Ahmad Mohd Aliff, Ab Rahman Shaifuzain, Islam Md Asiful
Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
J Clin Med. 2022 Jun 28;11(13):3752. doi: 10.3390/jcm11133752.
Diabetes mellitus (DM) is a known risk factor for infection following total joint arthroplasty. This study looked at the prevalence and risk of infection in diabetic and non-diabetic patients who had primary total knee arthroplasty (TKA). PubMed, Scopus, Google Scholar, Web of Science, and Science Direct electronic databases were searched for studies published up to 21 April 2022. To compare the risk of infection between diabetic and non-diabetic subjects, a pooled prevalence, and a risk ratio (RR) with 95% confidence intervals (CIs) were used. This research has been registered with PROSPERO (CRD42021244391). There were 119,244 participants from 18 studies, with a total of 120,754 knees (25,798 diabetic and 94,956 non-diabetic). We discovered that the risks of infection in diabetic patients were 1.84 times significantly higher than in non-diabetic patients. Infection was more common in diabetic patients (1.9%) than in non-diabetic patients (1.2%). In a subgroup analysis, the risks of developing deep surgical site infection (SSI) were 1.96 times higher in diabetic patients, but no significant difference when compared in superficial SSI. Prevalence of deep SSI was higher in diabetic (1.5%) than in non-diabetic (0.7%), but the prevalence of superficial SSI was lower in diabetic (1.4%) than in non-diabetic (2.1%). Consistent with previous research, we found diabetes is a risk factor for infection following primary TKA. However, the risk is much lower than previously published data, indicating that other factors play a larger role in infection.
糖尿病（DM）是全关节置换术后感染的已知风险因素。本研究观察了接受初次全膝关节置换术（TKA）的糖尿病患者和非糖尿病患者的感染患病率及风险。检索了PubMed、Scopus、谷歌学术、科学网和科学Direct电子数据库中截至2022年4月21日发表的研究。为比较糖尿病患者和非糖尿病患者之间的感染风险，采用了合并患病率以及95%置信区间（CI）的风险比（RR）。本研究已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42021244391）。18项研究中有119244名参与者，共120754个膝关节（25798个糖尿病患者的膝关节和94956个非糖尿病患者的膝关节）。我们发现，糖尿病患者的感染风险比非糖尿病患者显著高1.84倍。糖尿病患者的感染情况比非糖尿病患者更常见（1.9%对1.2%）。在亚组分析中，糖尿病患者发生深部手术部位感染（SSI）的风险高1.96倍，但在浅表SSI方面比较时无显著差异。糖尿病患者深部SSI的患病率高于非糖尿病患者（1.5%对0.7%），但糖尿病患者浅表SSI的患病率低于非糖尿病患者（1.4%对2.1%）。与先前的研究一致，我们发现糖尿病是初次TKA术后感染的一个风险因素。然而，该风险远低于先前公布的数据，这表明其他因素在感染中起更大作用。
