Abstract
Introduction
Approximately 450 million people worldwide have diabetes mellitus. Since 1980, the age-standardized global prevalence of diabetes mellitus among adults has almost doubled from 4.7% to 8.5%(1). India, with 69.2 million people living with T2DM, is the world's second-largest population living with diabetes mellitus following to China It decreases the capability of the person to improve from disease and injury, and can also lead to obesity, as well as growing occurrence of osteoarthritis and the essential for joint replacement. Knee and hip arthroplasties are also increasingly common amongst diabetic population due to numerous reasons, and the percentage is as high as 52 %(4).
The Diabetic population has poor body resistance, poor tissue healing capacity, and high incidence of perioperative complications; the occurrence of stroke, urinary tract infections, intestinal obstruction, bleeding, and death has risen by 3.42-, 1.97-, 2.47-, 1.99-and 3.23-times respectively. Diabetes mellitus increases the occurrence of deep venous thrombosis (DVT) and infections in total knee replacement (TKR) patients with diabetes(5). This interpretation is not universally accepted, however, and some researchers believe that the occurrence of complications such as deep vein thrombosis, deep infection, and revision surgery does not differ between well-controlled diabetic and non-diabetic patients.
Challenged with such a vast diabetic population, the possible risk of perioperative or likely postoperative adverse effects stresses more research, such as how to adjust and control blood glucose, control infections, improve perioperative care, improve perioperative management and efcy of arthroplasties in diabetic group.
References
- Vijayakumar G, Manghat S, Vijayakumar R, Simon L, Scaria LM, Vijayakumar A, et al. Incidence of type 2 diabetes mellitus and prediabetes in Kerala, India: results from a 10-year prospective cohort. BMC Public Health. 2019 Jan 31;19(1):140.
- Globalization of Diabetes | Diabetes Care [Internet]. [cited 2019 Oct 23]. Available from: https://care.diabetesjournals.org/content/34/6/1249
- Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014 Jan 31;7(1):45–8.
- Centers for Disease Control and Prevention (CDC). Arthritis as a potential barrier to physical activity among adults with diabetes--United States, 2005 and 2007. MMWR Morb Mortal Wkly Rep. 2008 May 9;57(18):486–9.
- Bolognesi MP, Marchant MH, 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 Sep;23(6 Suppl 1):92–8.
- Sivarasu S, Mathew L. Artificial High — Flexion Knee Customized for Eastern Lifestyle. In: Lim CT, Goh JCH, editors. 13th International Conference on Biomedical Engineering. Springer Berlin Heidelberg; 2009. p. 1597–9. (IFMBE Proceedings).
- Kaufman KR, Hughes C, Morrey BF, Morrey M, An KN. Gait characteristics of patients with knee osteoarthritis. J Biomech. 2001 Jul;34(7):907–15.
- Nguyen U-SDT, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med. 2011 Dec 6;155(11):725–32.
- Arokoski JP, Jurvelin JS, Väätäinen U, Helminen HJ. Normal and pathological adaptations of articular cartilage to joint loading. Scand J Med Sci Sports. 2000 Aug;10(4):186–98.
- Roos EM. Joint injury causes knee osteoarthritis in young adults. CurrOpinRheumatol. 2005 Mar;17(2): 195–200.
- O’Reilly SC, Muir KR, Doherty M. Knee pain and disability in the Nottingham community: association with poor health status and psychological distress. Br J Rheumatol. 1998 Aug;37(8):870–3.
- McAlindon TE, Cooper C, Kirwan JR, Dieppe PA. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 1993 Apr;52(4):258–62.
- Walldius B. Arthroplasty of the Knee Using an Endoprosthesis. ActaOrthop Scand. 1957 Apr;28(sup24):1–112.
- Gunston FH. Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement. J Bone Joint Surg Br. 1971 May;53(2):272–7.
- Coventry MB, Upshaw JE, Riley LH, Finerman GA, Turner RH. Geometric total knee arthroplasty. I. Conception, design, indi.
- The anatomic total knee resurfacing arthroplasty. - PubMed - NCBI [Internet]. [cited 2019 Oct 23]. Available from: https:// www.ncbi. nlm.nih.gov/ pubmed/ 3967443
- Hungerford DS, Kenna RV, Krackow KA. The porous-coated anatomic total knee. OrthopClin North Am. 1982 Jan;13(1) :103–22.
- Salvati EA, Robinson RP, Zeno SM, Koslin BL, Brause BD, Wilson PD. Infection rates after 3175 total hip and total knee replacements performed with and without a horizontal unidirectional filtered air-flow system. J Bone Joint Surg Am. 1982 Apr;64(4):525–35.
- Bannister GC, Auchincloss JM, Johnson DP, Newman JH. The timing of tourniquet application in relation to prophylactic antibiotic administration. J Bone Joint Surg Br. 1988 Mar;70(2):322–4.
- Taylor GJ, Leeming JP, Bannister GC. Effect of antiseptics, ultraviolet light and lavage on airborne bacteria in a model wound. J Bone Joint Surg Br. 1993 Sep;75(5):724–30.
- Abularrage CJ, Weiswasser JM, Dezee KJ, Slidell MB, Henderson WG, Sidawy AN. Predictors of lower extremity arterial injury after total knee or total hip arthroplasty. J Vasc Surg. 2008 Apr;47(4):803–7; discussion 807-808.
- Vince K, Chivas D, Droll KP. Wound complications after total knee arthroplasty. J Arthroplasty. 2007 Jun;22(4 Suppl 1):39–44.
- Ranawat AS, Ranawat CS. Pain management and accelerated rehabilitation for total hip and total knee arthroplasty. J Arthroplasty. 2007 Oct;22(7 Suppl 3):12–5.
- Fisher J, McEwen HM, Barnett PI, Bell C, Stone MH, InghamE.Influences of sterilising techniques on polyethylene wear. Kn.
- Alberti KG, Thomas DJ. The management of diabetes during surgery. Br J Anaesth. 1979 Jul;51(7):693–710.
- Serna F, Mont MA, Krackow KA, Hungerford DS. Total knee arthroplasty in diabetic patients. Comparison to a matched control group. J Arthroplasty. 1994 Aug;9(4):375–9.
- Meding JB, Reddleman K, Keating ME, Klay A, Ritter MA, Faris PM, et al. Total knee replacement in patients with diabetes mellitus. Clin Orthop. 2003 Nov;(416): 208–16.
- Moon HK, Han CD, Yang IH, Cha BS. Factors affecting outcome after total knee arthroplasty in patients with diabetes mellitus. Yonsei Med J. 2008 Feb 29;49(1):129–37.
- Adams AL, Paxton EW, Wang JQ, Johnson ES, Bayliss EA, Ferrara A, et al. Surgical outcomes of total knee replacement according to diabetes status and glycemic control, 2001 to 2009. J Bone Joint Surg Am. 2013 Mar 20;95(6):481–7.
- Robertson F, Geddes J, Ridley D, McLeod G, Cheng K. Patients with Type 2 diabetes mellitus have a worse functional outcome post knee arthroplasty: a matched cohort study. The Knee. 2012 Aug;19(4):286–9.
- Singh JA, Lewallen DG. Diabetes: A Risk Factor for Poor Functional Outcome after Total Knee Arthroplasty. PLoS ONE [Internet]. 2013 Nov 13 [cited 2019 Oct
- Yang Z, Liu H, Xie X, Tan Z, Qin T, Kang P. The influence of diabetes mellitus on the post-operative outcome of elective primary total knee replacement: a systematic review and meta-analysis. Bone Jt J. 2014 Dec;96-B(12):1637–43.
- Clinical Outcome Evaluation of Primary Total Knee Arthroplasty in Patients with Diabetes Mellitus. - PubMed - NCBI [Internet]. [cited 2019 Oct 23]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28484205
- Wada O, Nagai K, Hiyama Y, Nitta S, Maruno H, Mizuno K. Diabetes is a Risk Factor for Restricted Range of Motion and Poor Clinical Outcome After Total Knee Arthroplasty. J Arthroplasty. 2016;31 (9):1933–7.
- Diabetes Mellitus is a Predictor for Poor Outcome After Total Knee Replacement: A Matched Cohort Study. Orthop Rheumatol Open Access J. :4.
- Diabetes Mellitus is a Predictor for Poor Outcome After Total Knee Replacement: A Matched Cohort Study. Orthop Rheumatol Open Access J. :4.
- Functional estrogen receptors in adult articular cartilage: estrogen replacement therapy increases chondrocyte synthesis of proteoglycans and insul... - PubMed - NCBI [Internet]. [cited 2019 Oct 23]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11014360.
Corresponding Author
Dr Sudhir Ravindran
Associate Professor in Orthopedics, Government Medical College Trivandrum