Optimal time period for blood glucose level evaluation after total knee arthroplasty in patients without diabetes: a prospective, observational study

Journal of Orthopaedic Surgery and Research

Toshiro Otani¹  Noriyuki Aibara²  Shuji Aomatsu²  Ryo Sasaki²  Kenichiro Takeshima³  Masaki Nagashima³  Ken Ishii³ 

[1]Department of Orthopaedic Surgery, International University of Health and Welfare Ichikawa Hospital, 6-1-14, Konodai, 272-0827, Ichikawa City, Chiba, Japan

[2]Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, 108-8329, Minato-ku, Tokyo, Japan

[3]Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3, Kōzunomori, 286-8686, Narita City, Chiba, Japan

[4]Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, 108-8329, Minato-ku, Tokyo, Japan

[5]Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852, Hatakeda, 286-8520, Narita City, Chiba, Japan

关键词: Total knee arthroplasty;    Periprosthetic infection;    Blood glucose level;    Diabetes mellitus;   

DOI  :  10.1186/s13018-022-03023-6

来源: Springer

【 摘 要 】

BackgroundPostoperative hyperglycemia has been reported to be a risk factor for postoperative infection even in patients without diabetes mellitus (DM). However, there is no standard for how long blood glucose level (BGL) monitoring should be performed after total knee arthroplasty (TKA). The purpose of this study was to determine the optimal time period for BGL evaluation after TKA in patients without DM.MethodsThis prospective study included 132 knees of 110 patients who underwent TKA between March 2018 and July 2021 in our hospital. Fasting BGLs were measured preoperatively, at 9:00 PM on the day of surgery (DOS), and at 7:00 AM on postoperative days (PODs) 1, 2, and 3. Patients were divided into two groups with a preoperative hemoglobin A1c (HbA1c) cut-off value of 5.9%, and the BGLs on POD 1 were compared between the two groups.ResultsThe BGLs were significantly higher on the DOS, POD 1, and POD 2 than preoperative levels. The BGL was significantly higher on POD 1 than at any other time point. Patients with an HbA1c ≥ 5.9% had significantly higher BGLs than those with an HbA1c < 5.9% on POD 1.ConclusionsThe optimal time period for BGL evaluation after TKA in patients without DM was considered to be from postoperative to POD 2. Patients with an HbA1c ≥ 5.9% may require careful perioperative glycemic control.

【 授权许可】

CC BY