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全肩关节置换术后,糖尿病患者与非糖尿病患者的并发症及翻修率相似。

Complications and revision rates after total shoulder arthroplasty are similar between patients with and without diabetes mellitus.

作者信息

Sanii Ryan, Kasto Johnny, Castle Joshua P, Jay Jordan, Burdick Gabriel, Muh Stephanie J

机构信息

Henry Ford Health, Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI, USA.

出版信息

Shoulder Elbow. 2024 Sep 25:17585732241278207. doi: 10.1177/17585732241278207.

Abstract

PURPOSE

There is wide variability in the conclusions of studies examining the effects of diabetes mellitus (DM) on outcomes of shoulder arthroplasty (SA). The objective of this study was to determine if there are differences in complication profiles between patients with DM and those without undergoing anatomic and reverse total SA.

METHODS

A retrospective review of patients undergoing SA in a single center from January 2014 to December 2019 was performed. Patients were then stratified into two cohorts, patients with controlled DM (mean hemoglobin A1C < 7%) and those without. Outcomes analyzed included intraoperative complications, postoperative complications, and revision surgery rates. Emergency department (ED) visits and hospital readmissions within 30 days were also recorded.

RESULTS

A total of 595 patients underwent SA. No significant difference was found between the diabetes ( = 151) and control group ( = 444) with regard to length of stay ( = .168), complications ( = .286), infection rate ( = .977), 30-day ED visits ( = .789), and readmissions ( = .230). The average time to revision was 26.8 months in the diabetes group and 26.6 months in the control group ( = .989).

CONCLUSIONS

Following SA patients with controlled DM showed no increased risk of postoperative infection, ED visitation,hospital readmission, and revision surgery rate when compared to non-diabetics.

LEVEL OF EVIDENCE

Level III-retrospective cohort.

摘要

目的

在研究糖尿病(DM)对肩关节置换术(SA)结局的影响时,研究结论存在很大差异。本研究的目的是确定DM患者与未接受解剖型和反向全肩关节置换术的患者在并发症情况上是否存在差异。

方法

对2014年1月至2019年12月在单一中心接受肩关节置换术的患者进行回顾性研究。然后将患者分为两组,即糖尿病控制良好组(平均糖化血红蛋白A1C<7%)和非糖尿病组。分析的结局包括术中并发症、术后并发症和翻修手术率。还记录了30天内的急诊科就诊情况和再次入院情况。

结果

共有595例患者接受了肩关节置换术。糖尿病组(n = 151)和对照组(n = 444)在住院时间(P = 0.168)、并发症(P = 0.286)、感染率(P = 0.977)、30天内急诊科就诊情况(P = 0.789)和再次入院情况(P = 0.230)方面均未发现显著差异。糖尿病组的平均翻修时间为26.8个月,对照组为26.6个月(P = 0.989)。

结论

与非糖尿病患者相比,糖尿病控制良好的患者在接受肩关节置换术后,术后感染、急诊科就诊、再次入院和翻修手术率的风险并未增加。

证据级别

三级——回顾性队列研究。

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