Insulin Dependence Increases the Risk of Failure After Total Knee Arthroplasty in Morbidly Obese Patients

Chad D. Watts, Matthew T. Houdek, Eric R. Wagner, Matthew Abdel, Michael J. Taunton

Research output: Contribution to journalArticle

15 Scopus citations


The aims of this study were to compare the outcomes between nondiabetic (n=1284), type II diabetic (n=530), and insulin-dependent type II diabetic (n=164) morbidly obese (body mass index ≥40kg/m2) patients undergoing primary total knee arthroplasty at 6-year follow-up. Patients with type II diabetes mellitus (DM) had similar outcomes when compared with non-DM patients. However, patients with insulin dependence had an increased risk of reoperation (hazard ratio [HR], 1.8; P=.005), revision (HR, 2; P=.02), and periprosthetic joint infection (HR, 2.1; P=.03), as well as decreased 10-year implant survivorship (84% vs 92%; P=.01) when compared to non-DM patients. Prospective studies should further evaluate outcomes and optimization measures within this population. Level of evidence: Level III-prognostic study.

Original languageEnglish (US)
Pages (from-to)256-259
Number of pages4
JournalJournal of Arthroplasty
Issue number1
StatePublished - Jan 1 2016



  • Complication
  • Diabetes
  • Insulin dependence
  • Morbid obesity
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Medicine(all)
  • Orthopedics and Sports Medicine

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