Abstract
Purpose
The purpose of this study was to compare the functional outcomes, activity levels, mortalities, implant survival rates, and complications of total knee arthroplasty (TKA) of patients with Parkinson’s disease (PD) with those of patients in a control group over a minimum ten year follow-up period.
Methods
From January 2007 to December 2009, 46 TKAs were performed in 29 patients with PD (PD group). Fifty-eight matched patients without PD were used as the control group in a two-to-one ratio using propensity scoring matching. The functional outcomes, activity levels, mortalities, implant survival rates, and complications of TKA in patients with PD and control group were compared.
Results
The mean Knee Society knee scores in PD and control group improved from 36.8 and 37.1 pre-operatively to 60.0 and 80.7 points at the final follow-up, respectively (p < 0.05). Outdoor ambulatory patients at the final follow-up included 13 of 20 (65.0 %) in PD group and 51 of 54 (94.4%) patients in control group (p < 0.05). The cumulative mortality rates in PD and control group were 31% (9/29) and 6.9% (4/58) (p < 0.05), at final follow-up, respectively. Kaplan-Meier survivorship analysis with revision of either components as endpoints in PD and control group estimated 89.7% and 98.3% chances of survival for ten years, respectively.
Conclusions
TKAs in patients with PD were shown to have worse functional outcomes and higher mortality over a minimum ten year follow-up period. Therefore, the necessity of the procedure should be considered carefully depending on patient needs and conditions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
All data generated or analyzed during this study are included in this published article.
References
de Lau LM, Breteler MM (2006) Epidemiology of Parkinson’s disease. Lancet Neurol 5(6):525–535. https://doi.org/10.1016/S1474-4422(06)70471-9
Kalia LV, Lang AE (2015) Parkinson’s disease. Lancet 386(9996):896–912. https://doi.org/10.1016/S0140-6736(14)61393-3
Park JH, Kim DH, Kwon DY, Choi M, Kim S, Jung JH, Han K, Park YG (2019) Trends in the incidence and prevalence of Parkinson’s disease in Korea: a nationwide, population-based study. BMC Geriatr 19(1):320. https://doi.org/10.1186/s12877-019-1332-7
Mehta S, Vankleunen JP, Booth RE, Lotke PA, Lonner JH (2008) Total knee arthroplasty in patients with Parkinson’s disease: impact of early postoperative neurologic intervention. Am J Orthop (Belle Mead NJ) 37(10):513–516
Koval KJ, Aharonoff GB, Rosenberg AD, Bernstein RL, Zuckerman JD (1998) Functional outcome after hip fracture: effect of general versus regional anesthesia. Clin Orthop Relat Res 348:37–41
Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
Insall JN, Hood RW, Flawn LB, Sullivan DJ (1983) The total condylar knee prosthesis in gonarthrosis. A five to nine-year follow-up of the first one hundred consecutive replacements. J Bone Joint Surg Am 65:619–628
Duffy GP, Trousdale RT (1996) Total knee arthroplasty in patients with Parkinson’s disease. J Arthroplast 11:899–904. https://doi.org/10.1016/s0883-5403(96)80130-6
Sun QC, Ru XL, Song BS, Duanmu QL, Xia YF, Qiao S, Yan SG, Wang XH (2018) Mid-term follow-up and clinical efficacy of total knee arthroplasty for osteoarthritis patients with Parkinson’s disease. Zhongguo Gu Shang 31(3):257–262. https://doi.org/10.3969/j.issn.1003-0034.2018.03.013
Tinning CG, Cochrane LA, Singer BR (2013) Primary total knee arthroplasty in patients with Parkinson’s disease: analysis of outcomes. Acta Orthop Belg 79:301–306
Vince KG, Insall JN, Bannerman CE (1989) Total knee arthroplasty in the patient with Parkinson’s disease. J Bone Joint Surg (Br) 71:51–54
Wong EH, Oh LJ, Parker DA (2018) Outcomes of primary total knee arthroplasty in patients with Parkinson’s disease. J Arthroplast 33(6):1745–1748. https://doi.org/10.1016/j.arth.2018.02.028
Oni OO, Mackenney RP (1985) Total knee replacement in patients with Parkinson’s disease. J Bone Joint Surg 67(3):424–425. https://doi.org/10.1302/0301-620X.67B3.3997953
Jamsen E, Puolakka T, Peltola M, Eskelinen A, Lehto MUK (2014) Surgical outcomes of primary hip and knee replacements in patients with Parkinson’s disease: a nationwide registry-based case-controlled study. Bone Joint J 96-B(4):486–491. https://doi.org/10.1302/0301-620X.96B4.33422
Rodon AJ, Tan TL, Schlitt PK, Greenky MR, Phillips JL, Purtill JJ (2018) Total joint arthroplasty in patients with Parkinson’s disease: survivorship, outcomes, and reasons for failure. J Arthroplast 33(4):1028–1032. https://doi.org/10.1016/j.arth.2017.11.017
Author information
Authors and Affiliations
Contributions
Ji-Hoon Baek, Yong-Chan Ha: writing and revision of article.
Chang Hyun Nam, Su Chan Lee, Hye Sun Ahn: data collection and statistical analysis.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics approval
This study was approved by the Institutional Review Board of Himchan hospital.
Consent to participate
All patients provided written informed consent to use their medical records in advance.
Consent for publication
Authors agree to publication. This manuscript has not been published in any journal.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Level of evidence: IV
Rights and permissions
About this article
Cite this article
Baek, JH., Nam, C.H., Lee, S.C. et al. Poor outcomes of primary total knee arthroplasty in patients with Parkinson’s disease. International Orthopaedics (SICOT) 45, 643–647 (2021). https://doi.org/10.1007/s00264-020-04924-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-020-04924-z