ArticleJournal of orthopaedic surgery and research2023
Does diabetes mellitus impair the clinical results of total knee arthroplasty under enhanced recovery after surgery?
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Mechanical versus kinematic alignment for total knee arthroplasty: a meta-analysis.Archives of orthopaedic and trauma surgery · 2025Pooled it
- 5E management protocol for enhanced recovery after total knee arthroplasty: stratified RCT.Journal of orthopaedic surgery and research · 2026Trial
- Metformin Use Is Associated With Reduced Inflammation and Pain After Total Knee Arthroplasty in Patients With Type 2 Diabetes.Orthopaedic surgery · 2026Article
- PBA-enriched glycated/ glycosylated synovial fluid proteomic signatures associated with metabolic dysregulation and cartilage degeneration in osteoarthritis with type 2 diabetes.Journal of translational medicine · 2026Article
- Optimizing Early Recovery Quality in Same-Day Discharge Total Hip Arthroplasty: A Narrative Review.Clinical interventions in aging · 2026Review
- Diabetes and total knee arthroplasty: A nationwide analysis of complications, hospitalization outcomes and revision burden.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Factors contributing to instability after primary total knee arthroplasty: a twenty five Year retrospective cohort study.International orthopaedics · 2025Article
- A development of machine learning models to preoperatively predict insufficient clinical improvement after total knee arthroplasty.Journal of orthopaedic surgery and research · 2025Article
- Outcomes of total knee arthroplasty in people with diabetes: An overview of systematic reviews and meta-analysis.Journal of orthopaedics · 2025Review
- Article
- Driving Forces for Outpatient Total Hip and Knee Arthroplasty with Enhanced Recovery After Surgery Protocols: A Narrative Review.Current pain and headache reports · 2024Review
- Observational
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDiabetes mellitus (DM) and osteoarthritis (OA) are common diseases that are predicted to increase in prevalence, and DM is a risk factor for OA progression and has a negative impact on the outcome. However, the evidence remains unclear on how it affects patients' clinical results of total knee arthroplasty (TKA) under enhanced recovery after surgery (ERAS).
methodsA retrospective single-center study was conducted comparing diabetic and non-diabetic patients who underwent TKA in West China Hospital of Sichuan University between September 2016 to December 2017 under ERAS. Consecutive propensity score matching (PSM) was conducted by 1:1 (DM: non-DM) matching analysis with all baselines as covariates. The primary clinical results were the improvement of knee joint function, the incidence of postoperative complications, and the FJS-12 sensory results 5 years after the operation between DM and Non-DM groups. The secondary clinical results were the postoperative length of stay (LOS), postoperative blood test and total blood loss (TBL).
resultAfter PSM, the final analysis included 84 diabetic patients and 84 non-diabetic patients. Diabetic patients were more likely to experience early postoperative complications (21.4% vs. 4.8%, P = 0.003), of which wound complications are the most significant (10.7% vs. 1.2%, P = 0.022). Diabetic patients experienced longer postoperative LOS with a significant increase in patients with LOS exceeding 3 days (66.7% vs. 50%, P = 0.028) and showed less postoperative range of motion (ROM) (106.43 ± 7.88 vs. 109.50 ± 6.33 degrees, P = 0. 011). Diabetic patients also reported lower Forgotten joint score (FJS-12) than non-diabetic patients (68.16 + 12.16 vs. 71.57 + 10.75, P = 0.020) in the 5-year follow-up and were less likely to achieve a forgotten knee joint (10.7% vs. 1.2%, P = 0.022). In additional, Compared with non-diabetics, diabetic patients showed lower hemoglobin (Hb) (P < 0.001) and hematocrit (HCT) (P < 0.001) and were more likely to suffer from hypertension before TKA (P < 0.001).
conclusionDiabetic patients show increased risk for postoperative complications, and have lower lower postoperative ROM and lower FJS-12 compared with non-diabetic patients after TKA under ERAS. More perioperative protocols are still needed to be investigated and optimized for diabetic patients.
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