Abstract
BackgroundPerforming total joint arthroplasty (TJA) in Parkinson’s disease (PD) patients may encounter a higher complication rate or worse functional outcomes compared with common patients. The relationship between PD and clinical outcomes after TJA is not fully understood.MethodsRetrospectively, we used manual charts to investigate the clinical outcomes in 41 patients including 24 total hip arthroplasty (THA) patients (28 hips) and 18 total knee arthroplasty (TKA) patients (22 knees) with a diagnosis of PD from 2009 to 2016. The stage of PD was confirmed by Hoehn and Yahr scale. Prosthesis survivorship was estimated with revision for any reason as the endpoint.ResultAll the clinical outcomes improved significantly (p < 0.05). Subgroup analysis revealed worse functional outcomes in mid- or end-stage PD patients. Sixteen short-term mild to moderate complications were noted. Two revisions were conducted for hip periprosthetic osteolysis and postoperative knee pain. The prosthesis survivorship at 60 months for TJA, total hip arthroplasty (THA), or total knee arthroplasty (TKA) was 91.6%, 94.1%, and 87.5%, respectively.ConclusionPatients with PD who underwent TJA would result in excellent pain relief and gain of function. However, patients at late-stage PD may suffer from functional loss. The effectiveness of TJA in patients with severe PD remains a concern. Physician should help delay the progression of PD which may optimize and stabilize the functional outcomes of TJA.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disease with a life expectancy of 7–14 years [1]
Prior research showed that patients with PD and OA seemed suffered from akathisia, paraesthesia, and heightened pain level in comparison with OA alone [7]
Previous researches have demonstrated a higher rate of complications after total hip arthroplasty (THA) or total knee arthroplasty (TKA) could be seen in patients with PD
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disease (after Alzheimer’s disease) with a life expectancy of 7–14 years [1]. Many PD patients demand lower limb total joint arthroplasty (TJA) for different reasons including end-stage osteoarthritis (OA), fracture, or osteonecrosis of the femoral head [3]. Gait abnormality and instability mean a higher rate of fall of patients with PD. A relevant study confirmed 4.48 times more likely of PD patients experienced hip fracture caused by severe falls [5, 6] which may sustain primary total hip arthroplasty or revision surgeries. Previous researches have demonstrated a higher rate of complications after THA or TKA could be seen in patients with PD. Performing total joint arthroplasty (TJA) in Parkinson’s disease (PD) patients may encounter a higher complication rate or worse functional outcomes compared with common patients. The relationship between PD and clinical outcomes after TJA is not fully understood
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