Introduction: Diabetes mellitus type 2 (DM II) affects 18.2 million Americans and can cause several chronic and morbid complications. Furthermore, 90% of Americans have radiographic evidence of osteoarthritis by age 40. Diabetes may be an important risk factor for symptomatic osteoarthritis later in life. The aim of our study is to determine if diabetic patients are predisposed to osteoarthritis.

Methods: We conducted a review of the all total knee arthroplasty (TKA) cases performed at our institute during the past two years for end stage osteoarthritis. We excluded TKAs performed for post-traumatic arthritis and patients with inflammatory diseases. Comorbidities and demographical information including age, gender, BMI, and family history were collected from our database. A cross sectional study was performed to analyze the prevalence of DM II in our population. This prevalence was compared to that of diabetics in the general population available from various sources including the National Center for Health Statistics.

Results: Our cohort included a total of 3421 patients (1972 females, 1449 males) who had undergone TKA for end stage osteoarthritis. The average age and BMI were 66 years (range: 39–92) and 32 (range: 21–65) respectively. The prevalence of diabetes mellitus type 2 in our cohort was 12%, while the prevalence of DM II in the general US population currently ranges from 6%–7%.

Discussion: Chronic diabetes causes multiorgan failure via microvascular and macrovascular damage and may possibly lead to degeneration of articular cartilage and eventual arthritis. Based on this study, diabetes appears to be a strong predisposing factor for arthritis. Our laboratory has launched an extensive series of experiments delinating the potential cellular mechanism for such association.