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Parkinson’s disease increases the risk of perioperative complications after total knee arthroplasty: a nationwide database study

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Therefore, the purpose of this study was to evaluate the short-term perioperative outcomes of PD patients who underwent total knee arthroplasty (TKA). We specifically evaluated: (1) perioperative surgical and medical complications; (2) lengths of stay (LOS); and (3) total hospital charges.

Methods

The Nationwide Inpatient Sample was used to identify PD patients who underwent TKA between 2002 and 2013. To control for potential confounders, PD TKA and non-PD TKA patients were propensity score matched (1:3) based on age, sex, ethnicity, Charlson Comorbidity Index, and insurance type. A total of 31,979 PD and 95,596 non-PD TKA patients were included.

Results

PD patients had a 44% higher risk of suffering from any complication (OR 1.44; 95% CI 1.35–1.54), a 45% increased risk for any medical complication (OR 1.45; 95% CI 1.36–1.55), and a 9% higher risk for any surgical complication (OR 1.09; 95% CI 0.84–1.41). Compared to the matched cohort, PD patients had a mean LOS that was 6.5% longer (95% CI 5.46–7.54) and mean total hospital charges that were 3.05% higher (95% CI 1.99–4.11).

Conclusions

PD patients are more likely to have postoperative complications, longer LOS, and higher costs after TKA than non-PD TKA patients. Since many of these complications can be prevented, a team-based multi-specialty patient optimization is needed.

Level of evidence

Level III, therapeutic study.

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Acknowledgements

The authors of the present study would like to thank Suparna M. Navale MS, MPH for performing the statistical analysis, and the Healthcare Cost and Utilization Project data partners for contributing to the Nationwide Inpatient Sample database.

Funding

There was no funding provided for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Jared M. Newman & Qais Naziri

  2. Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA

    Nipun Sodhi, Anton Khlopas, Alison K. Klika, Thomas J. Kryzak & Carlos A. Higuera

  3. St. Georges University School of Medicine, True Blue, Grenada

    Alyeesha B. Wilhelm

  4. Department of Orthopaedic Surgery, Lenox Hill Hospital, 100 East 77th Street, New York, NY, 10075, USA

    Michael A. Mont

Authors
  1. Jared M. Newman
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  2. Nipun Sodhi
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  3. Alyeesha B. Wilhelm
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  4. Anton Khlopas
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  5. Alison K. Klika
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  6. Qais Naziri
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  7. Thomas J. Kryzak
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  8. Carlos A. Higuera
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  9. Michael A. Mont
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Contributions

CAH has been involved in the following relevant financial activities outside of this work: KCI, Zimmer Biomet, Covance, Pfizer, TenNor Therapeutics Limited; and has received research support funding outside of this work from Stryker, Myoscience, CD Diagnostics, KCI, OREF, Pacira, 3M, Cymedica, Ferring Pharmaceuticals, and Orthofix, Inc. MAM has been involved in the following relevant financial activities outside of this work: Stryker Orthopaedics, DJ Orthopedics, Microport, Johnson & Johnson, Medical Compression Systems, OnGoing Care Solutions, Sage Products LLC, TissueGene, Pacira Pharmaceuticals, Merz, Orthosensor, Cymedica, Mallinckrodt Pharmaceuticals, Abbott, Performance Dynamics Inc., Peerwell; and has received research support funding outside of this work from National Institutes of Health (NIAMS & NICHD).

Corresponding author

Correspondence to Michael A. Mont.

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Conflict of interest

The author declares that there is no competing interest.

Ethical approval

This study used publicly available, de-identified data, and was deemed exempt by our institutional review board.

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Newman, J.M., Sodhi, N., Wilhelm, A.B. et al. Parkinson’s disease increases the risk of perioperative complications after total knee arthroplasty: a nationwide database study. Knee Surg Sports Traumatol Arthrosc 27, 2189–2195 (2019). https://doi.org/10.1007/s00167-018-4970-y

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  • DOI: https://doi.org/10.1007/s00167-018-4970-y

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