title: Perioperative hyperglycaemia and incidence of post-operative complications in patients undergoing total knee arthroplasty.
abstract: OBJECTIVE
  The aim of this study was to assess whether hyperglycaemia in the post-operative period of total knee arthroplasty (TKA) affects post-operative complications regardless of diabetes mellitus (DM) diagnosis.
  
  
  METHODS
  All patients who had undergone primary TKA were included in the study. The following data were recorded: DM diagnosis, and pre- (BGL1), intra- (BGL2) and post-operative blood glucose levels (BGL3). After 1-year follow-up, medical, infectious and mechanical or surgery-related complications were recorded.
  
  
  RESULTS
  Of the 833 patients included, 130 (15.6 %) were diabetic. Median BGL1, BGL2 and BGL3 were 106.13, 93.49 and 134.16 mg/dl, respectively. After follow-up, 173 (20.8 %) patients presented complications, including 48 (5.76 %) medical complications and 94 (11.28 %) infections. Surgery-related complications presented in 31 (3.72 %) patients. A statistically significant association was found between BGL3 ≥ 126 mg/dl and complications (OR 1.95, p < 0.001), medical complications (OR 3.98, p < 0.001), and infections (OR 1.76, p < 0.006).
  
  
  CONCLUSIONS
  Hyperglycaemia during the post-operative period in diabetic and non-diabetic patients undergoing TKA increases post-operative medical and infectious complications. Glycemic control during this period must be performed in order to reduce these complications.
  
  
  METHODS
  Retrospective case series, Level IV.
authors: Trauma and Orthopedics Department, Hospital Clinic, Barcelona, Spain, reategui@clinic.ub.es.
authors: Diego
authors: D
authors: Reátegui
authors: Gerard
authors: G
authors: Sanchez-Etayo
authors: Esther
authors: E
authors: Núñez
authors: Monserrat
authors: M
authors: Tió
authors: Dragos
authors: D
authors: Popescu
authors: Monserrat
authors: M
authors: Núñez
authors: Luis
authors: L
authors: Lozano
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D008297:Male; D059035:Perioperative Period; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies