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. 2025 Apr 9;22(9):2132-2138.
doi: 10.7150/ijms.109689. eCollection 2025.

Reduced risk of diabetic retinopathy in osteoarthritis patients undergoing joint replacement surgery

Chin-Te Huang  1   2 , Yat-Yin Law  1   3 , Kai Wang  4   5   6 , Chia-Yi Lee  1   7 , Jing-Yang Huang  1   8 , Shun-Fa Yang  1   8 , Hsiang-Wen Chien  4   5   6   9
Affiliations

Reduced risk of diabetic retinopathy in osteoarthritis patients undergoing joint replacement surgery

Chin-Te Huang et al. Int J Med Sci. .

Abstract

Osteoarthritis (OA) is a progressive joint disorder frequently associated with multiple comorbidities. Emerging research suggests a potential link between OA and diabetic retinopathy, a microvascular complication of diabetes mellitus. This study investigates whether joint replacement surgery influences the risk of developing diabetic retinopathy in individuals with OA. Using data from the TriNetX database, we conducted a retrospective cohort study, categorizing OA patients into two groups based on whether they had undergone joint replacement surgery, with each group comprising 164,653 individuals. The primary outcome was the incidence of diabetic retinopathy, analyzed using Cox proportional hazards regression. Among patients who underwent joint replacement surgery, 844 developed diabetic retinopathy, compared to 1,336 cases in the non-surgery group. The incidence of diabetic retinopathy was significantly lower in the surgery group (P < 0.001). Additionally, cumulative incidence analysis confirmed a reduced risk in the surgery group (P < 0.001). Subgroup analyses further demonstrated a consistently lower risk across most demographic subgroups. In conclusion, our findings suggest that joint replacement surgery in OA patients is associated with a reduced risk of developing diabetic retinopathy. Further research is warranted to explore the underlying mechanisms and potential clinical implications.

Keywords: database, joint replacement surgery, diabetic retinopathy; epidemiology; osteoarthritis.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
The flowchart of participant selection. N: number, OA: osteoarthritis, PSM: propensity score-matching.
Figure 2
Figure 2
The Kaplan-Meier curve and cumulative incidence of diabetic retinopathy between the surgery and non-surgery groups.
Figure 3
Figure 3
Sensitive analysis of diabetic retinopathy risk in osteoarthritis. eGFR: estimated glomerular filtration rate, HbA1c: glycated hemoglobin, N: number.
See this image and copyright information in PMC

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