The increased rate of infection after shoulder replacement in patients with diabetes is statistically significant, according to research published in the Journal of the American Academy of Orthopaedic Surgeons.
Researchers studied the association between hemoglobin A1c levels and the rate of postoperative wound complications within six months of shoulder replacement and deep infection within a year of the surgery.
Here are four findings.
1. Patients with diabetes had a 1.4 percent risk of infection with 0.7 percent risk for deep infection, compared to a 0.9 percent risk of infection with 0.4 percent risk for deep infection in patients without diabetes.
2. The risk of wound complication and deep infection increased as the pre-surgery levels of HbA1c increased.
3. A pre-surgery HbA1c level of 8 milligrams per deciliter is a potential threshold for identifying increased risk of deep infection after shoulder replacement.
4. Limitations of the study included the use of HbA1c levels to measure blood sugar, reliance on a large administrative database and the database's inability to control for various factors.
"Further research is needed into the tools used to measure blood sugar levels and into the conditions associated with diabetes that place these patients at a higher risk for infection," said lead study author Jourdan Cancienne, MD. "Patients with diabetes and HbA1c levels of 8.0 and higher should be counseled that proceeding with surgery may place them at higher risk for prosthetic joint infection."