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Is it safe for my mother to undergo a knee surgery?

Dr Mathew Varghese
Head, Department of Orthopaedics,
St. Stephens Hospital,
New Delhi

Q: My 79 years old diabetic mother is suffering from problem in her left knee. Her knee bends to the left. The doctor told her that she cannot undergo a surgery for knee problem as she is suffering from diabetes. Can she undergo a surgery for her knee problem?

A:From your description your mother seems to have age related degeneration of a knee joint – commonly called osteoarthritis of the knee joint. Quite often the symptoms of instability and deformity may be worse in diabetics. Sometimes however, pain may be less in them because of nerve changes of diabetes. You have not mentioned about her level of activity and the physical limitations that she has. You only mentioned about the ‘problem in the knee’ and ‘everyday bending of the leg. I presume the changes are severe enough to warrant a surgical intervention. Mere X-ray changes are not an indication for surgery but significant pain that limits patient’s activity or restricts patient’s mobility are more important indicators of surgery. The decision has to be taken by the patient the surgeon can only guide on the pros and cons of surgery versus no surgery.

You are afraid that surgery cannot be done in your mother because she is a diabetic. This is not at all true. Surgery can be safely done in diabetic. The only precaution that one needs to take is to ensure that sugar is under good control before, during and after surgery. Also diabetics are more vulnerable for degenerative changes in the blood vessels and nerve damage. These must be investigated and checked for especially to look for coronary artery disease in the heart. Diabetics also are more vulnerable for infection and delayed wound healing. Your surgeon will take adequate precaution against these.

So, it is not true to think that surgery is not possible and, with due care, safe surgery can be done well even in diabetics of your mother’s age.