Total Hip Arthroplasty in Patients With Parkinson Disease: Improved Outcomes With Dual Mobility Implants and Cementless Fixation

Lazennec, Jean-Yves; Youngwoo, Kim; Pour, Aidin Eslam

doi:10.1016/j.arth.2017.11.062

Cited by 22 publications

(27 citation statements)

References 31 publications

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“…There has been a trend toward the use of dual mobility implants in high-risk dislocation populations such as PD patients; these have recently shown good longterm results. 26 The type of approach and implant used could not be determined given the database data and is a limitation that could have prevented discerning a significant difference in dislocation risk in our study.…”

Section: Discussionmentioning

confidence: 96%

“…6 However, the present study's sample size exceeds or is comparable with previous studies evaluating the impact of comorbid PD on various outcomes following primary THA. 22,26,28,29 In addition to stratification by disease stage, prospective studies investigating the effects of cup style and individual comorbidities such as diabetes mellitus or obesity would improve the strength of analysis, as accounting for these unobserved covariates would alleviate the limitations, and resulting potential bias, imposed by propensity-score matching. 30,31 This, along with a larger sample size, would increase the generalisability of our findings to the Parkinson's disease population as a whole.…”

Section: Discussionmentioning

confidence: 99%

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Total hip arthroplasty in Parkinson’s disease patients: a propensity score-matched analysis with minimum 2-year surveillance

et al. 2019

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Introduction: Parkinson’s disease (PD) patients experience chronic pain related to osteoarthritis at comparable rates to the general population. While total hip arthroplasty (THA) effectively improves pain, functionality, and quality of life in PD patients, long-term outcomes following THA are under-reported. This study sought to investigate whether PD patients have an increased risk of complications and revision following THA in comparison to the general population. Methods: Utilising New York State’s Statewide Planning and Research Cooperative System, all PD patients who underwent THA from 2009 to 2011 with minimum 2-year follow-up were identified. A control group (no-PD) was created via 1:1 propensity score-matching by age, gender, and Charlson/Deyo score. Univariate analysis compared demographics, complications, and revisions. Multivariate binary stepwise logistic regression identified independent predictors of outcomes. Results: 470 propensity score-matched patients (PD: n = 235; no-PD: n = 235) were identified. PD patients demonstrated higher rates of overall and postoperative wound infection ( p < 0.05), with comparable individual and overall complication and revision rates. PD did not increase odds of complications or revisions. PD patients had lengthier hospital stay (4.97 vs. 4.07 days, p = 0.001) and higher proportion of second primary THA >2-years postoperatively (69.4% vs. 59.6%, p = 0.027). Charlson/Deyo index was the greatest predictor of any surgical complication (OR = 1.17, p = 0.029). Female sex was the strongest predictor of any medical complication (OR = 2.21, p < 0.001). Discussion: Despite lengthier hospital stays and infection-related complications, PD patients experienced comparable complication and revision rates to patients from the general population undergoing THA.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty in Parkinson’s disease patients: a propensity score-matched analysis with minimum 2-year surveillance

et al. 2019

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“…The majority of studies have demonstrated that THA and TKA are safe in patients with Parkinson's disease and achieve excellent pain control [16][17][18][19]. Functional outcomes are less clear, but longer term are likely related at least in part to disease progression [13,14,39].…”

Section: Discussionmentioning

confidence: 99%

“…The literature on THA and TKA outcomes in PD patients is largely limited to case series of operations performed between the 1970s and 1990s [11][12][13][14][15]. Of the larger studies that have been done, all demonstrated that PD patients experienced relief of pain, the most common reason for surgery, but changes in functional status were less consistent [16][17][18][19]. Studies of perioperative complications associated with TKA and THA have suggested that comorbid PD is associated with increased rates of perioperative urinary tract infection, cognitive dysfunction, blood transfusion, periprosthetic infection, hip fracture, or dislocation [19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Parkinson Disease Associated Differences in Elective Orthopedic Surgery Outcomes: A National Readmissions Database Analysis

Fullard¹,

Thibault

Zisling

et al. 2020

JPD

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Background: Advances in the treatment of Parkinson’s disease (PD) have allowed for improvements in mortality and quality survival, making the management of comorbid conditions of aging, such as osteoarthritis, crucial. Objective: To determine the extent to which PD impacts hospitalization outcomes after an elective orthopedic procedure. Methods: This retrospective cohort study used data from the National Readmissions Database and included adults ages 40 and above with and without PD. Primary outcomes included length of stay of the index admission, discharge disposition and 30-day readmission. Logistic regression was used to compare the odds of readmission for PD patients compared to non-PD. Clinical conditions associated with readmission were compared between the two groups. Results: A total of 4,781 subjects with PD and 947,475 subjects without PD met inclusion criteria. Length of stay (LOS) during the index admission was longer for PD patients. PD patients were much more likely to be discharged to inpatient post-acute care (49.3% vs 26.2%) while non-PD subjects were more likely to be discharged home with (31.9% [PD] vs 44.8% [non-PD]) or without home health (18.7% [PD] vs 28.9% [non-PD]). A total of 271 PD patients (5.66%) and 28,079 non-PD patients (2.96%) were readmitted within 30 days following surgery. After adjusting for age, sex, socioeconomic status, expected payer, comorbidities, index admission LOS, year and discharge disposition, PD subjects were 31% more likely to be readmitted than non-PD subjects (AOR 1.31, 1.07–1.62). Conclusions: Parkinson’s disease patients were readmitted more often than non-PD patients, although the rate of readmission was still low.

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“…Auch in einer retrospektiven Analyse von 59 Parkinsonpatienten, die mit einer zementfreien Hüftendoprothese mit DMC versorgt wurden, zeigte sich nach durchschnittlich 8,3 Jahren keine Dislokation. Jedoch traten eine IPD sowie vermutlich sturzbedingt 4 periprothetische Frakturen auf [60]. In 2 Untersuchungen an gemischten Kollektiven von Hochrisikopatienten (neurodegenerative Erkrankungen, Alter über 70 bzw.…”

Section: Neuromuskuläre Erkrankungenunclassified

Dual-Mobility Cups in Primary Total Hip Arthroplasty

et al. 2021

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Dual-mobility cups (DMCs) were introduced in France more than 40 years ago and are increasingly used not only in hip revision but also primary hip arthroplasty. Due to a simulated large-head articulation and increased jumping distance, DMCs can contribute to a high range of motion in the hip joint and reduce the risk of instability. Numerous studies have reported low dislocation rates and high survival rates in the mid-term follow-up. Nevertheless, long-term data, especially on primary hip replacement, remain limited, and the effect of recent designs and material innovations is still unclear. Therefore, primary DMCs are mainly proposed in patients at high risk for dislocation (i.e. pelvitrochanteric insufficiency, compromised spinopelvic mobility, neuromuscular disorders, obesity and femoral neck fractures). Based on a review of recently published studies referring to these indications, the current study discusses the advantages and disadvantages of DMCs.

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Total Hip Arthroplasty in Patients With Parkinson Disease: Improved Outcomes With Dual Mobility Implants and Cementless Fixation

Abstract: Our study shows that elective primary or revision THA using cementless implants with dual mobility bearing surface in patients with PD provides satisfactory long-term outcomes, although many of these patients may see a general worsening of their activities over time due to PD.

Cited by 22 publications

References 31 publications

Total hip arthroplasty in Parkinson’s disease patients: a propensity score-matched analysis with minimum 2-year surveillance

Total hip arthroplasty in Parkinson’s disease patients: a propensity score-matched analysis with minimum 2-year surveillance

Parkinson Disease Associated Differences in Elective Orthopedic Surgery Outcomes: A National Readmissions Database Analysis

Dual-Mobility Cups in Primary Total Hip Arthroplasty

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