Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Knee
Abstract number: 25127
PREOPERATIVE HYPERGLYCAEMIA ASSOCIATES WITH INCREASED RISK OF
INFECTED KNEE REPLACEMENT
Esa JäMSEN 1 , Pasi NEVALAINEN 2 , Jarkko KALLIOVALKAMA 1 , Teemu MOILANEN 1
1 Coxa, Hospital for Joint Replacement, Tampere (FINLAND), 2 Tampere University
Hospital, Tampere (FINLAND)
Background: Obesity and diabetes increase the risk of surgical-site infections. Many
patients with diabetes, however, do not have proper diagnosis and antihyperglycaemic
treatment. In patients with diabetes, poor glycaemic control has been
associated with higher risk of postoperative complications. Materials and methods:
We analyzed the association between preoperative glucose and deep infection rate
in a series of 1,565 primary total knee replacements performed due to osteoarthritis
in 2002-2006. Results: During the prospective 1-year follow-up, 15 deep infections
(0.96%), defined according to Centres for Disease Control and Prevention, were
diagnosed. The infection rate was significantly higher in patients with preoperative
glucose >=7.0 mmol/L (126 mg/dL) compared to those with normal glucose (=7.0 mmol/L. Glycosylated haemoglobin (HbA1c)
was measured preoperatively in 381 patients. No infections occurred among patients
with normal glycosylated haemoglobin (=6.5%. Conclusions: To us, preoperative
screening for hyperglycaemia appears as a feasible way to identify patients with
increased risk of deep infection following primary knee replacement. The underlying
mechanisms warrant further research.
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