Outcomes of ACL reconstruction in patients with diabetes

Robert H. Brophy, Laura J. Huston, Rick W. Wright, Samuel K. Nwosu, Christopher C. Kaeding, Richard D. Parker, Jack T. Andrish, Robert G. Marx, Eric C. Mccarty, Annunziato Amendola, Brian R. Wolf, Warren R. Dunn, Michelle L. Wolcott, Kurt P. Spindler

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4 Scopus citations

Abstract

Purpose 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. Methods 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. Results 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. Conclusions 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.

Original languageEnglish
Pages (from-to)969-973
Number of pages5
JournalMedicine and Science in Sports and Exercise
Volume48
Issue number6
DOIs
StatePublished - Jun 1 2016

Keywords

  • ACTIVITY LEVEL
  • ANTERIOR CRUCIATE LIGAMENT
  • KNEE INSTABILITY
  • PATIENT-REPORTED OUTCOMES

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    Brophy, R. H., Huston, L. J., Wright, R. W., Nwosu, S. K., Kaeding, C. C., Parker, R. D., Andrish, J. T., Marx, R. G., Mccarty, E. C., Amendola, A., Wolf, B. R., Dunn, W. R., Wolcott, M. L., & Spindler, K. P. (2016). Outcomes of ACL reconstruction in patients with diabetes. Medicine and Science in Sports and Exercise, 48(6), 969-973. https://doi.org/10.1249/MSS.0000000000000876