Correlation Study Between Diabetes Mellitus,Abnormal Glucose Tolerance And Prosthetic Joint Infection After Artificial Joint Replacement

Background:Total joint arthroplasty(TJA)has been one of the most effective methods of treating advanced joint diseases.However,complications after TJA,especially prosthetic joint infection(PJI),usually lead to serious consequences.Diab etes patients and those patients with abnormal glucose tolerance have weak resistance to infection and poor ability to heal tissue,so infection tends to happen.Whether diabetes and abnormal glucose tolerance are related to PJI after TJA are still controversial in Chinese and foreign literature.Objective:To investigate the correlation between diabetes mellitus and the incidence of prosthetic joint infection(PJI)after artificial joint replacement.Methods:The clinical data of 1799 patients who underwent primary total hip and knee artificial joint replacement from January 2010 to March 2016 in our hospital were selected to conduct the retrospective cohort study.There were 361 diabetes patients were divided into the case group,the other 1438 non-diabetic patients were set as control group.Conditional logistic regressions were run to calculate the odds ratios(ORs)and the 95% confidence intervals(CIs).Results:The risk of PJI for diabetic patients was 1.83(95%CI: 1.01-3.32,P<0.05)times higher than that for non-diabetic patients.When the operation time exceeded 180 mins,the OR value was 3.2(95%CI: 1.2-8.7,P<0.05),significantly higher than that when the operation time was less than 180 mins.The risk was higher among the diabetic patients with bilateral artificial joint replacement(OR:7.2;95%CI: 1.2-43.6;P<0.05)than the patients with unilateral artificial joint replacement(O R = 1.9).Diabetic patients and patients with abnormal glucose tolerance took higher risks of PJI than patients with normal blood glucose by 7.5 times(95%CI:,1.4-38.7,P<0.05)and 5.8 times(95%CI:,1.1-31.6,P<0.05),respectively.Conclusion:Diabetes and abnormal glucose tolerance will statistically increase risks of PJI after artificial joint replacement.PJI is more likely to occur for diabetic patients with bilateral artificial joint replacement and patients with the operation time highe r than 180 mins.