ArticleActa orthopaedica et traumatologica turcica2023
Predictive value of different glycemic control markers in total hip or knee arthroplasty: A prospective study.
Article in Acta orthopaedica et traumatologica turcica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 8 citations in OpenAlex.
- Anti-diabetic medications' effect on outcomes and glycemic markers following TJA in patients with type 2 diabetes.Archives of orthopaedic and trauma surgery · 2025Article
- Periprosthetic joint infection after arthroplasty: advances and future prospects.Journal of orthopaedic surgery and research · 2025Review
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6 authors at 1 institution in 1 country.
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Abstract
objectiveThe optimal glycemic control marker before total hip or knee arthroplasty remains inconclusive. Hemoglobin A1c (HbA1c) is widely used, while fructosamine may be valuable for predicting periprosthetic joint infection (PJI). Fructosamine levels can be affected by serum albumin levels; albumin-corrected fructosamine (AlbF) can be calculated to overcome this issue. The objective of this study was to evaluate the predictive value of different markers for complications after primary total hip or knee arthroplasty.
methodsThis prospective cohort study included 304 patients (mean age: 65 years [range, 16-85), mean follow-up: 32 months (range, 12-49)] who underwent primary total hip or knee arthroplasty between 2018 and 2021. Of them, 156 patients had diabetes. Mean HbA1c was 6.5% (range, 4.8%-13%), fructosamine 244 µmol/L (range, 98-566 µmol/L), and AlbF 632 (range, 238-2308). Patients who did and did not have diabetes were matched 1 : 1. Hemoglobin A1c 7% and fructosamine 292 µmol/L were used as cutoff. Complications were documented. Glycemic markers were compared using logistic regression analyses, with a special focus on PJI.
resultsIn the logistic regression analyses, HbA1c was strongly associated with total complications [adjusted odds ratio (OR): 3.61; 95% CI, 1.65-7.91, P = .001], while fructosamine was associated with PJI (adjusted OR: 13.68; 95% CI, 1.39-134.89, P = .025). Albumin-corrected fructosamine did not show any additional benefits.
conclusionPreoperative assessment before total hip or knee arthroplasty must not focus on a single marker; HbA1c is a good predictor of total complications, while fructosamine is a better predictor of PJI. To the best of our knowledge, in its first orthopedic study, AlbF did not show any advantages. LEVEL OF EVIDENCE: Level II, Prognostic Study.
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