Trial reportActa orthopaedica2018
Outcomes following hip and knee replacement in diabetic versus nondiabetic patients and well versus poorly controlled diabetic patients: a prospective cohort study.
Trial report in Acta orthopaedica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2022Guideline
- A Systematic Review Supporting the Endocrine Society Clinical Practice Guideline for the Management of Hyperglycemia in Adults Hospitalized for Noncritical Illness or Undergoing Elective Surgical Procedures.The Journal of clinical endocrinology and metabolism · 2022Pooled it
- Association of preoperative fasting blood glucose with 1-year Harris Hip Score after hip fracture in older adults: a multicenter retrospective cohort study.Frontiers in endocrinology · 2026Observational
- Observational
- The impact of diabetes status on pain and physical function following total joint arthroplasty for hip and knee osteoarthritis: variation by sex and body mass index.Scientific reports · 2024Article
- Cardiac interventions on total knee arthroplasty: a national inpatient sample-based analysis.Archives of orthopaedic and trauma surgery · 2024Article
- The impact of diabetes on physical and mental health status and patient satisfaction after total hip and knee arthroplasty.PloS one · 2024Article
- Effect of diabetes mellitus on the outcomes of total ankle arthroplasty: is controlled diabetes mellitus a risk factor?Journal of orthopaedic surgery and research · 2023Article
- Preoperatively elevated HbA1c levels can meaningfully improve following total joint arthroplasty.Archives of orthopaedic and trauma surgery · 2023Article
- Common procedures and conditions leading to inpatient hospital admissions in adults with and without diabetes from 2015 to 2019 in Germany : A comparison of frequency, length of hospital stay and complications.Wiener klinische Wochenschrift · 2023Article
- Diabesity: a superadded effect contributing to worse total primary hip replacement operative outcomes for patients with diabetes and obesity.Archives of orthopaedic and trauma surgery · 2023Article
- Ligament Alteration in Diabetes Mellitus.Journal of clinical medicine · 2022Review
- [Preoperative management in fast-track arthroplasty].Der Orthopade · 2022Review
- Diabetes mellitus and perioperative outcomes: a scoping review of the literature.British journal of anaesthesia · 2022Article
- Application of Different Doses of Tranexamic Acid Plus Traditional Chinese Medicine in Hip Arthroplasty in Patients with Diabetes and Its Influence on Intraoperative Blood Loss and Postoperative Drainage.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Letter to the Editor: "Failure to Medically Optimize Before Total Hip Arthroplasty: Which Modifiable Risk Factor Is the Most Dangerous?"Arthroplasty today · 2021Article
- Dysglycemia and Arthroplasty Outcomes: A Review.Cureus · 2020Review
- Article
- Relationship between Body Mass Index and Complications during the First 45 Days after Primary Total Hip and Knee Replacement: A Single-Center Study from South America.Clinics in orthopedic surgery · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
Background and purpose - The impact of diabetes and glycemic control before joint replacement on clinical and patient-reported outcomes is unclear. We compared pain, function, complications, and length of hospital stay in diabetic and nondiabetic patients receiving primary total hip (THR) or knee replacement (TKR) and compared these outcomes in patients with poorly controlled versus well-controlled diabetes. Patients and methods - We conducted a prospective cohort study of patients undergoing primary THR (n = 300) or TKR (n = 287) for osteoarthritis. Self-reported diabetes and glycemic control (HbA1c ≤ or >7%) extracted from medical notes were used. Adjusted comparisons were performed with generalized linear models including body mass index (BMI) and comorbidities. Results - Diabetes prevalence was 11% (THR 8%; TKR 14%). Diabetic patients were more likely to have a higher BMI and greater number of comorbidities. The median length of hospital stay was 1 day longer in diabetic patients (p = 0.004), but this attenuated after adjustments for BMI and comorbidities (p = 0.3). Inpatient pain was greater for diabetic patients but attenuated following adjustment. The 12-month postoperative WOMAC subscales were similar by diabetes status following adjustment. There was little evidence of difference in outcomes according to glycemic control. Interpretation - The associations between diabetes and worse postoperative outcomes in patients undergoing THR or TKR for osteoarthritis appear to be predominantly due to associated obesity and comorbidities. In diabetic patients there is little evidence of association between postoperative outcome and preoperative glycemic control. The underlying mechanisms and causal pathways of obesity, diabetes, and multimorbidity that lead to worse outcomes after joint replacement are not well known.
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