Surgical outcomes of primary hip and knee replacements in patients with Parkinson's disease: a nationwide registry-based case-controlled study

• Published in: The bone & joint journal Vol. 96-B; no. 4; pp. 486 - 491
• Main Authors: Jämsen, E, Puolakka, T, Peltola, M, Eskelinen, A, Lehto, M U K
• Format: Journal Article
• Language: English
• Published: England 01.04.2014
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - mortality; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - mortality; Case-Control Studies; Female; Finland - epidemiology; Hip Dislocation - etiology; Hip Prosthesis - adverse effects; Hospitalization - statistics & numerical data; Humans; Kaplan-Meier Estimate; Knee Prosthesis - adverse effects; Length of Stay - statistics & numerical data; Male; Middle Aged; Osteoarthritis, Hip - complications; Osteoarthritis, Hip - mortality; Osteoarthritis, Hip - surgery; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - mortality; Osteoarthritis, Knee - surgery; Parkinson Disease - complications; Parkinson Disease - mortality; Prosthesis-Related Infections - etiology; Prosthesis-Related Infections - mortality; Registries; Reoperation - statistics & numerical data; Risk Factors; Treatment Outcome; Finland; Joint replacement; Parkinson’s disease; Revision; Hip dislocation; Mortality; Arthroplasty register
• DOI: 10.1302/0301-620X.96B4.33422
• ISSN: 2049-4394

We evaluated the duration of hospitalisation, occurrence of infections, hip dislocations, revisions, and mortality following primary hip and knee replacement in 857 patients with Parkinson's disease and compared them with 2571 matched control patients. The data were collected from comprehensive nationwide Finnish health registers. The mean follow-up was six years (1 to 13). The patients with Parkinson's disease had a longer mean length of stay (21 days [1 to 365] vs 13 [1 to 365] days) and an increased risk for hip dislocation during the first post-operative year (hazard ratio (HR) 2.33, 95% confidence intervals (CI) 1.02 to 5.32). There was no difference in infection and revision rates, and one-year mortality. In longer follow-up, patients with Parkinson's disease had higher mortality (HR 1.94, 95% CI 1.68 to 2.25) and only 274 (34.7%) were surviving ten years after surgery. In patients with Parkinson's disease, cardiovascular and psychiatric comorbidity were associated with prolonged hospitalisation and cardiovascular diseases also with increased mortality.