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Published in: Journal of Orthopaedic Surgery and Research 1/2024

Open Access 01-12-2024 | Phlebothrombosis | Systematic Review

Influence of diabetes on the risk of deep vein thrombosis of patients after total knee arthroplasty: a meta-analysis

Authors: Jingzhi An, Li Han, Xiaojuan Ma, Yanyan Chang, Cuixin Zhang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

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Abstract

Background

Previous studies evaluating the influence of diabetes on the risk of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) showed inconsistent results. The aim of the study was to systematically evaluate the association between diabetes and DVT after TKA in a meta-analysis.

Methods

An extensive search was conducted in PubMed, Embase, and Web of Science to identify relevant cohort studies. Random-effects models were employed to pool the results after taking account of the potential influence of heterogeneity.

Results

Thirteen cohort studies involving 546,156 patients receiving TKA were included, with 71,110 (13.0%) diabetic patients before surgery and 1479 (2.1%) patients diagnosed as DVT after surgery. Overall, diabetes was associated with an increased risk of DVT after TKA (risk ratio [RR]: 1.43, 95% confidence interval [CI]: 1.12–1.84, p = 0.004; I2 = 44%). Sensitivity analysis limited to studies with chemoprophylaxis (RR: 1.96, 95% CI: 1.50–2.54), and studies with multivariate analysis (RR: 1.54, 95% CI: 1.12–2.11) showed consistent results. Subgroup analysis showed that diabetes was associated with higher risk of postoperative DVT in Asian countries (RR: 1.93, 95% CI: 1.49–2.52, p < 0.001; I2 = 1%) but not in Western countries (RR: 1.07, 95% CI: 0.86–1.34, p = 0.52; I2 = 0%; p for subgroup difference < 0.001).

Conclusion

Diabetes may be a risk factor for DVT after TKA, even with the chemoprophylaxis of anticoagulants. The association between diabetes and DVT after TKA may be more remarkable in patients from Asian countries.
Literature
Metadata
Title
Influence of diabetes on the risk of deep vein thrombosis of patients after total knee arthroplasty: a meta-analysis
Authors
Jingzhi An
Li Han
Xiaojuan Ma
Yanyan Chang
Cuixin Zhang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-024-04624-z

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