How Obesity, Diabetes, and Infection Interact After Total Joint Replacement

Some orthopedists insist that patients with diabetes have tight glycemic control before they undergo total hip or knee replacement, presumably to prevent postoperative infection. To examine the interplay between diabetes and obesity as risk factors for periprosthetic joint infection, Finnish researchers analyzed a single-center database of 7181 primary hip or knee replacement operations. Both deep incisional infections and joint (or joint space) infections that occurred during the first postoperative year were counted.

The overall incidence of infection was 0.7% (52 cases). After multivariate analysis with adjustment for diabetes, body-mass index (BMI), and several other variables, periprosthetic infection was associated significantly with b…