Diabetes Doesn't Seem to Raise Risks After Knee Replacement

Rates of infection, blood clots similar in those with and without the condition, study finds

By Mary Elizabeth Dallas

Wednesday, February 27, 2013

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WEDNESDAY, Feb. 27 (HealthDay News) -- People with diabetes who undergo knee replacement surgery are not at greater risk for infection, deep vein thrombosis (a type of blood clot), or other complications following the procedure than people without diabetes, new study findings indicate.
"This current study suggests that patients with diabetes who have higher glucose [blood sugar] levels may not be at greater risk of poor surgical outcomes," explained study author Annette Adams, of the Kaiser Permanente Southern California Department of Research and Evaluation.
"There appear to be other factors at play, and patients and their providers need to consider multiple factors, including but not limited to diabetes status, as they make decisions about whether to have this surgery," she added in a news release from the American Academy of Orthopaedic Surgeons.
For the study, the researchers examined the records of more than 40,000 patients who had a total knee replacement between 2001 and 2009. Of these patients, 12.5 percent had controlled diabetes and 6.2 percent had uncontrolled diabetes. The investigators found that 1.1 percent of these patients had revision surgery and 0.7 percent developed a deep infection.
There was no significant increase in the risk for complications after total knee replacement for patients with controlled or uncontrolled diabetes, compared to those who did not have the disease, the study authors found.
Rates of complications, such as deep infection, deep vein thrombosis and pulmonary embolism (when a blood clot reaches the lungs) were similar in those with diabetes and those who did not have the condition, according to the report released online and published in the March print edition of the Journal of Bone and Joint Surgery.
The researchers noted, however, that nearly 57 percent of the patients with diabetes who underwent a total knee replacement were obese, compared with about 40 percent of those who did not have diabetes. A related disease or condition affected 17.5 percent of the patients with diabetes, compared with just 2.4 percent of the other patients.
The study findings also indicated that patients with uncontrolled diabetes were not at greater risk for heart attack or a readmission to the hospital, and 1.2 percent of these patients had revision surgery, compared with 1.7 percent of patients whose diabetes was controlled.

SOURCE: American Academy of Orthopaedic Surgeons, news release, Feb. 27, 2013

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