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Total hip arthroplasty in Parkinson's disease patients: a propensity score-matched analysis with minimum 2-year
Neil V Shah1, Maximillian Solow2, Joshua D Lavian1
1Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY), Downstate Medical Center, NY, USA.
Introduction:
Parkinson's disease (PD) patients experience chronic pain related to osteoarthritis at comparable rates to the general population. While total hip arthroplasty (THA) effectively improves pain, functionality, and quality of life in PD patients, long-term outcomes following THA are under-reported. This study sought to investigate whether PD patients have an increased risk of complications and revision following THA in comparison to the general population.
Methods:
Utilising New York State's Statewide Planning and Research Cooperative System, all PD patients who underwent THA from 2009 to 2011 with minimum 2-year follow-up were identified. A control group (no-PD) was created via 1:1 propensity score-matching by age, gender, and Charlson/Deyo score. Univariate analysis compared demographics, complications, and revisions. Multivariate binary stepwise logistic regression identified independent predictors of outcomes.
Results:
470 propensity score-matched patients (PD: n = 235; no-PD: n = 235) were identified. PD patients demonstrated higher rates of overall and postoperative wound infection (p < 0.05), with comparable individual and overall complication and revision rates. PD did not increase odds of complications or revisions. PD patients had lengthier hospital stay (4.97 vs. 4.07 days, p = 0.001) and higher proportion of second primary THA >2-years postoperatively (69.4% vs. 59.6%, p = 0.027). Charlson/Deyo index was the greatest predictor of any surgical complication (OR = 1.17, p = 0.029). Female sex was the strongest predictor of any medical complication (OR = 2.21, p < 0.001).
Discussion:
Despite lengthier hospital stays and infection-related complications, PD patients experienced comparable complication and revision rates to patients from the general population undergoing THA.