Introduction

Approximately 450 million people worldwide have diabetes mellitus. Since 1980, the age-standardized global prevalence of diabetes mellitus among adults has almost doubled from 4.7% to 8.5%⁽¹⁾. India, with 69.2 million people living with T2DM, is the world's second-largest population living with diabetes mellitus following to China It decreases the capability of the person to improve from disease and injury, and can also lead to obesity, as well as growing occurrence of osteoarthritis and the essential for joint replacement. Knee and hip arthroplasties are also increasingly common amongst diabetic population due to numerous reasons, and the percentage is as high as 52 %⁽⁴⁾.

The Diabetic population has poor body resistance, poor tissue healing capacity, and high incidence of perioperative complications; the occurrence of stroke, urinary tract infections, intestinal obstruction, bleeding, and death has risen by 3.42-, 1.97-, 2.47-, 1.99-and 3.23-times respectively. Diabetes mellitus increases the occurrence of deep venous thrombosis (DVT) and infections in total knee replacement (TKR) patients with diabetes⁽⁵⁾. This interpretation is not universally accepted, however, and some researchers believe that the occurrence of complications such as deep vein thrombosis, deep infection, and revision surgery does not differ between well-controlled diabetic and non-diabetic patients.

Challenged with such a vast diabetic population, the possible risk of perioperative or likely postoperative adverse effects stresses more research, such as how to adjust and control blood glucose, control infections, improve perioperative care, improve perioperative management and efcy of arthroplasties in diabetic group.

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Dr Sudhir Ravindran

Associate Professor in Orthopedics, Government Medical College Trivandrum