Insulin Dependence Increases the Risk of Failure After Total Knee Arthroplasty in Morbidly Obese Patients

Chad D. Watts; Matthew T. Houdek; Eric R. Wagner; Matthew P. Abdel; Michael J. Taunton

doi:10.1016/j.arth.2015.08.026

Insulin Dependence Increases the Risk of Failure After Total Knee Arthroplasty in Morbidly Obese Patients

Chad D. Watts, Matthew T. Houdek, Eric R. Wagner, Matthew P. Abdel, Michael J. Taunton

Orthopedic Surgery

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

The aims of this study were to compare the outcomes between nondiabetic (n=1284), type II diabetic (n=530), and insulin-dependent type II diabetic (n=164) morbidly obese (body mass index ≥40kg/m²) patients undergoing primary total knee arthroplasty at 6-year follow-up. Patients with type II diabetes mellitus (DM) had similar outcomes when compared with non-DM patients. However, patients with insulin dependence had an increased risk of reoperation (hazard ratio [HR], 1.8; P=.005), revision (HR, 2; P=.02), and periprosthetic joint infection (HR, 2.1; P=.03), as well as decreased 10-year implant survivorship (84% vs 92%; P=.01) when compared to non-DM patients. Prospective studies should further evaluate outcomes and optimization measures within this population. Level of evidence: Level III-prognostic study.

Original language	English (US)
Pages (from-to)	256-259
Number of pages	4
Journal	Journal of Arthroplasty
Volume	31
Issue number	1
DOIs	https://doi.org/10.1016/j.arth.2015.08.026
State	Published - Jan 1 2016

Keywords

Complication
Diabetes
Insulin dependence
Morbid obesity
Total knee arthroplasty

ASJC Scopus subject areas

Orthopedics and Sports Medicine

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10.1016/j.arth.2015.08.026

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title = "Insulin Dependence Increases the Risk of Failure After Total Knee Arthroplasty in Morbidly Obese Patients",

abstract = "The aims of this study were to compare the outcomes between nondiabetic (n=1284), type II diabetic (n=530), and insulin-dependent type II diabetic (n=164) morbidly obese (body mass index ≥40kg/m2) patients undergoing primary total knee arthroplasty at 6-year follow-up. Patients with type II diabetes mellitus (DM) had similar outcomes when compared with non-DM patients. However, patients with insulin dependence had an increased risk of reoperation (hazard ratio [HR], 1.8; P=.005), revision (HR, 2; P=.02), and periprosthetic joint infection (HR, 2.1; P=.03), as well as decreased 10-year implant survivorship (84% vs 92%; P=.01) when compared to non-DM patients. Prospective studies should further evaluate outcomes and optimization measures within this population. Level of evidence: Level III-prognostic study.",

keywords = "Complication, Diabetes, Insulin dependence, Morbid obesity, Total knee arthroplasty",

author = "Watts, {Chad D.} and Houdek, {Matthew T.} and Wagner, {Eric R.} and Abdel, {Matthew P.} and Taunton, {Michael J.}",

note = "Funding Information: The institution of all authors has received funding from Zimmer (Warsaw, IN), Stryker (Mahwah, NJ), DePuy (Warsaw, IN), and Biomet (Warsaw, IN). One or more of the authors consults for DJO Orthopedics (MJT). Publisher Copyright: {\textcopyright} 2016 Elsevier Inc. Copyright: Copyright 2016 Elsevier B.V., All rights reserved.",

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AU - Taunton, Michael J.

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PY - 2016/1/1

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N2 - The aims of this study were to compare the outcomes between nondiabetic (n=1284), type II diabetic (n=530), and insulin-dependent type II diabetic (n=164) morbidly obese (body mass index ≥40kg/m2) patients undergoing primary total knee arthroplasty at 6-year follow-up. Patients with type II diabetes mellitus (DM) had similar outcomes when compared with non-DM patients. However, patients with insulin dependence had an increased risk of reoperation (hazard ratio [HR], 1.8; P=.005), revision (HR, 2; P=.02), and periprosthetic joint infection (HR, 2.1; P=.03), as well as decreased 10-year implant survivorship (84% vs 92%; P=.01) when compared to non-DM patients. Prospective studies should further evaluate outcomes and optimization measures within this population. Level of evidence: Level III-prognostic study.

AB - The aims of this study were to compare the outcomes between nondiabetic (n=1284), type II diabetic (n=530), and insulin-dependent type II diabetic (n=164) morbidly obese (body mass index ≥40kg/m2) patients undergoing primary total knee arthroplasty at 6-year follow-up. Patients with type II diabetes mellitus (DM) had similar outcomes when compared with non-DM patients. However, patients with insulin dependence had an increased risk of reoperation (hazard ratio [HR], 1.8; P=.005), revision (HR, 2; P=.02), and periprosthetic joint infection (HR, 2.1; P=.03), as well as decreased 10-year implant survivorship (84% vs 92%; P=.01) when compared to non-DM patients. Prospective studies should further evaluate outcomes and optimization measures within this population. Level of evidence: Level III-prognostic study.

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Insulin Dependence Increases the Risk of Failure After Total Knee Arthroplasty in Morbidly Obese Patients

Abstract

Keywords

ASJC Scopus subject areas

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