Hip Pelvis.  2014 Sep;26(3):136-142. 10.5371/hp.2014.26.3.136.

Clinical Implication of Diabetes Mellitus in Primary Total Hip Arthroplasty

Affiliations
  • 1Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea. khrhyu@empas.com

Abstract

PURPOSE
The purpose of this study was to investigate the effect of diabetes mellitus on primary total hip arthroplasty by comparing the clinical outcomes of patients diagnosed to have diabetes mellitus before the operation with those without diabetes.
MATERIALS AND METHODS
A total 413 patients who underwent unilateral cementless total hip arthroplasty from June 2006 to May 2009 were recruited and divided into diabetic and non-diabetic groups. The comparative analysis between the two groups was made. We evaluated Harris hip score, postoperative complications such as wound problem, surgical site infection, other medical complication and length of stay in hospital as clinical parameters. Radiographic evaluations were also included to determine loosening, dislocation and osteolysis.
RESULTS
Patients with diabetes had an increased incidence of orthopaedic complications including surgical site infection and mortality, but other medical complications were not increased in diabetic patients. All complications after primary total hip arthroplasty were associated with diabetes mellitus, but the degree of diabetes was not associated with complications.
CONCLUSION
Diabetes mellitus increases incidence of orthopaedic complications, particularly deep infection, after cementless primary total hip arthroplasty.

Keyword

Diabetes mellitus; Total hip arthroplasty; Infection; Complications

MeSH Terms

Arthroplasty, Replacement, Hip*
Diabetes Mellitus*
Dislocations
Hip
Humans
Incidence
Length of Stay
Mortality
Osteolysis
Postoperative Complications
Wounds and Injuries

Cited by  1 articles

Comparison of Functional Outcomes and Associated Complications in Patients Who Underwent Total Hip Arthroplasty for Femoral Neck Fracture in Relation to Their Underlying Medical Comorbidities
Byung Yoon Park, Kuk Pil Lim, Won Yong Shon, Y. Nishanth Shetty, Ki Seong Heo
Hip Pelvis. 2019;31(4):232-237.    doi: 10.5371/hp.2019.31.4.232.


Reference

1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011; 94:311–321.
Article
2. Park IB, Baik SH. Epidemiologic characteristics of diabetes mellitus in Korea: current status of diabetic patients using Korean health insurance database. Korean Diabetes J. 2009; 33:357–362.
Article
3. Jämsen E, Nevalainen P, Eskelinen A, Huotari K, Kalliovalkama J, Moilanen T. Obesity, diabetes, and preoperative hyperglycemia as predictors of periprosthetic joint infection: a single-center analysis of 7181 primary hip and knee replacements for osteoarthritis. J Bone Joint Surg Am. 2012; 94:e101.
4. Iorio R, Williams KM, Marcantonio AJ, Specht LM, Tilzey JF, Healy WL. Diabetes mellitus, hemoglobin A1C, and the incidence of total joint arthroplasty infection. J Arthroplasty. 2012; 27:726–729.
Article
5. Malinzak RA, Ritter MA, Berend ME, Meding JB, Olberding EM, Davis KE. Morbidly obese, diabetic, younger, and unilateral joint arthroplasty patients have elevated total joint arthroplasty infection rates. J Arthroplasty. 2009; 24:6 Suppl. 84–88.
Article
6. Mraovic B, Suh D, Jacovides C, Parvizi J. Perioperative hyperglycemia and postoperative infection after lower limb arthroplasty. J Diabetes Sci Technol. 2011; 5:412–418.
Article
7. Suh KT, Lee HS, Kim MS, Lee JS, Kim JI. Total hip arthroplasty in patients with diabetes mellitus. J Korean Orthop Assoc. 2009; 44:526–532.
Article
8. Jain NB, Guller U, Pietrobon R, Bond TK, Higgins LD. Comorbidities increase complication rates in patients having arthroplasty. Clin Orthop Relat Res. 2005; 435:232–238.
Article
9. Higuera CA, Elsharkawy K, Klika AK, Brocone M, Barsoum WK. 2010 Mid-America Orthopaedic Association Physician in Training Award: predictors of early adverse outcomes after knee and hip arthroplasty in geriatric patients. Clin Orthop Relat Res. 2011; 469:1391–1400.
Article
10. National Health Insurance Service of Korea. Instructions for assessment of propriety in medical care expenses. Seoul: National Health Insurance Service of Korea;2009. p. 85–109.
11. Choong PF, Dowsey MM, Carr D, Daffy J, Stanley P. Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen. Acta Orthop. 2007; 78:755–765.
Article
12. Namba RS, Paxton L, Fithian DC, Stone ML. Obesity and perioperative morbidity in total hip and total knee arthroplasty patients. J Arthroplasty. 2005; 20:7 Suppl 3. 46–50.
Article
13. Eveillard M, Mertl P, Canarelli B, et al. Risk of deep infection in first-intention total hip replacement. Evaluation concerning a continuous series of 790 cases. Presse Med. 2001; 30:1868–1875.
14. Marchant MH Jr, Viens NA, Cook C, Vail TP, Bolognesi MP. The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty. J Bone Joint Surg Am. 2009; 91:1621–1629.
Article
15. Harris AH, Bowe TR, Gupta S, Ellerbe LS, Giori NJ. Hemoglobin A1C as a marker for surgical risk in diabetic patients undergoing total joint arthroplasty. J Arthroplasty. 2013; 28:8 Suppl. 25–29.
Article
16. Stryker LS, Abdel MP, Morrey ME, Morrow MM, Kor DJ, Morrey BF. Elevated postoperative blood glucose and preoperative hemoglobin A1C are associated with increased wound complications following total joint arthroplasty. J Bone Joint Surg Am. 2013; 95:808–814.
Article
17. Rizvi AA, Chillag SA, Chillag KJ. Perioperative management of diabetes and hyperglycemia in patients undergoing orthopaedic surgery. J Am Acad Orthop Surg. 2010; 18:426–435.
Article
18. Ridgeway S, Wilson J, Charlet A, Kafatos G, Pearson A, Coello R. Infection of the surgical site after arthroplasty of the hip. J Bone Joint Surg Br. 2005; 87:844–850.
Article
19. Rosenthal VD, Richtmann R, Singh S, et al. International Nosocomial Infection Control Consortiuma. Surgical site infections, International Nosocomial Infection Control Consortium (INICC) report, data summary of 30 countries, 2005-2010. Infect Control Hosp Epidemiol. 2013; 34:597–604.
Article
20. Bolognesi MP, Marchant MH Jr, Viens NA, Cook C, Pietrobon R, Vail TP. 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. 92–98.
Article
21. Lai K, Bohm ER, Burnell C, Hedden DR. Presence of medical comorbidities in patients with infected primary hip or knee arthroplasties. J Arthroplasty. 2007; 22:651–656.
Article
22. Pedersen AB, Mehnert F, Johnsen SP, Sørensen HT. Risk of revision of a total hip replacement in patients with diabetes mellitus: a population-based follow up study. J Bone Joint Surg Br. 2010; 92:929–934.
23. Charnley J. Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin Orthop Relat Res. 1972; 87:167–187.
Article
24. Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D. Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. Br Med J (Clin Res Ed). 1982; 285:10–14.
Article
25. Meehan J, Jamali AA, Nguyen H. Prophylactic antibiotics in hip and knee arthroplasty. J Bone Joint Surg Am. 2009; 91:2480–2490.
Article
26. Prokuski L, Clyburn TA, Evans RP, Moucha CS. Prophylactic antibiotics in orthopaedic surgery. Instr Course Lect. 2011; 60:545–555.
Article
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