Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications

F Díaz-Dilernia; A García-Mansilla; T Nicolino; J Costantini; L Carbo

doi:10.1016/j.recot.2023.04.001

Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications

Rev Esp Cir Ortop Traumatol. 2023 Sep-Oct;67(5):418-425. doi: 10.1016/j.recot.2023.04.001. Epub 2023 Apr 7.

[Article in English, Spanish]

Authors

F Díaz-Dilernia¹, A García-Mansilla², T Nicolino³, J Costantini³, L Carbo³

Affiliations

¹ Sunnybrook Health Sciences Centre/Holland Orthopaedic & Arthritic Centre, Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canadá. Electronic address: fernandodiazdilernia@gmail.com.
² Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: garciamansillaagustin@gmail.com.
³ Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

PMID: 37031862
DOI: 10.1016/j.recot.2023.04.001

Abstract

Introduction: Thanks to improvements in the medical treatment of Parkinson's disease (PD), the life expectancy of these patients has increased, but the overall outcome after total knee arthroplasty (TKA) is controversial. We aim to analyse a series of patients with PD, evaluating their clinical status, functional results, complications and survival rates after TKA.

Methods: We retrospectively studied 31 patients with PD operated between 2014-2020. The mean age was 71 years (SD±5.8). There were 16 female patients. The mean follow-up was 68.2 months (SD±36). We used the Knee Scoring System (KSS) and the Visual Analog Scale (VAS) for the functional evaluation. The Modified Hoehn and Yahr Scale was used to assess the severity of PD. All complications were recorded, and survival curves were performed.

Results: The mean postoperative KSS evaluation had an increase of 40 points [35 (SD±15) vs 75 (SD±15) (P<.001)]. The mean postoperative VAS decreased 5 points [8 (SD±2) vs 3 (SD±2) (P<.001)]. Thirteen patients reported being very satisfied, 13 were satisfied, and only 5 were poorly satisfied. Seven patients suffered surgical complications, and 4 patients had recurrent patellar instability. At a mean 68.2 months follow-up, the overall survival rate was 93.5%. When considering the secondary patellar resurfacing as the endpoint, the survival rate was 80.6%.

Conclusions: In this study, TKA was associated with excellent functional outcomes in patients with PD. At a mean 68.2 months follow-up, TKA had excellent survivorship in the short term, with recurrent patellar instability as the most common complication. Even though these findings confirm the effectiveness of TKA in this population, a thorough clinical evaluation and multidisciplinary approach are needed to decrease the likelihood of complications.

Keywords: Artroplastia total de rodilla; Complicaciones; Complications; Enfermedad de Parkinson; Functional outcomes; Parkinson's disease; Resultados funcionales; Survival rate; Tasa de supervivencia; Total knee arthroplasty.