Analysis of prosthesis survival after primary hip arthroplasty in elderly patients with Parkinson's syndrome

Abstract

To explore the effect of Parkinson's syndrome on the survival of prosthesis after primary hip arthroplasty in elderly patients with femoral neck fracture. Methods: A total of 81 elderly patients (81 hips) with femoral neck fracture and primary hip replacement surgery, who came from the Department of Orthopaedics, Central Hospital of Xiangtan City from January 1, 2009 to December 30, 2010, were retrospectively analyzed, including 36 males and 45 females. Sixteen patients with Parkinson's syndrome were selected as a Parkinson's syndrome group, and the other 65 patients were served as a control group. The survival status of the prosthesis was followed up to December 30, 2017 and it was compared between the 2 groups (average follow-up was 7.5 years). Results: During the follow-up period, 5 patients in the Parkinson's group underwent revision of the hip joint, and the reasons for revision were periprosthetic fracture in 4 patients and aseptic loosening in 1 patient, but there was no dislocation or infection. There were 7 cases of revision in the control group, including 1 case of infection, 4 cases of aseptic loosening, 1 case of periprosthetic fracture, and 1 case of dislocation. In the follow-up period, the revision rate was 31.2% in the Parkinson's group and 10.8% in the control group (P<0.05). Parkinsonism was a risk factor for hip revision (OR=3.77, 95% CI 1.12 to 3.15). The incidence of periprosthetic fractures in the Parkinson's group was significantly higher than that in the control group (P<0.05). There was no statistical difference in the revision of the hip joint because of aseptic loosening, infection, and dislocation between the 2 groups (P>0.05). Conclusion: During an average of 7.5 years of follow-up, the older patients in the Parkinson's syndrome group have higher prosthetic failure rates after primary hip arthroplasty than those in the control group. The periprosthetic fractures are the most common causes. The development of individualized surgical procedures, the implementation of step-by-step rehabilitative exercises, and the suitable protective measures, and the enhancement of drug management and anti-osteoporosis treatment for Parkinson's syndrome may have positive implications for improving the survival of prosthesis in such patients.