Importancia del control glicémico previo a la artroplastia electiva: ¿opción o necesidad?

Abstract

There is an important overlap between diabetes mellitus (DM) and arthroplasties (AT). The number of diabetic patients undergoing AT annually has increased as DM significantly augments the risk of developing severe osteoarthritis. This represents an impact in the short and long term, both in patients’ recovery and in their ability to engage in physical activity after the intervention. At the same time, appropriate glycemic control previous to elective AT, even in patients without a diagnosis of DM, appears to be necessary to counteract the state of hyperglycemia caused by the surgical stress, and with it, the associated complications. At present, HbA1C has been the most utilized marker in assessing the glycemic state. Nevertheless, there are disagreements regarding the cutoff point to use, which has led to the search of other markers, among them, fructosamine. The objective of this review is to present current evidence on the importance of glycemic control prior to elective AT, and the screening strategies implemented at present.