Surgery
Joint Replacement Myth #5: Diabetics Can’t Have Elective Foot Surgery
In this mini-article, Dr. Lee dispels the misconception regarding foot surgery and diabetes.
Myth: Diabetics can’t have elective foot surgery.
Response: This is a common statement I hear from patients. Just because a patient also has diabetes typically doesn’t mean they have to live with foot pain or can’t have foot surgery.
While some evidence shows there’s increased risk of complications in patients with diabetes during or after foot surgery (and surgery may not be appropriate for some patients), there are usually measures a patient (and surgeon) can take to minimize these risks. One of the most critical factors is making sure the diabetes is appropriately controlled before, during, and after surgery. The lower a diabetic patients hemoglobin A1c, the less at risk the patient is for complications. However, it’s important for patients to discuss and consider all risks and potential complications with their surgeons, before proceeding with surgery.
Weight loss and “prehab” are also important measures before surgery, especially if the patient will be expected to stay off their foot for a period of time.
Finally, following the surgeons orders with regard to activity level and weight bearing status is critical. Diabetic neuropathy (numbness in the feet) often limits the post-operative pain, a powerful motivator to follow instructions. Diabetic patients must recognize that just because they can’t feel their feet and have little to no pain, they still need to follow their surgeon's instructions for recovery.
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