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Clin Orthop Surg. 2013 Jun;5(2):118-23. doi: 10.4055/cios.2013.5.2.118. Epub 2013 May 15.

Relations between long-term glycemic control and postoperative wound and infectious complications after total knee arthroplasty in type 2 diabetics.

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  • 1Department of Orthopedic Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.

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 ≥ 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.

KEYWORDS:

Early deep infection; Total knee replacements; Type 2 diabetes mellitus; Wound complication

PMID:
23730475
[PubMed - indexed for MEDLINE]
PMCID:
PMC3664670
Free PMC Article
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