Illnesses Hamper Joint Replacement Recovery
Complications After Joint Replacement Surgery More Likely in People With Diabetes, High Blood Pressure, or Obesity
June 1, 2005 -- People with certain medical conditions need to take special
care to prevent complications from joint replacement surgery.
Researchers say these findings have major implications for the more than
700,000 annual joint replacement surgeries, including those of the shoulder,
knee, and hip joints. They found that people with diabetes, high blood
pressure, and obesity are much more likely to have problems following joint
The findings show that doctors should be aggressive about controlling blood
sugar, reducing blood pressure, and preventing blood clots in order to reduce
the risk of dangerous complications after joint replacement surgery.
Predicting Joint Replacement Risks
Researchers used a database of nearly 1 million Americans who had shoulder,
hip, or knee joint replacement surgery to determine what factors affected the
likelihood of complications after the procedure. The study appears in the
current issue of the journal Clinical Orthopaedics and Related
The results showed that high blood pressure, diabetes, and obesity were all
important predictors of increased complications for people undergoing joint
Of these three, obesity was associated with the highest risk of post-surgery
complications and the need for additional care after hospital discharge.
For example, the study showed that 3.7% of obese patients experienced
in-hospital complications after joint replacement surgery compared with 2.6% of
Overall, post-surgery complications were 30% more likely in people with
diabetes, 50% more likely in obese patients, and 10% more likely in people with
high blood pressure. Complications included infection and blood clots.
In addition, researchers found that the likelihood of "nonroutine"
discharge from the hospital was 30% higher for people with diabetes and 45% in
obese patients. For those who were both obese and had diabetes, the additional
risk jumped to 75%. Nonroutine discharges are when the patient is discharged to
another facility for further medical care, such as to intermediate-care
facilities or home health care.
"With this knowledge, surgeons should not only be able to better counsel
their patients before surgery but also consider strategies during and after
surgery to ensure better outcomes. However, the risks and benefits of a joint
replacement procedure should be weighed by surgeons on an individual patient
basis," says researcher Nitin Jain, MD, MSPH, a post-doctoral fellow at
Brigham & Women's Hospital, in a news release.