Journal article
Diabetes Mellitus Blunts the Symptom Physical Function, and Health-Related Quality of Life Benefits of Total Knee Arthroplasty: A Systematic Review With Meta-analysis of Data From More Than 17000 Patients
The journal of orthopaedic and sports physical therapy, v 51(6)
01 Jun 2021
PMID: 33870736
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE: To compare physical function, pain, impairments (stiffness, range of motion, and strength), and health-related quality of life (HRQoL) outcomes between patients with and without diabetes mellitus. before and after a total knee arthroplasty (TKA).
DESIGN: Prognosis systematic review.
LITERATURE SEARCH: We searched MEDLINE/PubMed, CINAHL, SPORTDiscus, and Web of Science to August 2019.
STUDY SELECTION CRITERIA: We included longitudinal studies that examined physical function, pain, impairments, and HRQoL outcomes among patients receiving a TKA and with or without diabetes.
DATA SYNTHESIS: For quantitative synthesis, we stratified outcomes based on time relative to TKA: preoperative, less than 1 year after a TKA (early postoperative), and 1 year or more after a TKA (late postoperative). We used random-effects meta-analysis to calculate standardized mean differences (SMDs) and 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development and Evaluation system for qualitative synthesis.
RESULTS: We included 21 studies (n = 17472 patients). Patients with diabetes mellitus had worse preoperative physical function (SMD, -0,16: 95% CI: -0.24, -0.08) and HRQoL (SMD, -0.16; 95% CI: -026, -0.05), worse early postoperative pain (SMD, -0.22; 95% CI: -0.39, -0.05) and strength (SMD, -0.45; 95% CI: -0.77, -0.14), and worse late postoperative physical function (SMD, -023; 95% CI: -0.40, -0.06), range of motion (SMD, -0.23; 95% CI: -0.46, 0.00), and HRQoL (SMD, -0.19; 95% CI: -0.29, -0.08) than patients without diabetes mellitus. The overall risk of bias across studies was high, and the certainty of evidence ranged from low to very low.
CONCLUSION; Patients with diabetes mellitus had worse patient-reported and clinician-assessed outcomes before and after a TKA. Given the limitations of included studies, these results may change with future research.
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Details
- Title
- Diabetes Mellitus Blunts the Symptom Physical Function, and Health-Related Quality of Life Benefits of Total Knee Arthroplasty: A Systematic Review With Meta-analysis of Data From More Than 17000 Patients
- Creators
- Annalisa Na - Drexel UniversityLaura M. Oppermann - The University of Texas Medical Branch at GalvestonDaniel C. Jupiter - The University of Texas Medical Branch at GalvestonRonald W. Lindsey - Univ Texas Med Branch, Dept Orthopaed Surg & Rehabil, Galveston, TX 77555 USARogelio A. Coronado - Vanderbilt University Medical Center
- Publication Details
- The journal of orthopaedic and sports physical therapy, v 51(6)
- Publisher
- J O S P T
- Number of pages
- 28
- Grant note
- 90AR5009 / Interdisciplinary Rehabilitation Research Training Program of the National Institute on Disability, Independent Living, and Rehabilitation Research (US Department of Health and Human Services' Administration for Community Living) K12 HD055929 / US National Institutes of Health Rehabilitation Research Career Development Program grant; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Foundation for Physical Therapy Research
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Physical Therapy (and Rehabilitation Sciences)
- Web of Science ID
- WOS:000656917900003
- Scopus ID
- 2-s2.0-85107181982
- Other Identifier
- 991019169698604721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Rehabilitation
- Sport Sciences