Total hip arthroplasty complications in patients with or without controlled diabetes mellitus during hospitalization

Abstract

IntroductionTotal hip arthroplasty (THA) is a procedure that aims to restore the function of the hip joint. Diabetes mellitus (DM) is one of the most prevalent comorbidities among patients undergoing THA. DM involves various immunological and metabolic aspects, which lead to limitations and surgical complications.ObjectiveTo evaluate the association between THA complications and controlled DM during hospitalization period.MethodsCross-sectional research through the analysis of retrospective records of a private hospital in Salvador, Bahia. The chi-squared and Fisher's exact tests were used in SAS statistical program.ResultsMost patients were elderly females. The most prevalent comorbidities in the sample were hypertension and diabetes. The most frequent underlying pathology in the sample was coxarthrosis; among patients with DM, it was femoral neck fracture. The most common complications were changes in the hemolymphopoietic system, among which anemia was the most frequent complication. Cardiovascular, nervous, and blood glucose complications were positively associated with controlled DM. In turn, hemolymphopoietic, genitourinary, digestive, electrolyte, and infectious complications were not associated with DM. Having DM was a protective factor for thermal complications. There was no statistically significant difference between patients that had or did not have DM in each complication group studied.ConclusionPatients with controlled DM did not present more complications than those without DM during hospitalization in the post THA.

Occurrence of late postoperative knee and hip arthroplasty postoperative complications / Ocorrência de complicações no pós-operatório tardio de artroplastia de joelho e quadril

“…We recorded a high incidence of complications in the late postoperative period of patients submitted to primary total knee and hip arthroplasty, which resulted in a high rate of readmission and the occurrence of one death. Although the incidence of complications is variable due to lack of standardization, international studies report rates ranging from 3 to 17% [10][11][12] , a value much lower than that found in our study (32.3%). However, developing countries tend to have a considerably higher incidence, which may justify this finding.…”

The Influence of Diabetes Mellitus on Patients Undergoing Primary Total Lower Extremity Arthroplasty: A Systematic Review and Meta-Analysis

“…The 23 identified articles described patients undergoing primary THA or TKA. Specifically, 4 studies [ 16 , 17 , 19 , 21 ] investigated single primary THA, 11 studies [ 14 , 15 , 18 , 28 – 35 ] investigated single primary TKA, and 8 studies [ 5 , 20 , 22 – 27 ] investigated both primary TKA and THA. The detailed characteristics of each study are shown in Table 1 .…”

“…The NOS score of the methodological quality for each study is shown in Table 2 . Among the 18 cohort studies, 13 studies [ 14 , 15 , 18 , 20 , 23 – 26 , 28 , 29 , 32 , 33 , 35 ] had largely high quality with scores above six, 4 studies [ 21 , 22 , 27 , 34 ] were of average quality with scores of six, and one study had a score of five points suggesting low quality. Of the five case-control studies, only one study [ 17 ] had a score of six, indicating average quality, while the other studies [ 16 , 19 , 30 , 31 ] had scores greater than six.…”

Artroplastia de quadril em idosos hospitalizados e o uso de antibioticoprofilaxia

“…Outros autores também encontraram prevalência de ITU no pré-operatório em, 10,8% de 83 pacientes. 18 Observou-se neste estudo que, a maioria das cirurgias foram eletivas, o que contribui para a diminuição de ocorrências de complicações relacionadas a procedimentos realizados em situações de urgência. A demora maior que A cefazolina foi o antibiótico de escolha para a maioria dos procedimentos cirúrgicos de prótese de quadril e foi utilizada em média por 65:52 horas (aproximadamente 3 dias).…”

“…Outros estudos encontraram taxas entre 3% a 5%. 18,20,21,24 E o microorganismo mais frequente o Staphylococcus aureus, entretanto esses estudos não avaliaram se os protocolos institucionais foram observados. 3,20 Neste estudo a taxa de infecção pós-operatória relacionada a cirurgias de prótese de quadril foi baixa, apesar de ter ocorrido inadequado cumprimento aos protocolos de antibióticoprofilaxia cirúrgica, porém deve-se considerar que não foi avaliada a dose de antibiótico administrada antes do inicio da cirurgia, devido a ausência de informação no prontuário.…”