INFLUENCE OF DIABETES MELLITUS ON OUTCOMES AFTER SHOULDER ARTHROPLASTY

Document Type

Conference Proceeding

Publication Date

9-1-2023

Publication Title

JSES International

Abstract

Background: The prevalence of type 2 diabetes mellitus (DM) in the United States is approximately 11% and increasing. Following joint replacement, diabetic patients have close to a threefold increase in risk for postoperative complications. However, there is a relative paucity of studies examining this association for total shoulder arthroplasty (TSA). This present study aimed to address this gap in knowledge by determining the differences in outcomes after TSA in patients with and without DM. Additionally, this study also aimed to determine whether a dose-response relationship exists between Hemoglobin A1c (HbA1c) and adverse or suboptimal outcomes after TSA. Methods: A total of 812 patients who underwent primary TSA (anatomic or reverse) between 2014 and 2019 were identified by querying the electronic medical record system at our institution. Patients with less than 1-year postoperative follow-up or incomplete outcomes data were excluded. Medical charts were reviewed to identify patients with a preoperative diagnosis of DM and to record the most recent HbA1c measurement prior to the date of surgery for all patients. Primary outcome measures were shoulder range of motion (ROM) and visual analog scale (VAS) pain scores. Secondary outcomes were emergency department (ED) and hospital readmission rates and peri- and postoperative complications. Results: A total of 595 patients were included in this study with 151 (25%) having a preoperative diagnosis of DM. Both the DM and non-DM groups experienced significant improvements in ROM and VAS score following surgery (p<0.05) and were not significantly different between the two groups. Our analysis also indicated that diabetics have no significant differences in length of stay, postoperative complications, infection rates, hospital readmissions, and all-case ED visitations, when compared to non-diabetic patients. Lastly, HbA1c did not significantly correlate with peri- or postoperative complications, improvement in VAS score or ROM, or readmission rates. Conclusions: Patients with DM benefited significantly from shoulder arthroplasty and achieved satisfactory pain relief and improvement in shoulder mobility. Furthermore, HbA1c does not seem correlate with increased risk of post-operative complications. Longer term follow up is needed.

Volume

7

Issue

5

First Page

1943

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