Total Knee Arthroplasty In Patients With Parkinson's Disease- A Critical Analysis of Available Evidence

Ashraf, Munis; Priyavadhana, Sruthi; Sambandam, Senthil; Mounasamy, Varatharaj; Sharma, Om P.

doi:10.2174/1874325001711011087

Cited by 12 publications

(6 citation statements)

References 15 publications

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“…Total knee arthroplasty might partially alleviate pain for long periods (up to 3 years) for PD patients with musculoskeletal pain coming from bony degenerative changes. However, the functional outcome appeared to deteriorate post-operatively, over the long term [ 92 ]. Similarly, reverse shoulder arthroplasty, designed to provide inherent shoulder constraint, reduced shoulder pain for PD patients with musculoskeletal pain coming from degenerative changes of shoulder joints, but clinical function was inferior compared to controls [ 93 ].…”

Section: Treatment Of Pain In Pdmentioning

confidence: 99%

An overview of pain in Parkinson's disease

Tai

Lin

2020

Clinical Parkinsonism & Related Disorders

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Pain is a common non-motor symptom of Parkinson's disease (PD) and the prevalence of pain among PD patients varies because of the disease stage, co-morbidities, and evaluating tools. Risk factors for pain in PD include an early age of onset, long disease duration, motor complications, concomitant depressive symptoms, female gender, and associated medical conditions. In patients with PD, pain can be classified as musculoskeletal pain, chronic body pain (central or visceral), fluctuation-related pain, nocturnal pain, orofacial pain, pain with discolouration/oedema/swelling, and radicular/neuropathic pain; musculoskeletal pain as the most common type. Potential underlying mechanisms include a disruption of peripheral nociception and alterations in central pain threshold/processing. Genetic polymorphisms in genes that confer pain susceptibility might also play a role in the occurrence of pain in PD. In advanced stage of patients with PD, polyneuropathy could occur in patients using high dosage of levodopa. Pain often correlates to other non-motor symptoms of PD, including depression, sleep, and autonomic symptoms. Dopaminergic drugs, non-dopaminergic medications, botulinum toxin, deep brain stimulation, and physiotherapy have shown some benefits for certain types of PD-related pain. An increased awareness of pain as a common non-motor symptom of PD provides further insights into sensory system dysregulation in this disease. In this review, we aim to summarizes the clinical features of pain in patients with PD and emphasize the latest evidence of pain related to levodopa treatment.

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Section: Treatment Of Pain In Pdmentioning

confidence: 99%

An overview of pain in Parkinson's disease

Tai

Lin

2020

Clinical Parkinsonism & Related Disorders

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“…It is hypothesized that medications used to treat PD can cause abnormalities in the coagulation-fibrinolysis process. 6 However, several other factors such as surgical exposure, increased surgical time (required to overcome the exposure secondary to rigidity of hamstrings), and implant choice (more use of revision and constrained prosthesis to balance the knee joint and avoid dislocations causes more blood loss 7 ) may have a notable influence on this outcome.…”

Section: Discussionmentioning

confidence: 99%

Complications During the Hospital Stay, Length of Stay, and Cost of Care in Parkinson Patients Undergoing Total Knee Arthroplasty: A Propensity Matched Database Study

et al. 2022

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Background: Patients with Parkinson disease (PD) undergoing total knee arthroplasty (TKA) can present with a unique subset of challenges during their hospital stay. The literature is limited to single-center studies with a small number of patients. This study was aimed to analyze the inpatient complications, length of stay (LOS), and cost of care (COC) associated after TKA with PD over 4 years (2016 to 2019). Methods: In this retrospective cohort study, we used National Inpatient Sample (NIS) database data from 2016 to 2019 and compared in-hospital complications, LOS, and COC among patients undergoing TKA with and without PD. Results: The National Inpatient Sample database is used to identify 558,371 patients (555,289 without PD and 3,082 with PD) who underwent TKA. After propensity-matching, there was an increased incidence of blood loss anemia (PD group 22.3%, control group 13.5%, P # 0.01), periprosthetic dislocations (1.5% in PD group, 0.4% in control group, P , 0.001), and periprosthetic mechanical complications including but not limited to periprosthetic fractures, knee dislocations, patellar maltracking, and subluxations (1.1% in PD group, 0.6% in control group, P = 0.024) in the PD group. The other inhospital complications including mortality, acute renal failure, myocardial infarction, pneumonia, pulmonary embolism, deep vein thrombosis, periprosthetic fracture, and wound dehiscence showed no notable differences. The average total incurred charges for the PD group were higher, with a mean of $67,581.58 (SD $44,554.64), than that in the control group, with a mean of $64,795.51 (SD $45,841.25) (P , 0.001). The average LOS was higher in the PD group with a mean of 2.7 days (SD = 1.93) compared with the control group (mean = 2.3, SD = 1.73 days, P , 0.001).

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“…However, its functional outcome often worsens in the long term. In patients with PD, TKA is a difficult procedure that requires a holistic approach involving several specialists, including orthopaedic surgeons, neurologists, physiatrists, pain service staff, and geriatrics specialists, whose collaboration is necessary to ensure the success of the intervention ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

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

Rodríguez-Merchán

Kalbakdij-Sánchez²

2022

EFORT Open Reviews

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Parkinson’s disease (PD) is a common neurodegenerative disorder. When patients with PD undergo total knee arthroplasty (TKA) for knee osteoarthritis, poorer knee function and poorer quality of life are obtained than in matched cohorts (MCs). However, the degree of patient satisfaction is usually high. The mean length of stay is 6.5% longer in patients with PD than in MCs. Compared with MCs, patients with PD undergoing TKA have a 44% higher risk of complications. In patients with PD, the overall complication rate is 26.3% compared with 10.5% in MCs; the periprosthetic joint infection rate is 6.5% in patients with PD vs 1.7% in MCs; and the periprosthetic fracture rate is 2.1% in patients with PD vs 1.7% in MCs. The 90-day readmission rate is 16.29% in patients with PD vs 12.66% in MCs. More flexion contractures occur in patients with PD. The rate of medical complications is 4.21% in patients with PD vs 1.24% in MCs, and the rate of implant-related complications is 5.09% in patients with PD vs 3.15% in MCs. At 5.3 years’ mean follow-up, the need for revision surgery is 23.6%. The 10-year implant survival, taking revision of any of the components as an endpoint, is 89.7% in patients with PD vs 98.3% in MCs.

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Total Knee Arthroplasty In Patients With Parkinson's Disease- A Critical Analysis of Available Evidence

Cited by 12 publications

References 15 publications

An overview of pain in Parkinson's disease

An overview of pain in Parkinson's disease

Complications During the Hospital Stay, Length of Stay, and Cost of Care in Parkinson Patients Undergoing Total Knee Arthroplasty: A Propensity Matched Database Study

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

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