Please login to view this media
- Talk
- 24/09/2021
- UK
Diabesity is Associated with a Worse Functional Outcome and a Higher Risk of Superficial and Deep Wound Infection after Total Primary Hip Replacement
Description
In a recent presentation, Jack Lovie discusses the findings of a study investigating the effects of diabesity—defined as diabetes resulting from obesity—on outcomes following total hip replacement surgery. Beginning with the context of the study, Jack explains that both diabetes and obesity negatively influence surgical outcomes, leading to worse functional recovery and increased infection risks post-operatively. The study reveals that 5% of hip replacement patients have a pre-operative diabetes diagnosis, and among those with maturity onset diabetes, a staggering 61% are also diagnosed with obesity. Thus, the simultaneous impact of these two morbidities warrants further examination.
The objective was to understand how diabesity affects primary total hip replacement outcomes. A retrospective case-control study was conducted involving patients from a single center, examining pre-operative data and 12 months’ worth of post-operative findings through questionnaires. The analysis differentiated between patients with diabesity, those with only diabetes, only obesity, and a control group without either condition. Key assessments included the Oxford Hip Score, EQ5D, post-operative satisfaction, and complication rates.
Jack highlights that while both diabetes and obesity independently contribute to poorer outcomes, there is also a "super added diabesity effect" that exacerbates the impacts of the individual conditions. Patients with both morbidities exhibited a combined reduction in improvement on the Oxford Hip Score by a significant margin, with similar findings in pre-operative quality of life metrics as measured by EQ5D. Notably, the study found that while obesity increased the risk of deep infections post-surgery, the presence of diabesity further elevated that risk, reaffirming the importance of understanding the combined effects of these conditions.
Limitations of the study were acknowledged, such as the lack of data regarding severity of diabetic control through HbA1c levels, and the focus on one-year post-operative results, leaving long-term outcomes unexplored. Jack concludes by asserting the need for heightened awareness among surgical teams about the complexities surrounding patients with diabesity, as they experience not only worse functional improvements but also higher infection rates due to this combination of conditions.