Hip replacement with Type 1 Diabetes

A 30-year-old friend with Type 1 Diabetes has been postponing needed hip replacement surgery due to fears of complications, infection, or rejection of the prosthesis.  Are these reasonable fears?  Is there any way to access hospital data to see which hospitals in our metropolitan area (San Francisco) have the lowest rate of complications with hip replacement surgery?  And can we find out which surgeons have expertise with diabetic patients?  Any advice or ideas?  Thank you!

[carolanivey]

Hi there,

From what I've read, if your friend's blood glucose is under control, the increased risks are small. The much greater post-operative danger is if the patient's blood sugar is NOT under control. Also, the risks for hip replacement appear to be less than for a joint farther from the heart, like the knee, ankle, or foot. Foot healing is slower for a normal person, much less a diabetic.

I'm not sure how to find a hip surgeon who has good experience with diabetics. Maybe someone else will chime in here with advice. Maybe check with the local chapter of the ADA? Or maybe you'll just have to pull out the phone book and start calling orthopedic surgeons' offices. What you ARE going to want is a surgeon that does hips, hips, and only hips. You want someone who's up on all the latest techniques and has extensive experience in dealing with post-op complications. Also someone who is accessible, at least through his or her staff. My surgeons have had excellent assistants whom I can call, and can get me an answer to a question or a solution to a problem within 24 hours if not the same day.

Your friend's endocrinologist (or whoever is treating him for diabetes) may be able to refer him to a suitable surgeon, as well.

As for hospitals, try the Health and Human Services' hospital compare tool at hhs (dot) gov.

Good luck!