The course of the early recovery period after total arthroplasty in patients with diabetes

Abstract

More than 20% of patients undergoing total joint arthroplasty (TJA) have diabetes mellitus (DM), which is one of the risk factors for complications in the postoperative period. The aim: to determine the peculiarities of the course of the postoperative period in patients with diabetes after TJA, in particular, after hip and knee arthroplasty (HKA). Materials and methods. A retrospective analysis of the inpatient charts of 50 patients who underwent HKA operations against the background of concomitant DM was performed. All patients were divided into two groups: 1) patients with hip arthroplasty, 2) patients with knee arthroplasty. The course of the intraoperative and postoperative (p/o) periods and the development of complications were analyzed. The results. All patients were aged from 38 to 86 years, had increased weight (BMI — 26.0-29.42 kg/m). Among the complications, arterial hypertension was most often observed (in groups 64.0% and 68.0%, respectively), nausea and vomiting were often observed (32.0% and 28.0%, respectively), disturbances in the rhythm and depth of breathing (16.0% and 20.0% respectively). The need for analgesia in the p/o period was 96.0% and 100.0% of patients, which indicates insufficient quality of analgesia. Other clinical and anamnestic indicators, the course of the perioperative period and the development of complications were similar in patients undergoing both hip and knee replacement surgeries (p>0.05). Conclusions. Clinical and anamnestic data, the spectrum of existing concomitant pathology, characteristics of carbohydrate metabolism and its disorders, features of the course of the perioperative period and detected complications were of the same type in patients regardless of the location of the intervention. There was no significant difference in the studied parameters (p>0.05). Identified complications and insufficient effectiveness of p/o analgesia dictates the need to find optimal methods of perioperative analgesia during HKA operations.