Power J Denise, Trifoi Flaviu, Canizares Mayilee, Perruccio Anthony V, Shanmugaraj Ajaykumar, Gandhi Rajiv, Davey J Roderick, Syed Khalid, Mahomed Nizar N, Veillette Christian, Rampersaud Y Raja
Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.
Arthritis Community Research and Epidemiology Unit (ACREU), Krembil Research Institute, Toronto, Ontario, Canada.
PLoS One. 2024 Apr 24;19(4):e0302315. doi: 10.1371/journal.pone.0302315. eCollection 2024.
To assess the impact of diabetes on physical and mental health status, as well as patient satisfaction, one-year following knee and hip total joint arthroplasty (TJA) for osteoarthritis (OA).
Participants were 626 hip and 754 knee TJA patients. Pre-surgery data were collected on socio-demographics and health status. The 12-item Short Form Health Survey (SF-12) was collected pre- and one year post-surgery, and physical (PCS) and mental component (MCS) summary scores computed. One-year patient satisfaction was also recorded. Four regression models tested the effect of diabetes on: 1) PCS change score; 2) MCS change score; 3) achieving minimal clinically important improvement (MCII) on PCS; and 4) patient satisfaction ('Somewhat or Very Satisfied' vs. 'Somewhat or Very Dissatisfied'). An interaction between surgical joint and diabetes was tested in each model.
Self-reported diabetes prevalence was 13.0% (95% CI: 11.2%-14.7%) and was more common in knee 16.1% (95% CI: 13.4%-18.7%) than hip 9.3% (95% CI: 7.0%-11.5%) patients. In adjusted analyses, change scores were 2.3 units less on the PCS for those with diabetes compared to those without (p = 0.005). Patients with diabetes were about half as likely to achieve MCII as patients without diabetes (p = 0.004). Diabetes was not significantly associated with satisfaction or changes in MCS scores. Diabetes effects did not differ by surgical joint.
Findings support that diabetes has a negative impact on improvements in physical health after TJA. Considering the growing prevalence of OA and diabetes in the population, our findings support the importance of perioperative screening and management of diabetes in patients undergoing TJA.
评估糖尿病对骨关节炎（OA）患者行膝关节和髋关节全关节置换术（TJA）一年后的身心健康状况以及患者满意度的影响。
参与者为626例髋关节TJA患者和754例膝关节TJA患者。收集术前社会人口统计学和健康状况数据。在术前和术后一年收集12项简短健康调查问卷（SF - 12），并计算身体（PCS）和心理成分（MCS）总结得分。还记录了患者一年后的满意度。四个回归模型测试了糖尿病对以下方面的影响：1）PCS变化得分；2）MCS变化得分；3）在PCS上达到最小临床重要改善（MCII）；4）患者满意度（“有点满意或非常满意”与“有点不满意或非常不满意”）。在每个模型中测试手术关节和糖尿病之间的相互作用。
自我报告的糖尿病患病率为13.0%（95%可信区间：11.2% - 14.7%），在膝关节患者中更为常见，为16.1%（95%可信区间：13.4% - 18.7%），高于髋关节患者的9.3%（95%可信区间：7.0% - 11.5%）。在调整分析中，与无糖尿病患者相比，糖尿病患者的PCS变化得分低2.3分（p = 0.005）。糖尿病患者达到MCII的可能性约为无糖尿病患者的一半（p = 0.004）。糖尿病与满意度或MCS得分变化无显著关联。糖尿病的影响在不同手术关节之间无差异。
研究结果支持糖尿病对TJA术后身体健康改善有负面影响。考虑到人群中OA和糖尿病患病率的不断上升，我们的研究结果支持对TJA患者进行围手术期糖尿病筛查和管理的重要性。
