Total Joint Arthroplasty in Patients With Parkinson's Disease: Survivorship, Outcomes, and Reasons for Failure

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

doi:10.1016/j.arth.2017.11.017

Cited by 40 publications

(45 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While patients in both groups were readmitted with infec-tion, it was more common among PD patients. A greater risk of post-operative infection (prosthetic and non-prosthetic) in PD has been previously demonstrated and was confirmed with the current data [20,21]. Due to dysphagia and dysautonomia, PD patients are at higher risk for aspiration pneumonia and UTI, which can develop during or after a hospitalization and prompt readmission.…”

Section: Discussionsupporting

confidence: 88%

“…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]. Length of hospital stay for PD patients was also consistently longer [23,24].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Fullard¹,

Thibault

Zisling

et al. 2020

JPD

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 88%

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

View full text Add to dashboard Cite

show abstract

“…A number of studies have been published on cerebral dysfunction (i.e., a state of confusion, history of excessive alcohol consumption, Parkinson's disease, or neuromuscular disorders) and the risk of dislocation following THA (7,29,30). Several analyses have been performed on various patient characteristics (e.g., age, sex, height, weight, pre-operative diagnosis and cerebral dysfunction) and the rate of dislocation; the only variable associated with a higher dislocation rate was found to be cerebral dysfunction (7).…”

Section: Incidence Of Dislocation Following Total Hip Arthroplasty (Tmentioning

confidence: 99%

Causes of and treatment options for dislocation following total hip arthroplasty (Review)

Xiao

Xue

2019

Exp Ther Med

View full text Add to dashboard Cite

The second most common complication following total hip arthroplasty (THA) is dislocation. The majority of dislocations occur early in the post-operative period and are due to either patient-associated or surgical factors. The patient-associated factors that have been implicated as causes of post-operative dislocation include previous surgery, lumbar spine fusion surgery and/or neurological impairment. The surgical factors include surgical approach, component orientation and prosthetic and/or bony impingement. In order to delineate the cause of the hip instability a thorough history and physical and a radiographic assessment (possibly including advanced imaging) needs to be performed. Approximately two thirds of cases are successfully treated; one third of cases will require surgical treatment (e.g., revision arthroplasty (including constrained liners, the use of elevated rim liners and dual mobility implants or trochanteric advancement). In this review, we discuss the causes leading to dislocation following THA and evaluate the different treatment options available.

show abstract

“…Furthermore, we found excellent prosthetic survivorship in PD patients (60 months, 91.6% (95% CI 80.4–99.9%)). However, previous studies [16, 27] suggested TJA in PD patients resulted in a higher risk of revision or hip dislocation. Recurrent posterior dislocation was also reported in PD patients [28].…”

Section: Discussionmentioning

confidence: 96%

“…Previous studies presented conflict conclusions with regard to functional outcomes. One study presented improvement in SF-12 scores in PD patients who underwent TJA, but it was greater in the control cohort [16]. Certain studies confirmed poor functional improvement in PD patients after TJA [17, 18], and two studies indicate the functional results depend on the severity and progression of PD [18, 19].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

View full text Add to dashboard Cite

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.

show abstract

Total Joint Arthroplasty in Patients With Parkinson's Disease: Survivorship, Outcomes, and Reasons for Failure

Cited by 40 publications

References 24 publications

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

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

Causes of and treatment options for dislocation following total hip arthroplasty (Review)

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

Contact Info

Product

Resources

About