title: Outcomes of ACL Reconstruction in Patients with Diabetes.
abstract: Diabetes has been associated with adverse outcomes after various types of surgery. There are no previously published data regarding the effect of diabetes on outcomes from anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to test the hypotheses that diabetes is associated with worse clinical outcomes and a higher prevalence of subsequent surgeries after ACLR.
  
  
  
  Anterior cruciate ligament-deficient patients (n = 2198) undergoing unilateral ACLR from a multicenter prospective study were included. Patients who self-reported diabetes on the basis of comorbidity questions before surgery were identified from the database. They were compared with the remainder of the cohort who did not self-report diabetes. All patients were followed up for a minimum of 2 yr after their index surgery. A minimum 2-yr follow-up was attained on 1905/2198 (87%) via completed outcome questionnaires and 2096/2198 (95%) regarding subsequent surgery. The primary outcome measures were three validated outcome instruments. The secondary outcome measure was the incidence of additional surgery on the ipsilateral and contralateral knees.
  
  
  
  Patients with diabetes had a significantly higher activity level at 2 yr (OR = 2.96; 95% CI, 1.30-6.77; P = 0.01), but otherwise slightly worse clinical outcomes, compared with patients without diabetes (OR range = 0.42-0.59). The prevalence of subsequent surgeries in patients with diabetes was not significantly different from the prevalence in patients without diabetes.
  
  
  
  Patients with diabetes maintain a higher activity level after ACLR despite slightly lower patient-reported outcome scores compared with patients without diabetes and do not have a higher rate of subsequent surgery.
authors.affiliation: 1Department of Orthopaedics, Washington University in St. Louis, Chesterfield, MO; 2Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN; 3Department of Orthopaedics, Washington University in St. Louis, St. Louis, MO; 4Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN; 5Department of Orthopaedics, The Ohio State University, Columbus, OH; 6Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH; 7Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; 8Department of Orthopaedics, University of Colorado Denver, Denver, CO; 9Department of Orthopaedic Surgery, Duke University, Durham, NC; 10Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA; and 11Department of Orthopaedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brophy
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Huston
authors.forename: Rick W
authors.initials: RW
authors.lastname: Wright
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Nwosu
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Kaeding
authors.forename: Richard D
authors.initials: RD
authors.lastname: Parker
authors.forename: Jack T
authors.initials: JT
authors.lastname: Andrish
authors.forename: Robert G
authors.initials: RG
authors.lastname: Marx
authors.forename: Eric C
authors.initials: EC
authors.lastname: McCarty
authors.forename: Annunziato
authors.initials: A
authors.lastname: Amendola
authors.forename: Brian R
authors.initials: BR
authors.lastname: Wolf
authors.forename: Warren R
authors.initials: WR
authors.lastname: Dunn
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Wolcott
authors.forename: Kurt P
authors.initials: KP
authors.lastname: Spindler
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries / Q000150:complications* / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction; D048909:Diabetes Complications; D006801:Humans; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors