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Perioperative hyperglycaemia and incidence of post-operative complications in patients undergoing total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to assess whether hyperglycaemia in the post-operative period of total knee arthroplasty (TKA) affects post-operative complications regardless of diabetes mellitus (DM) diagnosis.

Methods

All patients who had undergone primary TKA were included in the study. The following data were recorded: DM diagnosis, and pre- (BGL1), intra- (BGL2) and post-operative blood glucose levels (BGL3). After 1-year follow-up, medical, infectious and mechanical or surgery-related complications were recorded.

Results

Of the 833 patients included, 130 (15.6 %) were diabetic. Median BGL1, BGL2 and BGL3 were 106.13, 93.49 and 134.16 mg/dl, respectively. After follow-up, 173 (20.8 %) patients presented complications, including 48 (5.76 %) medical complications and 94 (11.28 %) infections. Surgery-related complications presented in 31 (3.72 %) patients. A statistically significant association was found between BGL3 ≥ 126 mg/dl and complications (OR 1.95, p < 0.001), medical complications (OR 3.98, p < 0.001), and infections (OR 1.76, p < 0.006).

Conclusions

Hyperglycaemia during the post-operative period in diabetic and non-diabetic patients undergoing TKA increases post-operative medical and infectious complications. Glycemic control during this period must be performed in order to reduce these complications.

Level of evidence

Retrospective case series, Level IV.

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Authors and Affiliations

  1. Trauma and Orthopedics Department, Hospital Clinic, Barcelona, Spain

    Diego Reátegui

  2. Anesthesiologic Department, Hospital Clinic, Barcelona, Spain

    Gerard Sanchez-Etayo & Monserrat Tió

  3. Institut Català de la Salut, Barcelona, Spain

    Esther Núñez

  4. Knee Unit, Trauma and Orthopedics Department, Hospital Clinic, Barcelona, Spain

    Dragos Popescu & Luis Lozano

  5. Reumathology Department, Hospital Clinic, Barcelona, Spain

    Monserrat Núñez

Authors
  1. Diego Reátegui
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  2. Gerard Sanchez-Etayo
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  3. Esther Núñez
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  4. Monserrat Tió
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  5. Dragos Popescu
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  6. Monserrat Núñez
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  7. Luis Lozano
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Correspondence to Diego Reátegui.

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Reátegui, D., Sanchez-Etayo, G., Núñez, E. et al. Perioperative hyperglycaemia and incidence of post-operative complications in patients undergoing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23, 2026–2031 (2015). https://doi.org/10.1007/s00167-014-2907-7

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  • DOI: https://doi.org/10.1007/s00167-014-2907-7

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