Анализ результатов эндопротезирования коленного сустава у пациентов, страдающих сахарным диабетом 2 типа

Abstract

A comparative assessment of knee joint alloplasty (KJA) results in patients with gonarthrosis with and without concomitant pathology of type 2 diabetes mellitus (DM 2) was carried out. The data of 104 patients were analyzed, who underwent prosthetics of the knee joints in 2003-2020 at the Center for Traumatology and Orthopedics at the Semashko Russian Railways Hospital (mean age 65,2 (10,5) years, mean observation period — 14 years, from 4 to 17 years). Primary total knee arthroplasty was performed with cement prostheses manufactured by Biomet (Aigisi, Avangard) and Eskulap. The patients were divided into 2 groups: group 1 - 56 patients without signs of DM, group 2 — 48 patients with DM. Comparison of the characteristics of patients without diabetes and with DM2 who underwent KJA showed that there were no signifcant differences in the incidence of intraoperative complications; patients with DM2 had slightly longer inpatient treatment and frequency of postoperative complications. Analysis of the clinical and functional state using the Knee Society Score indicated that in patients without diabetes the dynamics of improvement in the functional status of the knee joint was slightly more pronounced, and after 1 year there were statistically signifcant differences in terms of this scale. Evaluation of long¬term complications over a long observation period showed that the absolute majority of patients in both groups had no complications; however, in the group of patients with diabetes, the proportion of patients without complications was slightly lower than among patients without DM: 25,0 and 5,4% respectively. It was concluded that, during the decision-making on arthroplasty, surgical risk should be assessed for patients with diabetes, taking into account possible complications and the presence of other associated diseases. One of the main goals of the preoperative preparation of the considered patient category should be the stabilization of the blood plasma glucose level.