Posted on 16th May, 2023 at 5:22:25 AM
Leading a diabetic life is by no means an easy task; add to that the need for knee replacement surgery can at times create a lot of confusion. If you are reading this article chances are you or someone you know has diabetes and want to know if a TKR is safe for diabetic, will there be post-surgery complications? In this article we hope to address most of the misconceptions surrounding knee replacement for diabetics and what can be done to prevent pre & post-surgery trauma.
Firstly, it’s important to know advancements in knee replacement surgery have come a long way. In the early days when an incision in the muscle was required to reach the joint replacement, which also required a blood transfusion. Consequently, the recovery was painful and took about a month to recover. However, with the latest Minimally Invasive Total knee replacement surgery most normal patients start walking on the same day and are back to normal life in a week’s time. This surgery is safe for diabetic patients as well as long as it is performed under the guidance of an experienced knee replacement surgeon and certain pre and post-operative parameters are met.
So let’s get down to it.
How Does Diabetes Affect Joint Replacement Surgery?
Surgery and anesthesia used during surgery create inflammation in the operated region and initiate an autoimmune response by the body through the release of adrenaline, noradrenaline, cortisol, glucagon, and other hormones. In patients with uncontrolled diabetes, this can increase insulin resistance and glucose levels in the body. This can trigger significant hyperglycemia and can lead to deep tissue infection. Eventually, affecting surgical outcomes.
Any surgical procedure no matter how safe puts immense stress on the human body. Diabetic patients inherently have weakened immune systems, muscles, and body tissues. This weakness affects the overall recovery post-surgery.
Pre- Knee Replacement Surgery Measures for Diabetes patients?
“Being fully prepared for a surgery is half the battle won”.
We cannot emphasize enough on this when it comes to diabetic & Hyperglycemic patients. Be it type-1 or type-2 diabetes a rigorous pre-op regime has to be laid out depending on the patient's medical history with the objective of controlling diabetes and reducing risks.
Medical Management: When you first visit your orthopedic a detailed screening for Diabetes and related co-morbid conditions is important. Accordingly, working with your diabetologist a plan put in place to prepare you and your body for the surgery is important. This might require medical management of blood sugar levels and any other problems like high blood pressure, renal impairment, etc. These need to be brought to stable levels to go ahead with the surgery. Apart from medical management, your doctor might suggest a certain diet and physiotherapy to prepare for the surgery.
Diet: Type-2 diabetes is primarily a lifestyle disease and controlling your diet to reduce your HbA1c level (levels around 8% or less should suffice) plays a vital role in surgical outcomes. So what should your diet include… foods that are rich in antioxidants and have anti-inflammatory properties are essential to help manage surgical (inflammatory) stress on the body. It's highly recommended to consult a surgical dietitian who can help you get the best diet to prepare for knee surgery.
Exercise: This is something that is suggested to even normal patients. Diabetics, generally have weak muscles, its critical to undergo a muscle-strengthening program before surgery. Studies have shown that pre-op exercise significantly eases and reduces recovery periods. When you undergo knee replacement surgery under Dr. Shailendra Patil our Physiotherapist helps you with a home exercise program before and after surgery.
Post- Knee Replacement Surgery Measures for Diabetes patients?
Post surgery a diabetic patient with most parameters in control can start walking within a day or two. The medical management of diabetic and co-morbid conditions continues to avoid any post-surgery complications, that may arise. The exercise and diet plan continues for a few months until the patient is back to his normal life.
So as you have read by now that diabetic patients can undergo knee replacement surgery in a safe manner as long as it is done under professional care by your Knee surgeon and diabetologist. Especially minimally invasive techniques which involve less cutting and sticking and handling of tissue make surgery and recovery very smooth, even diabetic pts don’t get any healing problems post surgery
