Perioperative Management, Complications, and Outcomes of Shoulder Arthroplasty in Patients with Diabetes Mellitus.

Abstract

» Patients with diabetes mellitus (DM) undergoing shoulder arthroplasty (SA) have a unique risk profile, which must be considered by clinicians.» The presence of DM as a comorbidity is associated with longer length of stay following SA, greater likelihood of nonhome discharge, and a higher rate of 90-day readmission.» Though the incidence is low, patients with DM are at an increased risk of serious postoperative cardiovascular complications, such as pulmonary embolism, venous thromboembolism, and myocardial infarction.» DM has generally been associated with increased risk of postoperative infection. The optimal hemoglobin A1c threshold in patients undergoing SA remains inconclusive. When extrapolating from lower limb arthroplasty, the literature indicates that this threshold is most likely in the range of 7.5% to 8%.» Patients with DM are more likely to require revision surgery after SA and report lower postoperative satisfaction.