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Diabetes Mellitus: Musculoskeletal Manifestations and Perioperative Considerations for the Orthopaedic Surgeon

Uhl, Richard L. MD; Rosenbaum, Andrew J. MD; DiPreta, John A. MD; Desemone, James MD; Mulligan, Michael MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: March 2014 - Volume 22 - Issue 3 - p 183–192
doi: 10.5435/JAAOS-22-03-183
Review Article

Diabetes mellitus is a disease of uncontrolled hyperglycemia. Despite a more sophisticated understanding of the pathophysiology of diabetes mellitus and despite pharmacologic advancements that enable better glycemic control, the prevalence of this disease and its devastating sequelae continue to rise. The adverse effects of diabetes on the nervous, vascular, and immune systems render the musculoskeletal system vulnerable to considerable damage. Foot involvement has traditionally been thought of as the most severe and frequently encountered orthopaedic consequence. However, the upper extremity, spine, and muscles are also commonly affected. Orthopaedic surgeons are more involved than ever in the care of patients with diabetes mellitus, and they play a vital role in the multidisciplinary approach used to treat these patients. As a result, surgeons must have a comprehensive understanding of the musculoskeletal manifestations and perioperative considerations of diabetes in order to most effectively care for patients with diabetes mellitus.

From the Department of Orthopaedic Surgery (Dr. Uhl, Dr. Rosenbaum, Dr. DiPreta, and Dr. Mulligan) and the Department of Medicine (Dr. Desemone), Albany Medical Center, Albany, NY.

Dr. Uhl or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of Synthes and Auxilium Pharmaceuticals, and has received nonincome support (such as equipment or services), commercially derived honoraria, or other non–research-related funding (such as paid travel) from CONMED Linvatec, Stryker, and Synthes. Dr. DiPreta or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society, the New York State Society of Orthopaedic Surgeons, and the American Academy of Orthopaedic Surgeons. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Rosenbaum, Dr. Desemone, and Dr. Mulligan.

© 2014 by American Academy of Orthopaedic Surgeons
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