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Meta-Analysis
. 2020 Dec 15:2020:6661691.
doi: 10.1155/2020/6661691. eCollection 2020.

The Influence of Diabetes Mellitus on Patients Undergoing Primary Total Lower Extremity Arthroplasty: A Systematic Review and Meta-Analysis

Wanjin Qin  1 , Xiaoxiong Huang  1 , Huilin Yang  1 , Minjie Shen  1
Affiliations
Meta-Analysis

The Influence of Diabetes Mellitus on Patients Undergoing Primary Total Lower Extremity Arthroplasty: A Systematic Review and Meta-Analysis

Wanjin Qin et al. Biomed Res Int. .

Abstract

Background: Diabetes mellitus (DM) is a common disease that has an adverse impact on most orthopedic surgeries, and its prevalence has gradually increased in recent years. We aim to investigate the influence of DM on comorbidities and complications of patients undergoing primary total lower extremity arthroplasty.

Methods: PubMed, Embase, Cochrane Library, Medline, and Web of Science were systematically searched for relevant studies published before December 2019. Demographic data, comorbidities, and postoperative complications after primary total hip arthroplasties (THA) or primary total knee arthroplasties (TKA) were assessed between DM and non-DM patients. Meta-analysis was conducted using Review Manager 5.3, and forest plots were drawn for each variable.

Results: A total of 1,560,461 patients (215,916 patients with DM and 1,344,545 patients without DM) from 23 studies were included in this meta-analysis. The incidences of several preoperative comorbidities (hypertension (HTN), kidney disease, cardiac and cerebrovascular disease) were generally higher in patients with DM. Moreover, DM patients had a higher rate of postoperative complications (superficial and deep infection, deep vein thrombosis (DVT), and in-hospital mortality) compared to non-DM patients.

Conclusions: DM patients were more likely to suffer from comorbidities and had a higher risk of complications in total lower extremity arthroplasty compared to non-DM patients. It is necessary to identify DM and control hyperglycemia in the perioperative period to prevent postoperative complications in patients with DM.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart showing the process of the literature search.
Figure 2
Figure 2
Forest plot showing the differences of comorbidities between DM patients and non-DM patients. (a) HTN. (b) Cerebrovascular disease. (c) Cardiac disease. (d) Kidney disease.
Figure 3
Figure 3
Forest plots showing the differences of infection and in-hospital mortality between DM patients and non-DM patients. (a) Superficial infection. (b) Deep infection. (c) Mortality.
Figure 4
Figure 4
Forest plots showing the subgroup analysis of DVT.
Figure 5
Figure 5
Funnel plot based on the deep infection evaluating publication bias.
See this image and copyright information in PMC

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