To investigate the effect of diabetes mellitus (DM) on the postoperative clinical outcomes and perioperative bleeding volume in patients with primary total knee arthroplasty. Clinical data of 49 patients with osteoarthritis underwent primary total knee arthroplasty (TKA) were collected and retrospectively analyzed from October 2015 and September 2016. Patients were set to two groups with (A) or without DM (B). Data were compared between 2 groups, including postoperative hemoglobin, hematocrit

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... ct), Hb, dominant blood loss, hidden blood loss, theoretical total blood loss, range of joint motion, VAS score, increasing rate of circumference length above 10 cm of the knee, HSS score, the operation time and hospitalization days. The results showed that the Hb and Hct of A group was significantly less than the B group (P<0.05). The dominant blood loss, the hidden blood loss and theoretical total blood loss of A group was significantly higher than B group (P<0.05). The hospitalization days of A group was significantly longer than B group (P<0.05). The VAS score and the increasing rate of circumference length above 10 cm of the knee of A group was significantly higher than B group at 3 days (P<0.05). The patients were all followed up 12 weeks. The HSS score of A group was significantly lower than B group at 4 weeks (P<0.05). There was no significant difference in the HSS score between 2 groups at 12 weeks after operation (P>0.05). The prosthesis was in good position, without loosening, subsidence, or osteolysis. In general, patients with DM got TKA have a higher bleeding and longer hospitalization days. DM acts as an adverse impact on recent functional recovery after TKA.