Relations between Long-term Glycemic Control and Postoperative Wound and Infectious Complications after Total Knee Arthroplasty in Type 2 Diabetics.
10.4055/cios.2013.5.2.118
- Author:
Hyuk Soo HAN
1
;
Seung Baik KANG
Author Information
1. Department of Orthopedic Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea. ossbkang@gmail.com
- Publication Type:Original Article
- Keywords:
Total knee replacements;
Wound complication;
Early deep infection;
Type 2 diabetes mellitus
- MeSH:
Aged;
Aged, 80 and over;
Arthroplasty, Replacement, Knee/*adverse effects;
Blood Glucose/metabolism;
Diabetes Mellitus, Type 2/blood/drug therapy/*metabolism;
Female;
Glucose/*metabolism;
Hemoglobin A, Glycosylated/metabolism;
Humans;
Hypoglycemic Agents/therapeutic use;
Incidence;
Insulin/therapeutic use;
Logistic Models;
Male;
Middle Aged;
Retrospective Studies;
Surgical Wound Infection/*metabolism
- From:Clinics in Orthopedic Surgery
2013;5(2):118-123
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The authors examined whether poor preoperative glucose control, as indicated by the hemoglobin A1c (HbA1c) level of more than 8%, is associated with postoperative wound and infectious complications in diabetic patients that have undergone total knee arthroplasty (TKA). METHODS: One hundred and sixty-seven TKAs performed in 115 patients with type 2 diabetes mellitus, from January 2001 through March 2007, were retrospectively reviewed. Logistic regression was used to identify the variables that had a significant effect on the risk of wound complications or early deep infection. The variables considered were age, gender, body mass index, comorbidities, operation time, antibiotic-impregnated cement use, amount of blood transfusion, close suction drain use, duration of diabetes, method of diabetes treatment, diabetes complications, and preoperative HbA1c level. RESULTS: The overall incidence of wound complications was 6.6% (n = 11) and there were seven cases (4.2%) of early postoperative deep infection. Logistic regression revealed that the independent risk factors of wound complications were preoperative HbA1C > or = 8% (odds ratio [OR], 6.07; 95% confidence interval [CI], 1.12 to 33.0) and operation time (OR, 1.01; 95% CI, 1.00 to 1.03). No variable examined was found to be significantly associated with the risk of early postoperative deep infection. CONCLUSIONS: Poorly controlled hyperglycemia before surgery may increase the incidence of wound complications among diabetic patients after TKA.
