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Diabetes does not influence the early outcome of total knee replacement: a prospective study assessing the Oxford knee score, short form 12, and patient satisfaction.
Knee. 2013 Dec; 20(6):437-41.KNEE

Abstract

BACKGROUND

There is conflicting evidence as to whether diabetes mellitus influences the functional outcome and patient satisfaction after a total knee replacement (TKR). The aim of this study was to assess the effect of diabetes upon the Oxford knee score (OKS), short form (SF)-12, and patient satisfaction after TKR.

METHODS

Prospective pre- and post-operative (one year) OKS and SF-12 scores for 2389 patients undergoing primary TKR were compiled, of which 275 (12%) patients suffered with diabetes. Patient satisfaction was assessed at one year.

RESULTS

Patients with diabetes were more likely to have a greater level of comorbidity (p<0.001), and a worse pre-operative OKS and SF-12 score (p<0.02), compared to those patients without diabetes. Diabetes was not a significant (p>0.41) independent predictor of post-operative OKS or the SF-12 physical score on multivariable analysis. Although, factors more prevalent within the diabetic cohort (heart disease, vascular disease, liver disease, anaemia, depression, back pain, worse pre-operative OKS and SF-12 score) were found to be independent predictors of post-operative OKS and SF-12 physical score. Interestingly, diabetes was associated with a significantly greater improvement in mental wellbeing (SF-12 mental component), which was confirmed on multivariable analysis. Patient satisfaction was not influenced by a concomitant diagnosis of diabetes (p=0.57).

CONCLUSION

The outcome of TKR as assessed by the OKS, SF-12, and overall patient satisfaction rates are not influenced by diabetes per se, although factors more prevalent within this population result in a worse post-operative outcome.

LEVEL OF EVIDENCE

prospective cohort study, level III.

Authors+Show Affiliations

Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK. Electronic address: nickclement@doctors.org.uk.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23993274

Citation

Clement, N D., et al. "Diabetes Does Not Influence the Early Outcome of Total Knee Replacement: a Prospective Study Assessing the Oxford Knee Score, Short Form 12, and Patient Satisfaction." The Knee, vol. 20, no. 6, 2013, pp. 437-41.
Clement ND, MacDonald D, Burnett R, et al. Diabetes does not influence the early outcome of total knee replacement: a prospective study assessing the Oxford knee score, short form 12, and patient satisfaction. Knee. 2013;20(6):437-41.
Clement, N. D., MacDonald, D., Burnett, R., & Breusch, S. J. (2013). Diabetes does not influence the early outcome of total knee replacement: a prospective study assessing the Oxford knee score, short form 12, and patient satisfaction. The Knee, 20(6), 437-41. https://doi.org/10.1016/j.knee.2013.07.009
Clement ND, et al. Diabetes Does Not Influence the Early Outcome of Total Knee Replacement: a Prospective Study Assessing the Oxford Knee Score, Short Form 12, and Patient Satisfaction. Knee. 2013;20(6):437-41. PubMed PMID: 23993274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes does not influence the early outcome of total knee replacement: a prospective study assessing the Oxford knee score, short form 12, and patient satisfaction. AU - Clement,N D, AU - MacDonald,D, AU - Burnett,R, AU - Breusch,S J, Y1 - 2013/08/02/ PY - 2013/01/21/received PY - 2013/07/16/revised PY - 2013/07/25/accepted PY - 2013/9/3/entrez PY - 2013/9/3/pubmed PY - 2014/8/13/medline KW - Diabetes mellitus KW - Outcome KW - Satisfaction KW - Total knee replacement SP - 437 EP - 41 JF - The Knee JO - Knee VL - 20 IS - 6 N2 - BACKGROUND: There is conflicting evidence as to whether diabetes mellitus influences the functional outcome and patient satisfaction after a total knee replacement (TKR). The aim of this study was to assess the effect of diabetes upon the Oxford knee score (OKS), short form (SF)-12, and patient satisfaction after TKR. METHODS: Prospective pre- and post-operative (one year) OKS and SF-12 scores for 2389 patients undergoing primary TKR were compiled, of which 275 (12%) patients suffered with diabetes. Patient satisfaction was assessed at one year. RESULTS: Patients with diabetes were more likely to have a greater level of comorbidity (p<0.001), and a worse pre-operative OKS and SF-12 score (p<0.02), compared to those patients without diabetes. Diabetes was not a significant (p>0.41) independent predictor of post-operative OKS or the SF-12 physical score on multivariable analysis. Although, factors more prevalent within the diabetic cohort (heart disease, vascular disease, liver disease, anaemia, depression, back pain, worse pre-operative OKS and SF-12 score) were found to be independent predictors of post-operative OKS and SF-12 physical score. Interestingly, diabetes was associated with a significantly greater improvement in mental wellbeing (SF-12 mental component), which was confirmed on multivariable analysis. Patient satisfaction was not influenced by a concomitant diagnosis of diabetes (p=0.57). CONCLUSION: The outcome of TKR as assessed by the OKS, SF-12, and overall patient satisfaction rates are not influenced by diabetes per se, although factors more prevalent within this population result in a worse post-operative outcome. LEVEL OF EVIDENCE: prospective cohort study, level III. SN - 1873-5800 UR - https://www.unboundmedicine.com/medline/citation/23993274/Diabetes_does_not_influence_the_early_outcome_of_total_knee_replacement:_a_prospective_study_assessing_the_Oxford_knee_score_short_form_12_and_patient_satisfaction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0968-0160(13)00126-9 DB - PRIME DP - Unbound Medicine ER -