Aaos: Diabetes Complicates Recovery After Joint Replacement Or Revision
SAN FRANCISCO, March 10 -- Diabetes may signal a rocky recovery from hip and knee arthroplasty by increasing perioperative complications, researchers found in an analysis of hundreds of thousands of procedures. Arthroplasty patients with diabetes, particularly those with type 1 disease, were at a significantly elevated risk of systemic and surgical events during their hospital stay, reported Milford H. Marchant, Jr., M.D., of Duke University, and colleagues at the American Academy of Orthopaedic Surgeons meeting here. These findings from the large National Inpatient Survey database support those of prior case series, Dr. Marchant said. "We need to identify the risk factors to patients so that they know they are at higher risk for complications," he said. Among the more than seven million inpatient stays at 1,000 hospitals regardless of patients' insurance status included in the database, 751,340 patients had a primary or revision hip or knee arthroplasty from 1988 through 2003. Overall, 64,262 of these patients (8.55%) had diabetes. Diabetic patients were at increased risk of systemic and surgical perioperative complications. Hip-replacement patients who had diabetes were more likely than those without diabetes to have: Inpatient mortality (0.50% versus 0.46%, P<0.001). Stroke (0.32% versus 0.15%, P<0.001). Pneumonia (0.68% versus 0.35%, P<0.001). Urinary tract infection (4.15% versus 2.93%, P<0.001). Ileus (1.11% versus 0.84%, P<0.001). Altered mental status (0.02% versus 0.00%, P=0.026). Transfusion (23.06% versus 18.89%, P<0.001). Sciatic nerve injury (0.09% versus 0.05%, P=0.031). Non-routine discharge (P<0.001). Higher inflation-adjusted hospital charges (mean $32,314 versus $30,589, P<0.001). Hip-arthroplasty revision among diabetic patients was also more frequent Continue reading >>
Diabetes And Joint Replacement Surgery 101
If you’re living with diabetes, you know better than anyone that your rulebook for general health is different than most. To add another layer to your health management puzzle, chances are you’ve found this post because you’re a diabetic preparing for a hip replacement or knee replacement or are trying to decide when the right time for a joint replacement is. With this, know that joint replacement surgery is one of the most successful procedures in all of modern medicine and that you have the power to further reduce your risk factors. What you do in the weeks leading up to your hip replacement or knee replacement will have a huge impact on your surgery results and recovery time. This is especially true for those with pre-existing conditions like diabetes. Taking action before surgery in a results-driven program is called “PreHab”. Read on as we talk about how diabetes can affect joint replacement surgery, examine surgical complications for those with diabetes, and offer some prehab diet suggestions to optimize your health before due day. How Can My Diabetes Affect Joint Replacement Surgery? Diabetes (especially when uncontrolled or paired with a related disease) greatly affects recovery time from joint replacement surgery. Those with diabetes are at a greater risk for infection, slower wound and incision repair, as well as a laundry list of secondary complications. Uncontrolled Diabetes: Blood sugar levels that are too high (240 and over or consistently outside of optimal zone) is often due to improper diet, lack of exercise, inconsistent medication use and other factors. The risks associated with uncontrolled diabetes include: heart disease, kidney disease, eye damage, neuropathy, amputations, dental issues and more. Controlled Diabetes: Blood sugar levels ma Continue reading >>
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Does Diabetes Raise Knee Replacement Risks?
Research is mixed on how diabetes affects surgery results. When arthritis makes it too painful to walk or climb stairs, a knee replacement could be the solution to help you get around more comfortably again. Yet this surgery, like any other procedure, comes with risks that may be even more pronounced if you have diabetes. The issue is an important one, considering that about half of people with diabetes also have arthritis, and many may eventually need a new knee or two. Possible Diabetes-related Surgery Complications: Two studies published in the Bone and Joint Journal in 2014 and 2009 — from Sichuan University in China and Duke University in North Carolina have suggested that people with diabetes face a significantly higher risk of postsurgical complications such as wound infection, stroke, deep vein thrombosis (blood clot), fracture around the implant, and joint loosening, particularly when their diabetes isn’t well controlled. High blood sugar, the hallmark of diabetes, is thought to cause surgical complications through its adverse effects on many organs and processes in the body. However, a 2013 study published in The Journal of Bone & Joint Surgery failed to find any association between diabetes and negative surgical outcomes. In that study, researchers retrospectively reviewed the electronic health records of more than 40,000 Kaiser Permanente patients who had a knee replacement. The investigators looked at three main surgical outcomes: deep infection, blood clots in the legs or lungs, and revision surgery (an operation to replace a failed knee implant). They compared outcomes in people with controlled and uncontrolled diabetes. After adjusting for age, sex, weight and other health problems, the researchers saw no differences in outcomes in patients with cont Continue reading >>
Diabetes Doesn't Seem To Raise Risks After Knee Replacement
WEDNESDAY, Feb. 27 (HealthDay News) -- People with diabetes who undergo knee replacement surgery are not at greater risk for infection, deep vein thrombosis (a type of blood clot), or other complications following the procedure than people without diabetes, new study findings indicate. "This current study suggests that patients with diabetes who have higher glucose [blood sugar] levels may not be at greater risk of poor surgical outcomes," explained study author Annette Adams, of the Kaiser Permanente Southern California Department of Research and Evaluation. "There appear to be other factors at play, and patients and their providers need to consider multiple factors, including but not limited to diabetes status, as they make decisions about whether to have this surgery," she added in a news release from the American Academy of Orthopaedic Surgeons. For the study, the researchers examined the records of more than 40,000 patients who had a total knee replacement between 2001 and 2009. Of these patients, 12.5 percent had controlled diabetes and 6.2 percent had uncontrolled diabetes. The investigators found that 1.1 percent of these patients had revision surgery and 0.7 percent developed a deep infection. There was no significant increase in the risk for complications after total knee replacement for patients with controlled or uncontrolled diabetes, compared to those who did not have the disease, the study authors found. Rates of complications, such as deep infection, deep vein thrombosis and pulmonary embolism (when a blood clot reaches the lungs) were similar in those with diabetes and those who did not have the condition, according to the report released online and published in the March print edition of the Journal of Bone and Joint Surgery. The researchers noted, how Continue reading >>
Hip Replacement Helps Heart, Depression, Diabetes
Everyday Health Senior Health Senior Health Hip Replacement Can Help Heart, Depression, and Diabetes Patients who undergo total hip replacement face lower risks of heart failure, depression, and diabetes, according to a new study presented at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons. THURSDAY, March 21, 2013 Replacing a hip may do more for people than help with mobility, according to new researchit can also lower risk of heart failure, depression, and diabetes. Researchers presented their findings at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons, saying the benefits of total hip replacements make it the clear choice for treating osteoarthritis of the hip when other treatment has failed. Researchers from Exponent, Inc., an engineering and consulting firm that does medical research, looked at 24,000 patients with osteoarthritis of the hip over seven years, and divided them into two groups: those who had a total hip replacement and those who did not. Not only did the patients who underwent total hip replacement have a 52 percent lower mortality risk after seven years, researchers found they also had a 40 percent lower risk of diabetes and a 31 percent lower risk of depression. The consistently reduced risk of mortality, heart failure, and diabetes suggests that increased activity after [total hip replacement] may have a beneficial effect in reducing long term disease and death, the study authors, led by Exponent researcher Scott Lovald, PhD, wrote in their report. The researchers attributed the decreased disease risk to the increased mobility and pain relief that comes with a total hip replacement. Pain relief and restored function can have a positive effect on a patients overall health, the researchers wrote in the Continue reading >>
Is Hip Replacement Surgery Safe For My Heart If I Have Diabetes?
Is hip replacement surgery safe for my heart if I have diabetes? While people with diabetes have a generally higher risk of cardiac problems than those without this condition, the increase in risk for cardiac complications with major surgery is quite lowand there may be no increase at all with good care. People with diabetes have higher rates of atherosclerosis, of course, and if you've already had a heart attack or kidney problems, those risk factors do increase your risk of heart problems with surgery. But after taking those factors into account, diabetes is not clearly linked to short-term complications with surgery. Major orthopedic surgery procedures such as hip replacement have a pretty low rate of major cardiac complications when performed by experienced teams at good hospitals. In short, good care can mitigate whatever increased risk of complications that your diabetes may carry. If you are having considerable pain from your hip, such as pain at rest, then I would strongly consider moving ahead with the surgery. Continue reading >>
Total Hip Replacement
A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a "cup-shaped" component of the pelvis called the acetabulum. The ball is the head of the thighbone (femur). Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal (or ceramic) ball and stem inserted into the femur bone and an artificial plastic (or ceramic) cup socket. The metallic artificial ball and stem are referred to as the "femoral prosthesis" and the plastic cup socket is the "acetabular prosthesis." Upon inserting the prosthesis into the central core of the femur, it is fixed with a bony cement called methylmethacrylate. Alternatively, a "cementless" prosthesis is used that has microscopic pores which allow bony ingrowth from the normal femur into the prosthesis stem. This "cementless" hip is felt to have a longer duration and is considered especially for younger patients. Total hip replacement is also referred to as total hip arthroplasty. Who is a candidate for total hip replacement? Total hip replacements are performed most commonly because of progressively worsening of severe arthritis in the hip joint. The most common type of arthritis leading to total hip replacement is degenerative arthritis ( osteoarthritis ) of the hip joint. This type of arthritis is generally seen with aging , congenital abnormality of the hip joint, or prior trauma to the hip joint. Other conditions leading to total hip replacement include bony fractures of the hip joint, rheumatoid arthritis , and death ( aseptic necrosis , or avascular necrosis ) of the hip bone. Hip bone necrosis can be caused by fractu Continue reading >>
Diabetes Mellitus And The Risk Of Total Knee Replacement Among Chinese In Singapore, The Singapore Chinese Health Study
Association between diabetes mellitus (diabetes) and risk of knee osteoarthritis (KOA) is confounded by high body mass index (BMI), a strong risk factor for both conditions. We evaluated the association between diabetes and incidence of total knee replacement (TKR) due to severe KOA in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese men and women, aged 45–74 years at recruitment in 1993–1998, and re-interviewed in 1999–2004. Height, weight, lifestyle factors and history of diabetes were obtained through in-person interviews at recruitment and re-interview. Incident cases of TKR were identified via record linkage with nationwide hospital discharge database. Subjects with/without prevalent diabetes had comparable BMI (24.0 kg/m2 versus 23.0 kg/m2). After an average of 14-years, 1,973 subjects had TKR attributable to KOA. Compared to subjects without diabetes, hazard ratio (HR) of TKR for subjects with diabetes was 0.63 [95% confidence interval (CI), 0.52–0.75] after controlling for BMI and other risk factors. An inverse association was also observed between incident diabetes at re-interview and subsequent risk of TKR (HR = 0.74; 95% CI = 0.58–0.94). The inverse diabetes-TKR risk association was similar by gender and across three categories of BMI. Our study does not support diabetes as a risk factor of KOA. Knee osteoarthritis (KOA) is among the leading causes of disability, imposing a heavy burden on individuals and population health globally1,2. Apart from age, KOA is often attributed to the biomechanical stress caused by weight-loading from obesity3,4. In a previous study, we have demonstrated a positive, log-linear relationship between body mass index (BMI) and risk of total knee replacement (TKR) for severe KOA over a wide range o Continue reading >>
Hip Replacement | Diabetes Forum The Global Diabetes Community
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I have joined as my Mum has just been diagnosed with Type 2 Diabetes. She is due to have a hip replacement operation - will the fact she has diabetes affect this at all?? I am sure I will have many more questions for you over the coming weeks. Hi Helen,welcome to the forum.Is you Mum on diabetic medication? The chances are that the operation will upset her blood sugar levels a bit but the hospital staff will be aware of this and keep an eye on it.If she has good control over her blood sugar levels then healing etc will not be a problem.Please feel free to ask any more questions and good luck to your mother with her operation. I had a hip replacement in May 2004 - I wasn't diabetic at the time so I can't really help with how diabetes will affect her surgery. I have had other surgeries since being diagnosed (not sure whether I am T1 or T2 - probably T2 insulin dependent as my pancreas was damaged by long term use of high dose steroids for my bowel condition). The surgeries were for bowel blockages and I must admit it was hard as I had to go on a "sliding scale" for the diabetes and it took quite a while to get off it again as, because it was bowel surgery, I was unable to eat for 5 days after surgery. The one thing I can say is that, at the time, the hip replacement revolutionised my life. I was able to walk without sticks or crutches and able to walk without a limp. I had a very skilled surgeon and the surgery was performed at the National Hospital for Orthopaedic Surgery. Sadly, because of other medical conditions, I am not very mobile at all these days although at lease the pain of the arthritis is gone which is fantastic. I wish her every success wi Continue reading >>
Diabetes And Hip Replacements??
Home Forums > Hip Replacement > Hip Replacement Pre-Op Area > ATTENTION: Download the new BoneSmart app today! This FREE app is available for iOS or android phones and tablets and will allow you to connect to the forum on all of your devices. The old Tapatalk app is being discontinued so get the new app now. Hello everyone. I am new here. This is my first post. I am 50, female, diabetic, and need both hips replaced. I am very immobile. That concerns me. I am also diabetic. Its not totally under control but my endocrinologist didnt seems overly concerned. Neither did the orthopedic surgeon. I am scared to death of post op complications of all kinds. Are there others here who are diabetic and had their hip replaced? Any and all info is very much appreciated. Is anyone out there that has diabetes and recovering from hip replacement? Has it caused problems for your recovery? Josephine FORUM ADMIN, DIRECTOR Administrator Absolutely not in any way, shape or form. I've nursed scores of diabetic patients for all kinds of surgery. If the blood sugars are a bit unstable, we'd put them on a short term insulin drip but nothing more than that. BTW, you don't need to post in both the pre-op and recovery forums. All the hippie members go in both. Welcome to the BoneSmart family Donna, great to have you join us. I am going to tag our resident ex Orthopaedic OR Nurse (who has over 50 years experience). @ Josephine : I am sure given that your Endocrinologist and OS do not have concerns that they will have all contingencies relating to your diabetes in hand and thought through carefully for your pre op and post op care. I know it is scary, but I am sure Jo will come with the best advice for you. I notice that you have posted on the post op side, I understand why, but the Mods may decide Continue reading >>
Diabetes Complicates Postsurgical Recovery, But Study Suggests Method To Identify Those At Risk
For years, physicians have struggled to predict the postsurgical recovery time of their patients—a variable with unknown causes. Gauging the period of recovery gives patients a sense of how soon they may be up and about, returning to their normal lives and to work. A prolonged recovery time can have multiple consequences, including psychosocial ones for the patient and economic ones for society. For persons with diabetes, recovery from surgery is particularly complicated. Research has shown that insulin resistance could result from surgery, and its intensity could define the recovery period. These patients also face a greater risk of infection and wounds that do not heal, leading to other health problems and higher hospital costs. Patients who suffer these complications risk being readmitted to the hospital, which brings on the added costs. The need to identify which patients face this risk has never been greater, as the Affordable Care Act (ACA) has brought new penalties for hospitals that see too many readmissions within 30 days of discharge. Now, a new study from Stanford University has opened up the potential for predictive gene signatures and the development of a diagnostic test that could foretell clinical recovery.1 Such a test could have enormous value when surgical patients have diabetes, for it could help hospitals stratify and target patients for enhanced care to prevent readmission. Traditional recovery parameters have included metrics such as length of hospital stay, while recent studies have focused on more patient-centered outcomes such as absence of symptoms, ability to perform regular activities, return to work, and quality of life. While there have been attempts to define the process of postoperative recovery, various stakeholders view the matter dif Continue reading >>
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Type 2 Diabetes And In-hospital Complications After Revision Of Total Hip And Knee Arthroplasty
Type 2 diabetes and in-hospital complications after revision of total hip and knee arthroplasty Ana Lpez-de-Andrs , Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing original draft, Writing review & editing,1 Valentn Hernndez-Barrera , Data curation, Formal analysis, Investigation, Methodology, Software, Supervision, Validation, Writing review & editing,1 Maria A. Martnez-Huedo , Formal analysis, Investigation, Methodology, Visualization, Writing review & editing,2 Manuel Villanueva-Martinez , Formal analysis, Investigation, Methodology, Visualization, Writing review & editing,3 Isabel Jimnez-Trujillo , Formal analysis, Investigation, Methodology, Visualization, Writing review & editing,1 and Rodrigo Jimnez-Garca , Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing original draft, Writing review & editing1,* 1 Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology, Nursing and Oral Medicine Department. Universidad Rey Juan Carlos. Alcorcn. Comunidad de Madrid. Spain 1 Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology, Nursing and Oral Medicine Department. Universidad Rey Juan Carlos. Alcorcn. Comunidad de Madrid. Spain Find articles by Valentn Hernndez-Barrera 3 Unit of Revision Hip and Knee Arthroplasty. Unidad de Recambios Protsicos. Hospital Beata Mara. Madrid. Spain Find articles by Manuel Villanueva-Martinez 1 Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology, Nursing Continue reading >>
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- Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies
Type-ii Diabetes: Challenges For The Aged And Diabetics Considering Total Joint-replacement (tkr And Thr).
Donald. F. Du Toit: PHD, FCS, MBCHB, FRCS, DPHIL (OXON). Emeritus, Division of Biomedical Sciences and Anatomy, University of Stellenbosch. Former Medical Neuroanatomy University Lecturer, and Senior Research Scientist, Diabetes Discovery Platform, MRC, Parow, South Africa. First Human Pancreas Transplantation in Diabetes Mellitus, South Africa, DF du Toit et al: S. Afr Med J. 1988: June 18, 73 (12): 723-5. HouseHold Medical Manual, 1(2), 12 January, 1-10, 2017. Total knee and hip replacement is a reliable, modern evidence-based treatment modality to relieve joint-pain, disability, and improve mobility, caused by severe compromising, age-related osteoarthritis in patients, meeting surgical inclusion criteria and accepted indications. Definition 1: Aging [L. aetas lifetime]. the process of growing old, resulting in part from failure of body cells to function normally or to produce new body-cells to replace those that are dead or malfunctioning.(Ref: Mosbys Medical Dictionary. St. Louis.1990). Definition 2: Osteoarthritis [Gk osteon + artrhon joint; itis inflammation]. A form of arthritis in which one or many joints undergo degenerative changes, including subchrondal bony sclerosis, loss of articular cartilage, and proliferation of bone and cartilage in the joint.(Ref: Mosbys Medical Dictionary. St Louis. 1990). itis is a misnomer as the degenerative disorder is not classically associated with inflammation in the true pathological sense of the word, but the joint involvement does often clinically cause swelling overlying weight-bearing joints such as the knee and in adjacent soft-tissues, ligaments and tendons ( /). Definition 3: Diabetes mellitus, a complex disorder (genetically based, and autoimmune disease components) of carbohydrates fat and protein metabolism that i Continue reading >>
Diabetes And Total Hip Replacement
Arthritis Home > Diabetes and Total Hip Replacement There are many important things to know about total hip replacement and diabetes. For example, if you have diabetes and are planning on having this surgery, it is important that you know the signs of low blood sugar. These can include weakness, sweating, and feeling very thirsty. Following hip replacement, let your doctor know if you experience any of these symptoms. You may have to check your blood sugar more often. What You Need to Know About Diabetes and Total Hip Replacement As a diabetic, you probably know a lot about the signs and symptoms that go along with abnormal blood sugar levels. Possible indications include: Having infections that don't go away or don't get better After your hip replacement surgery , these symptoms may indicate a problem. For example, an infection at the incision site can make it difficult to control blood sugar and may require IV antibiotics to treat the infection. To help identify what is causing the symptoms, you may be asked to check your blood sugar more frequently. It is important to report any changes to your doctor as soon as possible so that the appropriate treatment can be started, if necessary. As a person with diabetes , your riskfor hip replacement complications are higher. Although still uncommon, it is more likely for you to have: A reaction to certain drugs used during the hip replacement surgery For these reasons, it is important for you to attend all scheduled follow-up appointments and return sooner if any of the previously mentioned symptoms or other unusual symptoms develop. Infections are a concern of hip replacement surgery, so your doctor will treat any suspected infections more aggressively because you have diabetes. Because of the risks involved with hip replace Continue reading >>
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- Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies
Bone And Joint Problems Associated With Diabetes
Bone and joint problems associated with diabetes If you have diabetes, you're at increased risk of various bone and joint disorders. Certain factors, such as nerve damage (diabetic neuropathy), arterial disease and obesity, may contribute to these problems but often the cause isn't clear. Learn more about various bone and joint disorders, including symptoms and treatment options. Charcot (shahr-KOH) joint, also called neuropathic arthropathy, occurs when a joint deteriorates because of nerve damage a common complication of diabetes. Charcot joint primarily affects the feet. You might have numbness and tingling or loss of sensation in the affected joints. They may become warm, red and swollen and become unstable or deformed. The involved joint may not be very painful despite its appearance. If detected early, progression of the disease can be slowed. Limiting weight-bearing activities and use of orthotic supports to the affected joint and surrounding structures can help. Diabetic hand syndrome, also called diabetic cheiroarthropathy, is a disorder in which the skin on the hands becomes waxy and thickened. Eventually finger movement is limited. What causes diabetic hand syndrome isn't known. It's most common in people who've had diabetes for a long time. You may be unable to fully extend your fingers or press your palms together flat. Better management of blood glucose levels and physical therapy can slow the progress of this condition, but the limited mobility may not be reversible. Osteoporosis is a disorder that causes bones to become weak and prone to fracture. People who have type 1 diabetes have an increased risk of osteoporosis. Osteoporosis rarely causes symptoms in the early stages. Eventually, when the disease is more advanced, you may experience loss of height Continue reading >>
- Joint Disorders Associated with Diabetes
- Is it possible to catch diabetes? It sounds absurd, but that's what a reputable new study suggests. And it may be that other 'lifestyle' diseases such as joint pain and even obesity are contagious, too
- Do Simvastatin Side Effects Include Diabetes and Joint Pain?
