Diabetes is a Risk Factor for Restricted Range of Motion and Poor Clinical Outcome After Total Knee Arthroplasty

Wada, Osamu; Nagai, Koutatsu; Hiyama, Yoshinori; Nitta, Shingo; Maruno, Hideto; Mizuno, Kiyonori

doi:10.1016/j.arth.2016.02.039

Cited by 31 publications

(28 citation statements)

References 26 publications

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“…The patients with diabetes have the increase in collagen cross-links and dense collagen production [12,13]. This characteristic in patients with diabetes results in a thickened capsule and scar tissue, which contributes to limited joint mobility [14]. The patients with diabetes also have the poor bone quality irrespective of the bone mineral density (BMD).…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiologic factors affecting functional outcomes after volar locking plate fixation of dorsal angulated distal radius fractures

Lee

Park

Kang

et al. 2016

Journal of Orthopaedic Science

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Section: Discussionmentioning

confidence: 99%

Clinical and radiologic factors affecting functional outcomes after volar locking plate fixation of dorsal angulated distal radius fractures

Lee

Park

Kang

et al. 2016

Journal of Orthopaedic Science

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“…Most notably a 20-year longitudinal cohort study of 927 individuals revealed that DM has an independent role in the pathogenesis and advancement of OA, controlling age, sex, and body mass index [9]. Additionally, diabetes increases the complications and revision rate of arthroplasty procedures [13]. Recently, the epidemiological association between OA and DM has been further confirmed in two independent meta-analyzes studies which showed stronger evidence is accumulating in favor of an independent contribution of DM to the development and progression of OA [14,15].…”

Section: Declined Trabecular Bone Mineralization In Dm-oa Groupmentioning

confidence: 99%

“…They also found that high glucose conditions favored production of oxidants and promoted matrix catabolism which would accelerate OA [27]. Nevertheless, the majority of researches are vitro experiment with the chondrocytes in a hyperglycemic environment, which still have a big gap from vivo study with the complicated and inherent characteristic [13]. There is an unfortunate paucity of quality research studies in animal models of DM relevant to OA [16].…”

Section: Declined Trabecular Bone Mineralization In Dm-oa Groupmentioning

confidence: 99%

Diabetes Mellitus Accelerates Progression of Osteoarthritis in Streptozotocin-induced Diabetic Mice by Deteriorating Bone Microarchitecture, Bone Mineral Composition and Bone Strength of Subchondral Bone

Wang

Giambini

Liu

et al. 2020

Preprint

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Background : The purpose of this study is to develop an optimal DM-OA mice model; to validate that diabetes aggravates OA; and to evaluate the microarchitecture, chemical composition and biomechanical properties of SB as a consequence of the damaged induced by diabetes OA. Methods: Mice were randomly divided into three groups: DM-OA group, OA group and Sham group. Blood glucose levels, body weight and food intake of all animals were recorded. A semi-quantitative grading system (OARSI) was used to evaluated cartilage and SB degeneration. Microspectroscopy, microindentations, micro‑CT imaging and fracture load of compression testing were also used to evaluated the properties of trabecular SB. Results: Glycemic monitoring and pancreas pathological results indicated stable high blood glucose and massive destruction of pancreas and islet cells in the DM-OA group. The mineral-to-collagen ratio, microindentation elastic modulus, hardness, micro-architectural parameters, bone mineral density and fracture load of SB trabecular bone of the DM-OA group joint was lower than other two groups. On the other hand, The OARSI score, trabecular spacing and structural model index of the DM-OA group joint was higher than the other two groups. Conclusions: The glycemic and pancreatic pathological results indicated the DM-OA model to be a simple and reliable model induced by STZ and surgery. The results showed the mechanisms in which diabetes accelerates OA by damaging and deteriorating the functions SB including microarchitecture, chemical composition and biomechanical properties.

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“…On the other hand, this study showed that there was little improvement in muscle strength of the involved limb. Obviously, diabetes mellitus is associated with decreased muscle strength and quality of life in older adults [20,21], and a recent study [22] confirmed that diabetes mellitus adversely affects the knee flexion ROM and the final functional outcomes after TKA surgery. Also, diabetic patients had worse muscle strength at all follow-up time points in this study, suggesting that clinicians such as orthopedic surgeons should pay more attention to muscle weakness in diabetic patients during their rehabilitation period after TKA surgery.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome Evaluation of Primary Total Knee Arthroplasty in Patients with Diabetes Mellitus

Liu

Xia

et al. 2017

Med Sci Monit

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BackgroundThe aim of this study was to evaluate the safety and clinical outcome of primary total knee arthroplasty in patients with diabetes mellitus.Material/MethodsAmong the patients who were treated with total knee arthroplasty, there were 98 patients (116 knees) associated with diabetes. Osteoarthritis was diagnosed in 90 patients and rheumatoid arthritis was diagnosed in 8 patients. Various degrees of preoperative knee deformities were found in 82 knees. The average fasting blood glucose was 9.8±3.6 mmol/L at admission.ResultsThe clinical efficacy of TKA was satisfactory in patients with diabetes mellitus. Diabetic patients do not seem to have a significantly higher risk for infection and DVT after TKA. At the final follow-up time point, no prosthesis loosening was found and no revision was needed in any patients. The mean HSS scores increased and the excellent rate was 100%.ConclusionsUsing perioperative comprehensive assessment of heart and lung function, and by preventing infection and the formation of DVT, we achieved satisfactory early clinical efficacy of TKA in patients with diabetes mellitus.

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Diabetes is a Risk Factor for Restricted Range of Motion and Poor Clinical Outcome After Total Knee Arthroplasty

Cited by 31 publications

References 26 publications

Clinical and radiologic factors affecting functional outcomes after volar locking plate fixation of dorsal angulated distal radius fractures

Clinical and radiologic factors affecting functional outcomes after volar locking plate fixation of dorsal angulated distal radius fractures

Diabetes Mellitus Accelerates Progression of Osteoarthritis in Streptozotocin-induced Diabetic Mice by Deteriorating Bone Microarchitecture, Bone Mineral Composition and Bone Strength of Subchondral Bone

Clinical Outcome Evaluation of Primary Total Knee Arthroplasty in Patients with Diabetes Mellitus

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