative complications and impact of diabetes mellitus severity on revision total knee arthroplasty. J Knee Surg 33:228–234. https://doi.org/10.1055/s-0038-1677542
doi: 10.1055/s-0038-1677542
pubmed: 30650440
Marchant MH, Viens NA, Cook C et al (2008) The impact of diabetes on perioperative patient outcomes after total hip and total knee arthroplasty in the United States. J Arthroplasty 23:92–98. https://doi.org/10.1016/j.arth.2008.05.012
doi: 10.1016/j.arth.2008.05.012
pubmed: 18722309
Watts CD, Houdek MT, Wagner ER et al (2016) Insulin dependence increases the risk of failure after total knee arthroplasty in morbidly obese patients. J Arthroplasty 31:256–259. https://doi.org/10.1016/j.arth.2015.08.026
doi: 10.1016/j.arth.2015.08.026
pubmed: 26414110
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535. https://doi.org/10.1136/bmj.b2535
doi: 10.1136/bmj.b2535
pubmed: 19622551
pmcid: 2714657
Wylde V, Beswick AD, Dennis J, Gooberman-Hill R (2017) Post-operative patient-related risk factors for chronic pain after total knee replacement: a systematic review. BMJ Open 7:1–12. https://doi.org/10.1136/bmjopen-2017-018105
doi: 10.1136/bmjopen-2017-018105
Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560. https://doi.org/10.1136/bmj.327.7414.557
doi: 10.1136/bmj.327.7414.557
pubmed: 12958120
pmcid: 192859
Higgins J, Deeks J (2008) Chapter 9: analysing data and undertaking meta-analyses. In: Higgins J, Green S (eds) Cochrane handbook for systematic reviews of interventions. John Willey & Sons, Chichester, UK, pp 243–296
doi: 10.1002/9780470712184
Meding JB, Reddleman K, Keating ME et al (2003) Total knee replacement in patients with diabetes mellitus. Clin Orthop Relat Res. https://doi.org/10.1097/01.blo.0000093002.90435.56
doi: 10.1097/01.blo.0000093002.90435.56
pubmed: 14646763
England SP, Stern SH, Insall JN, Windsor RE (1990) Total knee arthroplasty in diabetes mellitus. Clin Orthop Relat Res. https://doi.org/10.1097/00003086-199011000-00023
doi: 10.1097/00003086-199011000-00023
pubmed: 2225615
Serna F, Mont MA, Krackow KA, Hungerford DS (1994) Total knee arthroplasty in diabetic patients. Comparison to a matched control group. J Arthroplasty 9:375–379. https://doi.org/10.1016/0883-5403(94)90047-7
doi: 10.1016/0883-5403(94)90047-7
pubmed: 7964768
Sibia US, Weltz AS, MacDonald JH, King PJ (2018) Insulin-dependent diabetes is an independent risk factor for complications and readmissions after total joint replacements. J Surg Orthop Adv 27:294–298
doi: 10.3113/JSOA.2018.0294
Webb ML, Golinvaux NS, Ibe IK et al (2017) Comparison of perioperative adverse event rates after total knee arthroplasty in patients with diabetes: insulin dependence makes a difference. J Arthroplasty 32:2947–2951. https://doi.org/10.1016/j.arth.2017.04.032
doi: 10.1016/j.arth.2017.04.032
pubmed: 28559194
Godshaw BM, Warren MS, Nammour MA et al (2020) Insulin-dependent diabetic patients are at increased risk of postoperative hyperglycemia when undergoing total joint arthroplasty. J Arthroplasty 35:2375–2379. https://doi.org/10.1016/j.arth.2020.04.082
doi: 10.1016/j.arth.2020.04.082
pubmed: 32448493
Papagelopoulos PJ, Idusuyi OB, Wallrichs SL, Morrey BF (1996) Long term outcome and survivorship analysis of primary total knee arthroplasty in patients with diabetes mellitus. Clin Orthop Relat Res. https://doi.org/10.1097/00003086-199609000-00015
doi: 10.1097/00003086-199609000-00015
pubmed: 8913158
Yang K, Yeo SJ, Lee BPH, Lo NN (2001) Total knee arthroplasty in diabetic patients: a study of 109 consecutive cases. J Arthroplasty 16:102–106. https://doi.org/10.1054/arth.2001.19159
doi: 10.1054/arth.2001.19159
pubmed: 11172278
Chiu FY, Lin CFJ, Chen CM et al (2001) Cefuroxime-impregnated cement at primary total knee arthroplasty in diabetes mellitus. A prospective, randomised study. J Bone Jt Surg Ser B 83:691–695. https://doi.org/10.1302/0301-620X.83B5.11737
doi: 10.1302/0301-620X.83B5.11737
Chan PKHH, Brenkel IJ, Aderinto J (2005) The outcome of total hip arthroplasty in diabetes mellitus. Br J Diabetes Vasc Dis 5:146–149. https://doi.org/10.1177/14746514050050030601
doi: 10.1177/14746514050050030601