Diabetic Foot Complications Despite Successful Pancreas Transplantation.
BACKGROUND
It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation.


METHODS
This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes. The mean age was 40.7 (range, 15-76) years. Diabetes type, transplantation type, body mass index, and diabetes duration before transplantation were confirmed. After pancreas transplantation, the occurrence and duration of foot and ankle complications were assessed.


RESULTS
Twenty-two patients (10.1%) had diabetic foot complications. Fifteen patients (6.9%) had diabetic foot ulcer and 7 patients (3.2%) had Charcot arthropathy. Three patients had both diabetic foot ulcer and Charcot arthropathy. Three insufficiency fractures (1.4%) were included. Mean time of complications after transplantation was 18.5 (range, 2-77) months. Creatinine level 1 year after surgery was higher in the complication group rather than the noncomplication group ( P = .02).


CONCLUSIONS
Complications of the foot and ankle still occurred following pancreas transplantation in patients with diabetes.


METHODS
Level III, comparative study.
1 Department of Orthopedic Surgery, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
Dong-Kyo
DK
Seo
2 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Ho Seong
HS
Lee
2 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Jungu
J
Park
2 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Chang Hyun
CH
Ryu
3 Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Duck Jong
DJ
Han
2 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Sang Gyo
SG
Seo
D000842:Ankle / Q000502:physiology*; D001177:Arthropathy, Neurogenic / Q000601:surgery*; D017719:Diabetic Foot / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005528:Foot / Q000601:surgery*; D006801:Humans; D008297:Male; D016035:Pancreas Transplantation / Q000592:standards*; D012189:Retrospective Studies
Charcot arthropathy; diabetes; diabetic foot; diabetic ulcer; pancreas transplantation