Is Preoperative Diabetes Control Associated with Postoperative Complications?

Some orthopedic surgeons are focusing on preoperative glycemic control in diabetic patients scheduled for elective surgery; the premise is that patients with better glycemic control will have fewer complications. In this retrospective U.S. cohort study of 40,000 patients (19% with diabetes) who underwent total knee replacement, researchers examined complication rates as a function of preoperative glycemic control. The diabetes cohort was divided into those with glycosylated hemoglobin (HbA_1c) levels <7% within several months prior to surgery, and those with levels ≥7%.

Five outcomes were tracked during the first postoperative year — need for revision arthroplasty, deep infection, thromboembolism, myocardial infarction (MI), and all-cause reh…