Good news for knee replacement patients with type 2 diabetes

Better-prepared patients. Improved recovery. Better overall health outcomes. YKC’s Dave Duffy looks at the potential impact of semaglutide (e.g. Ozempic) on knee replacement surgery for patients with type 2 diabetes.

There are lots of ways to alleviate the pain and slow the progression of osteoarthritis. Yet still there is no way to ‘cure’ it, which means that, as the condition progresses, a knee replacement remains a likely part of your future.

Knee replacement surgery is a common operation – more than 70,000 of them are carried out in England and Wales every year. The risk of complications is low, but no surgical operation is without risk which is why knee replacement tends only to be recommended for patients with advanced osteoarthritis – it’s all a matter of balancing the benefits and risks of carrying out the operation with the risks of not carrying it out.

If you have type 2 diabetes, though, that calculation is more difficult because diabetes increases the risk of surgical complications. Now, a team from Yale School of Medicine in the US have found that semaglutide, a diabetes medication which increases insulin secretion among other things, improves surgical outcomes for diabetes patients.

You might not have heard of semaglutide. But you probably will have heard of several of the brand names under which it is produced: Ozempic and Wegovy, for example.

Beyond weight loss

We’ve written before about the value of weight loss drugs in knee surgery in breaking the weight gain cycle. It’s hard to lose weight for your knee replacement surgery when the knee that needs replacing prevents you from getting the exercise you need.

As I explore in this post, weight loss drugs are having an impact on the patients I am seeing each week, but if you have diabetes, weight loss is only half the benefit of Ozempic and its ilk.

Reducing the risk from diabetes in surgery

Whatever the procedure: knee replacement, hip replacement, hernia repair or heart surgery – when a patient has diabetes, it’s a team effort to ensure we reduce risk as much as we can. From surgeons to physiotherapists, anaesthetists to the endocrinologists who look after diabetes, everybody works together to ensure we reduce the risk of infection, clots in the leg and other complications which are potentially life-changing risks for anyone, but greater risks for those with diabetes.

It’s not just about surgery; it’s about recovery too. A knee replacement is an invasive procedure that will require quite a bit of effort to get over. The fitter a patient is, the lower the risk of complications in surgery or in recovery, and the faster and easier that recovery is likely to be.

The simplest way to reduce risk is to ensure the patient is as fit as possible at the time of surgery with no medical condition that could be improved. For patients with diabetes, that includes managing your diabetes, ensuring the long-term control that reduces the risk of any nasty surprises. If a blood test suggests things aren’t quite as under control as we would like, we’ll refer you back to your diabetes specialist to ensure we minimise risk as much as we can.

This is where semaglutide comes in. According to Lee Rubin, MD, professor of orthopaedics & rehabilitation at Yale School of Medicine, “Our team found that three months of semaglutide use prior to surgery leads to markedly fewer minor and severe complications.” This, he said, means, “we can better prepare our diabetic patients for surgery, leading to improved recovery and overall health outcomes.”

This is exciting. If we can better prepare patients with diabetes, we reduce referrals, delay and frustration on the part of the patient. We reduce risk. And we increase the chances of successful knee replacement and recovery.

Do you have type 2 diabetes and are thinking about knee replacement? Please contact us, or call us on 03453 052 579.

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