Monday, February 22, 2021

Postoperative glucose control may lower risk of periprosthetic infection

 Is postoperative glucose variability associated with adverse outcomes following shoulder arthroplasty?

These authors investigated the association between postoperative glycemic variability and short-term complications for 1074 patients having total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA).

The mean patient age was 70 years, and 40% (!) of patients had a preoperative diagnosis of diabetes mellitus. 

A postoperative infection developed in 3 of 636 (0.5%) patients without diabetes compared with 9 of 424 (2.1%) patients with diabetes. Younger patient age and a preoperative diagnosis of diabetes mellitus showed statistically significant associations with postoperative infection. 

The first in-hospital glucose measurement beyond the reference tertile of 70-140 mg/dL showed a statistically significant association with postoperative infection,  whereas the second and third glucose measurements showed no association with postoperative infection.

The authors suggest that in-hospital glycemic control, as well as preoperative glycemic control and optimization, may be beneficial for reducing postoperative infections following shoulder arthroplasty.

Comment: Glycemic control before and immediately after shoulder arthroplasty may hold promise as modifiable risk factors for infection.

Interested readers should also view this related post When is a patient with diabetes safe for arthroplasty surgery?

Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).