Survivorship and Outcomes in Patients With Multiple Sclerosis Undergoing Total Joint Arthroplasty

Rondon, Alexander J.; Schlitt, Patrick K.; Tan, Timothy L.; Phillips, Jessica; Greenky, Max; Purtill, James J.

doi:10.1016/j.arth.2017.10.056

Cited by 14 publications

(11 citation statements)

References 20 publications

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“…It should be noted that no preoperative functional impairments were recorded, which means that the relative improvement, could not be assessed in this study. Rondon et al reported that, measured by the SF-12 score, the percentage functional improvement in MS patients was less pronounced from preoperative to postoperative [15].…”

Section: Patient Satisfaction and Functional Resultsmentioning

confidence: 99%

“…In the above-mentioned analysis of US private insurance data, a 1.4-fold increased 2-year infection rate (4.8%) was found [13]. In smaller cohort studies the infection rates were between 3-4.6 %, i. e. (non-significantly) increased compared to the control group [14,15]. Prolonged operation time as a risk factor for the periprosthetic infection could be excluded [14].…”

Section: Complications Following Thamentioning

confidence: 96%

“…Both the increased risk of total hip dislocation and periprosthetic joint infection are reflected in THA survival and revision rates in MS patients. Rondon et al described in their study a very high revision rate of 19 % with an average follow-up of 6 years [15]. An association with immunomodulatory therapy (e. g. interferon and glatiramer acetate) or immunosuppressive therapy (e.g.…”

Section: Tha Survival and Revision Ratesmentioning

confidence: 97%

“…This difference could not be explained by the surgical approach [14]. In a retrospective cohort study with 62 THAs and 46 TKAs, a significantly higher rate of prosthesis instabilities was found with 5.6 % [15]. Total hip dislocation is therefore a highly relevant complication in MS patients.…”

Section: Complications Following Thamentioning

confidence: 97%

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Total Hip Arthroplasty in Multiple Sclerosis

2019

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Systemic neurological disease represents a risk factor for complications after total hip arthroplasty (THA), especially for dislocation, infections, gait disorders and fall-related periprosthetic fractures. There is little specific literature on total hip arthroplasty in patients with multiple sclerosis. However, increased revision rates have been reported, which are in part due to dislocations. Implants with increased dislocation safety, e.g. tripolar acetabular systems, can represent a reasonable alternative. Due to gait disorders and a higher prevalence of osteoporosis, specific osteological evaluation and treatment should be considered to prevent periprosthetic fractures. This short review summarizes the current literature on total hip arthroplasty in patients with multiple sclerosis.

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Section: Patient Satisfaction and Functional Resultsmentioning

confidence: 99%

Section: Complications Following Thamentioning

confidence: 96%

Section: Tha Survival and Revision Ratesmentioning

confidence: 97%

Section: Complications Following Thamentioning

confidence: 97%

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Total Hip Arthroplasty in Multiple Sclerosis

2019

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“…To date, we found no literature reporting on the outcome following THA in NMOSD patients. However, it has been reported that patients with neuromuscular diseases including MS are subject to worse functional outcome and higher complication rate after total joint arthroplasty [ 16 , 17 ]. In our series, NMOSD patients experienced more difficulties in activities in daily life, sports and recreation prior to surgery comparing with non-NMOSD patients.…”

Section: Discussionmentioning

confidence: 99%

Patients with neuromyelitis optica spectrum disorder (NMOSD) are associated with adverse outcome after total hip arthroplasty: a matched case–control study

Chen

Qian

Qiu

et al. 2021

Orphanet J Rare Dis

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Background Neuromyelitis Optica Spectrum Disorders (NMOSD) are rare inflammatory diseases of the central nervous system that cause transverse myelitis and optic neuritis. Steroids are commonly administered in NMOSD patients. The use of steroids may lead to osteonecrosis, which makes some of the NMOSD patients candidate for total hip arthroplasty (THA). To date, the clinical outcome of THA in NMOSD patients have not been investigated. Aim Investigate the patient reported outcome measures (PROM), radiographic outcome and complication in NMOSD patients after THA, compared with that of non-NMOSD patients. Methods Patients from Jan. 2016 to October. 2020 were identified in our database. 12 NMOSD cases which met the inclusion criteria were matched to non-NMOSD cases in a ratio of 1:2 based on age, sex, Charlson Comorbidity Index (CCI) and surgical date. Relevant outcome were analyzed and compared between the two groups. Results There was a significantly increased risk of dislocation in NMOSD patients. Post-operative HOOS score was similar between the two groups even though the pre-operative HOOS score is significantly higher in the non-NMOSD group. NMOSD patients had poor performance in EQ-5D and EQ-VAS. The cups were placed more anteverted in NMOSD cases (P = 0.01). Conclusion There is a significantly increased risk of dislocation after THA in NMOSD patients. However, satisfactory improvement in functional outcome of the hip was achieved. Due to the natural process of NMOSD, rehabilitation and hip precaution should be patient-specific and time-specific.

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Differential Diagnosis of Suspected Multiple Sclerosis in Pediatric and Late-Onset Populations

Hua,

Solomon,

Tenembaum

et al. 2024

JAMA Neurol

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ImportanceWhile the typical onset of multiple sclerosis (MS) occurs in early adulthood, 2% to 10% of cases initially present prior to age 18 years, and approximately 5% after age 50 years. Guidance on approaches to differential diagnosis in suspected MS specific to these 2 age groups is needed.ObservationsThere are unique biological factors in children younger than 18 years and in adults older than age 50 years compared to typical adult-onset MS. These biological differences, particularly immunological and hormonal, may influence the clinical presentation of MS, resilience to neuronal injury, and differential diagnosis. While mimics of MS at the typical age at onset have been described, a comprehensive approach focused on the younger and older ends of the age spectrum has not been previously published.Conclusions and RelevanceAn international committee of MS experts in pediatric and adult MS was formed to provide consensus guidance on diagnostic approaches and key clinical and paraclinical red flags for non-MS diagnosis in children and older adults.

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Survivorship and Outcomes in Patients With Multiple Sclerosis Undergoing Total Joint Arthroplasty

Cited by 14 publications

References 20 publications

Total Hip Arthroplasty in Multiple Sclerosis

Total Hip Arthroplasty in Multiple Sclerosis

Patients with neuromyelitis optica spectrum disorder (NMOSD) are associated with adverse outcome after total hip arthroplasty: a matched case–control study

Differential Diagnosis of Suspected Multiple Sclerosis in Pediatric and Late-Onset Populations

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