Can Total Knee Replacement Surgery Be Affected by Diabetes?

Many patients who need total knee replacement surgery also suffer from diabetes.

total knee replacement surgery

The reason for this is that roughly half of the 30 million American adults living with diabetes also suffer from arthritis — and many may eventually need total knee replacement surgery.

Like any other surgical procedure, knee replacement or knee arthroplasty may pose additional risks for diabetics. However, research on how diabetes affects the outcome of surgery is mixed.

Post-Surgical Complications that May Be Related to Diabetes

A 2009 study from Duke University and another from China’s Sichuan University in 2014 both found that diabetics face a much greater chance of complications after knee arthroplasty — especially when blood sugar levels are not well-controlled.

According to this research, diabetes increases the risks of infection, joint loosening and fracture around the implant. In addition, the studies determined that strokes and deep vein thrombosis (DVT) are more common post-surgical complications in diabetic patients.

Diabetes May Not Be the Reason for Negative Surgical Outcomes

Though it seems counterintuitive, other researchers have come to pretty much the opposite conclusion.

In 2013, The Journal of Bone and Joint Surgery published a study of diabetics and total knee replacement surgical outcomes. After reviewing data from 40,000 patients, the researchers found no difference between the rates of complications in diabetics and those for people without diabetes.

This research also suggests that blood sugar control may not be crucial for successful knee arthroplasty. Patients with uncontrolled diabetes were no more likely to suffer a negative surgical outcome than those with well-controlled blood sugar.

In addition, experts suspect that obesity could be at least partly to blame for knee replacement complications in some diabetics. Heavier patients are more likely to suffer infection, DVT and less successful surgical outcomes, and obesity along with diabetes could increase the risk.

Diabetes Is Still a Concern for Knee Replacement Surgery

Clearly, further research is needed to determine exactly how diabetes and blood sugar control affect joint replacement results. Until scientists figure everything out, diabetics and their orthopedic surgeons should be mindful of the condition when planning a total knee arthroplasty procedure. Inflammation — both from the diabetes and after surgery — should also be considered, as increased inflammation may be related to diabetic complications.

No surgery is risk-free, particularly for diabetics. However, the likelihood of suffering a post-surgical complication after total knee arthroplasty is lower if your procedure is performed by a highly skilled joint reconstruction specialist. In northern Utah, Dr. Trevor Magee at Comprehensive Orthopedics & Sports Medicine is the go-to expert for total knee replacement surgery.

As a fellowship-trained, board-certified orthopedic surgeon with specialized expertise in minimally invasive MAKOplasty™ robot-assisted joint replacement, Dr. Magee has the skills and training to handle the challenges of knee arthroplasty in diabetics. If you have diabetes and are considering total knee replacement surgery, contact our Salt Lake City, Sandy or Park City office today to schedule a consultation.