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Outcomes of hip arthroplasty in Parkinson’s disease: a meta-analysis and systematic review

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A Letter to the Editor to this article was published on 12 April 2022

Abstract

Purpose

Hip arthroplasty in Parkinson’s disease (PD) is considered to be associated with higher mortality, perioperative complications, and worse clinical outcomes. The purpose of this study was to evaluate the outcomes of hip arthroplasty in PD.

Methods

The PUBMED, EMBASE, and Cochrane Library databases were searched for all available studies comparing the outcomes of hip arthroplasty in PD and non-PD patients. The quality of the studies was scored using the Newcastle–Ottawa scale (NOS). Meta-analysis was performed using Stata 12.0 software.

Results

Six retrospective cohort studies with a total of 59,878 patients were included. Among them, there were 15,313 patients in the Parkinson’s group and 44,565 in the non-Parkinson’s group. Results showed that patients in the Parkinson’s group were more likely to have periprosthetic fracture (OR = 7.93, 95% CI, 1.96–32.04; P = 0.004), revision surgery (OR = 2.33, 95% CI, 1.37–3.98; P = 0.002), deep vein thrombosis (OR = 2.34, 95% CI, 1.56–3.49; P < 0.01), and urinary tract infection (OR = 1.34, 95% CI, 1.20–1.49; P < 0.01) than those in the non-Parkinson’s group. The Parkinson’s group had a longer hospital stay (WMD = 0.38, 95% CI, 0.24–0.52; P < 0.01) and higher hospitalization costs (WMD = 2487.08, 95% CI, 225.99–4748.17; P = 0.03), but there was no significant difference in short-term postoperative mortality (OR = 1.07, 95% CI, 0.65–1.73; P = 0.80). Hip arthroplasty can significantly improve the function of patients with PD and reduce pain.

Conclusion

Although hip arthroplasty in patients with PD is associated with a higher revision rate and potential risk, it does not increase short-term mortality and can reduce pain, improve function, and improve quality of life. The periprosthetic fracture risk and revision rate are significantly higher and should be accounted for when deciding on operative treatment and communicated to patient with PD.

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Acknowledgements

We would like to thank all participants for their cooperation.

Author information

Author notes

  1. Yu Zhang

    Present address: Department of Orthopedics, the People’s Hospital of Leshan, Baita Street 238#, Leshan, 614000, Sichuan province, China

  2. Shan-shan Chu

    Present address: Department of Neurology, the People’s Hospital of Leshan, Baita Street 238#, Leshan, 614000, Sichuan province, China

Authors and Affiliations

  1. Department of Orthopedics, the People’s Hospital of Leshan, Baita Street 238#, Leshan, 614000, Sichuan province, China

    Kai Liu, Qiu Huang & Yongcai Wang

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Contributions

Yu Zhang and Shan-shan Chu searched literature, extracted relevant data, made statistical analysis and written the article. When there was a disagreement, Liu and Huang gave advice and guidance. Finally, under the help of Wang, we completed the manuscript.

Corresponding author

Correspondence to Yongcai Wang.

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Our hospital did not require ethical approval for such articles, so this paper did not apply for ethical approval.

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The authors declare no competing interests.

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Yu Zhang and Shan-shan Chu are contributed equally to this work

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Zhang, Y., Chu, Ss., Liu, K. et al. Outcomes of hip arthroplasty in Parkinson’s disease: a meta-analysis and systematic review. International Orthopaedics (SICOT) 46, 705–716 (2022). https://doi.org/10.1007/s00264-021-05228-6

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  • DOI: https://doi.org/10.1007/s00264-021-05228-6

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