Postoperative Impact of Diabetes, Chronic Kidney Disease, Hemodialysis, and Renal Transplant After Total Hip Arthroplasty

被引：31
作者：
Kildow, Beau J. [1 ]
Agaba, Perez [1 ]
Moore, Brian F. [1 ]
Hallows, Rhett K. [1 ]
Bolognesi, Michael P. [1 ]
Seyler, Thorsten M. [1 ]
机构：
[1] Duke Univ, Med Ctr, Div Orthopaed Surg, POB 3000, Durham, NC 27710 USA
来源：
JOURNAL OF ARTHROPLASTY | 2017年 / 32卷 / 09期
关键词：
total hip arthroplasty; diabetes; chronic kidney disease; hemodialysis; renal transplantation; TOTAL KNEE ARTHROPLASTY; CHRONIC DIALYSIS PATIENTS; TOTAL JOINT ARTHROPLASTY; UNITED-STATES; RISK-FACTORS; MORTALITY; COMPLICATIONS; REPLACEMENT; FAILURE; INFECTION;
D O I：
10.1016/j.arth.2017.01.018
中图分类号：
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];
学科分类号：
摘要：
Background: The prevalence of diabetes mellitus (DM), chronic kidney disease (CKD), hemodialysis (HD), and renal transplantation (RT) is increasing. This study assessed postoperative complications among diabetic patients with CKD, HD, or post-RT after total hip arthroplasty (THA). Methods: Four cohorts were created using a nationwide database: DM&THA, DM&CKD&THA, DM&HD&THA, and DM&RT&THA. Cohorts were matched to a control group by age and gender. Thirty-day medical complications and 90-day and 2-year surgical complications were evaluated. Results: All 30-day complications were higher in each cohort. Ninety-day and 2-year surgical complications in the DM&HD&THA cohort were increased compared to the DM&RT&THA cohort. Remarkably, no increased risk of periprosthetic joint infection, periprosthetic fracture, or revision was noted post-THA in the DM&RT&THA cohort. Conclusion: Diabetic patients with worsening kidney function are associated with increased post-THA complications. Postsurgical risks decline following RT. Diabetic patients with kidney failure may want to undergo RT prior to THA to optimize surgical outcomes. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码：S135 / +
页数：7
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