CORR Insights®: Is Parkinson’s Disease Associated with Increased Mortality, Poorer Outcomes Scores, and Revision Risk After THA? Findings from the Swedish Hip Arthroplasty Register

Abstract

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Efficacy of Direct Anterior Approach Versus Posterior Lateral Approach for Total Hip Replacement in Patients with Parkinson’s Disease

“…The reason may be that elderly patients with Parkinson’s disease experience limb tremors, muscle tonicity, and difficulty in maintaining abduction neutral position when lying down, and are prone to internal retraction and internal rotation movements leading to hip dislocation, and PLA may cause periarticular soft tissue injury, resulting in hip instability after hip arthroplasty. The present study showed no statistically significant difference in the postoperative hip prosthesis position between the 2 groups, which was consistent with the research results by Giori et al [ 21 ]. The reason may be that DAA separates the deep fascia of the thigh from the gap between the broad fascial tensor and rectus femoris to expose the hip joint without cutting any muscle tendon.…”

“…Xu et al [ 20 ] used a multifactorial statistical analysis to demonstrate that PLA surgery in patients with Parkinson’s disease was more likely to cause hip instability, leading to a higher incidence of dislocation, which was attributed to excessive destruction of the posterior joint capsule and externally rotated muscle groups by PLA; therefore, an anterior or lateral approach was recommended. Giori et al [ 21 ] found that the rate of dislocation with DAA in patients with combined Parkinson’s disease was (2.2%) similar to that of patients without Parkinson’s (1.9%), suggesting a lower postoperative dislocation rate with DAA in patients with concomitant Parkinson’s disease. The results of the present study demonstrated that the incidence of PLA hip dislocation was higher than that of PLA hip dislocation in patients without Parkinson’s disease (4.4%).…”