Total hip arthroplasty in patients with diabetes mellitus.

Overview

Diabetes mellitus is a common disease. It affects multiple organ systems. Adverse effects of hyperglycemia on infection, fracture healing, and bone remodeling have been recently reported. This study was conducted to evaluate the clinical and radiographic results of 93 total hip arthroplasties in 78 consecutive patients with diabetes. All femoral components were cemented using contemporary cementing techniques. Prophylactic antibiotics were given in each case. The mean follow-up period was 4.1 years (range, 2-6.5 years). Ninety-six percent of the hips were rated excellent or good. Radiolucencies were observed in only 3.7% of the stems, while 22.2% of the cups showed radiolucencies. There was a 4% revision incidence. There was no postoperative infection in this series--a distinct improvement from previously reported series. However, complications remained high at 24.3%. The most frequent complication was urinary tract infection (14.2%). The most serious complication was myocardial infarction. The authors believe total hip arthroplasty can be safely performed in patients with diabetes, provided that adequate medical and follow-up evaluations are performed. The medium-term clinical and radiographic follow-up evaluations are not inferior to reported series in patients without diabetes.