The Maximum Threshold Value for HbA1c in Diabetic Patients Undergoing Elective Total Knee Arthroplasty | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2024]

Author(s):

1. Dahui Shen: Department of Joint Surgery, Lianyungang Clinical College of Nanjing Medical University,Lianyungang,China

2. Shoukang Sun: Department of Joint Surgery, The Affiliated Lianyungang Hospital of Xuzhou Medical University,Lianyungang,China

3. Zhifang Mu: Department of Clinical Care, The First People s Hospital of Lianyungang,Lianyungang,China

4. Dong Yuefu: Department of Joint Surgery, Lianyungang Clinical College of Nanjing Medical University,Lianyungang,China

Abstract:

Objective: To establish an optimal preoperative HbA1c threshold that enhances surgical outcomes and minimises postoperative complications in diabetic patients undergoing elective total knee arthroplasty (TKA). Study Design: Prospective cohort study. Place and Duration of the Study: Department of Orthopaedics, First People s Hospital of Lianyungang, China, from January 2021 to March 2024. Methodology: A total of 152 diabetic patients scheduled for elective TKA were included. Data on preoperative HbA1c levels were collected and analysed to assess their impact on postoperative outcomes using the Oxford Knee Score (OKS). Patients were divided into groups based on HbA1c levels and compared for functional and pain recovery one year postoperatively. Statistical analyses included binary and multivariate logistic regression, with an emphasis on the minimum clinically important di erence for OKS. Results: Patients with a preoperative HbA1c below 7.35mmol/L exhibited signi cantly better functional and pain recovery outcomes at one-year post-TKA. The receiver operating characteristic curve (ROC) analysis con rmed the predictive power of HbA1c, with an Area Under the Curve of 0.734 for functional improvement and 0.721 for pain improvement. Conclusion: The study identi es 7.35mmol/L as the optimal preoperative HbA1c threshold for diabetic patients undergoing elective TKA, with lower levels associated with improved functional and pain outcomes. Maintaining HbA1c below this level preoperatively can signi cantly enhance postoperative recovery and patient satisfaction.

Page(s): 1073-1078

DOI: 10.29271/jcpsp.2024.09.1073

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 34, Issue: 9, Year: 2024

Keywords:

Diabetes mellitus , Total knee arthroplasty , Diabetes mellitus , Haemoglobin A1C , Oxford knee score

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