Surgical outcomes of primary hip and knee replacements in patients with Parkinson’s disease

a nationwide registry-based case-controlled study

E. Jämsen, T. Puolakka, M. Peltola, A. Eskelinen, M. U. K. Lehto

Abstract

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.

Cite this article: Bone Joint J 2014;96-B:486–91.

Footnotes

  • The work of one of the authors had been financially supported by the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (grant 9P016).

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

    This article was primary edited by G. Scott and first proof edited by D. Rowley.

  • Supplementary material. Tables demonstrating additional results, and a sensitivity analysis including only cemented unilateral total joint replacements, are available alongside the electronic version of this article on our website www.bjj.boneandjoint.org.uk

  • Received November 4, 2013.
  • Accepted December 31, 2013.
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