{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:10:08Z","timestamp":1789078208056,"version":"build-2803163510"},"reference-count":40,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>While diabetic nephropathy (DN) is a known risk factor for poor outcomes in major surgery, its specific impact on perioperative complications following primary total knee arthroplasty (TKA) has not been well-quantified in large-scale studies. This study aimed to determine the correlation of pre-existing DN on perioperative complications, mortality, and healthcare resource utilization in patients undergoing primary TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study utilized the US National Inpatient Sample (2016\u20132019). Patients undergoing primary TKA were stratified into DN and non-DN cohorts using ICD-10 codes, excluding end-stage renal disease or revision cases. A 1:1 propensity score-matched analysis was performed to balance demographics, hospital characteristics, and 30 comorbidities between cohorts. Outcomes included surgical\/medical complications, mortality, length of stay (LOS), and hospitalization costs. Multivariable logistic regression analyzed associations pre- and post-PSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DN prevalence increased significantly from 1.2% (2016) to 3.4% (2019). After PSM, DN patients had significantly higher adjusted risks of multiple complications. Surgical complications included increased transfusion (aOR=1.64), intubation\/mechanical ventilation (aOR=1.52), periprosthetic infection (aOR=1.38). Medical complications included pulmonary edema (aOR=3.40), acute myocardial infarction (aOR=2.13), stroke (aOR=1.43), atrial fibrillation\/flutter (aOR=1.09), postoperative delirium (aOR=1.66), urinary retention (aOR=1.26), and urinary tract infection (aOR=1.25). Resource utilization significantly increased, with higher odds of extended LOS (aOR=1.44) and elevated hospitalization costs (aOR=1.19).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings underscore that DN is significantly associated with a distinct pattern of TKA complications, advocating for targeted perioperative strategies to mitigate risks in this growing population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261488192","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:34:01Z","timestamp":1788910441000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of diabetic nephropathy on outcomes following total knee arthroplasty: A propensity score-matched analysis"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5694-0670","authenticated-orcid":false,"given":"Yongzhe","family":"Cui","sequence":"first","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1727-5876","authenticated-orcid":false,"given":"Yuanwei","family":"Wu","sequence":"additional","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjia","family":"Li","sequence":"additional","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6382-3767","authenticated-orcid":false,"given":"Qinfeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingying","family":"Li","sequence":"additional","affiliation":[{"name":"903rd Hospital, Joint Logistic Support Force, Chinese People\u2019s Liberation Army"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"Yang","sequence":"additional","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00249"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200704000-00012"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2019.12.005"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2023.08.013"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2025.2468741"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2014.03.009"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3663"},{"key":"e_1_3_5_9_2","first-page":"822","article-title":"Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study","volume":"11","author":"Lin M-H","year":"2021","unstructured":"Lin M-H, Lin S-J, Kuo L-T, et al. 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