Functional outcomes after total joint arthroplasty are related to the severity of Parkinson’s disease: a mid-term follow-up

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.

The impact of Parkinson’s disease on results of primary total knee arthroplasty

“…It has been stated by Rong et al that patients with late-stage PD can have functional loss after TKA ( 12 ). Rong et al retrospectively analysed the clinical outcomes of 18 patients with TKA (22 knees).…”

“…The efficacy of TKA in patients with severe PD remains a concern. To optimise and stabilise the functional outcomes of a TKA, the medical team should attempt to slow the progression of PD ( 12 ).…”

“…The clinical results were compared between them. Of the subject in TKA group, the KSFS (P < 0.01), the Short Form (12) Health Survey scale (SF-12) physical component summary (PCS) (P < 0.01) and mental component summary (MCS) (P < 0.01), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain (P = 0.03) and function score (P < 0.01) were significantly higher in group II. Moreover, comparisons of the final clinical data with preoperative data were carried out in each group.…”

“…In 2018, Rondon et al revealed that the overall survival of TKA at 2, 5, and 10 years was 95.2%, 89.8%, and 66.2%, respectively ( 20 ). In 2019, Rong et al found a survival rate of 87.5% at 60 months ( 12 ). In the study by Baek et al published in 2021, a Kaplan–Meier survival analysis with revision of either component as an endpoint in the PD and control groups estimated an 89.7% and 98.3% chance of survival over 10 years, respectively ( 18 ).…”

“…The efficacy of TKA in patients with severe PD remains a concern. To optimise and stabilise the functional outcomes of a TKA, the medical team should attempt to slow the progression of PD (12). Goh et al have claimed that although patients with PD have relatively poorer knee function and QoL, they experience functional gains, and high satisfaction is achieved (14).…”