Total shoulder arthroplasty in patients with Parkinson's disease

Abstract

Currently, there is little information available on the results of total shoulder arthroplasty (TSA) in patients with Parkinson's disease. The purpose of the current study was to determine the results, risk factors for an unsatisfactory outcome, and rates of failure of TSA in patients with Parkinson's disease. Between 1978 and 2005, 49 total shoulder arthroplasties were performed in patients with Parkinson's disease for osteoarthritis of the shoulder. Forty-three shoulders (36 patients) were followed for a minimum of 2 years (mean, 8 years) or until the time of revision surgery. Total shoulder arthroplasty in patients with Parkinson's disease was associated with significant improvement in pain from 4.6 to 1.8 (P < .001), external rotation from 21 degrees to 44 degrees (P < .001), and active abduction from 100 degrees to 119 degrees (P = .0489). There was no significant improvement in internal rotation (P = .09). There was no significant difference in outcome between males and females nor was there an association with stage of Parkinson's disease and outcome (P > .05). Eight shoulders underwent revision arthroplasty. Three of the 8 revisions were performed less than 1 year from the time of surgery due to instability. Total shoulder arthroplasty is associated with significant long-term improvement in pain, external rotation, and abduction in patients with Parkinson's disease. However, early postoperative instability appears to be higher in this patient population. The results of TSA in our patients with Parkinson's disease were marginal, with 20 (47%) achieving unsatisfactory results.