Total knee arthroplasty in Parkinson’s disease patients. Preliminary results
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Jun 30, 2014
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Abstract
Background: Parkinson’s disease is a progressive, chronic, neurodegenerative disorder with an approximate incidence of 31/100,000 persons in Argentina.The aim of this study was to assess a group of patients with Parkinson’s disease who underwent total knee arthroplasty.Methods: Between 2009 and 2011, 11 patients with Parkinson’s disease (average age 68 years, range 65-80) who underwent cemented posterior stabilized total knee arthroplasty for osteoarthritis were retrospectively reviewed. All patients were evaluated with a visual analogue scale for pain, the Knee Society Scoring, the WOMAC and the degree of subjective satisfaction. Degree of Par- kinson severity was measured with the Modified Hoehn and Yahr Scale. Complications were recorded.Results: The average follow-up was two years (range 1-3). Results for pain and function were: visual analogue scale for pain improved an average of 3 points; KSS pain 37/74; functional KSS 36/51, WOMAC 67/31. Satisfaction was good to excellent in 7 cases. The Modified Hoehn and Yahr Scale was 1.5 points preoperatively and 2.6 points postoperatively. There were 6 complications: two confusional syndromes, a deep venous thrombosis, a prosthetic dislocation and two painful prostheses.Conclusion: Total knee arthroplasty in patients with Parkinson’s disease is a procedure that improves functional outcomes and pain, but it produces more complications than in the general population.
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Bonifacio, J. P., Costa Paz, M., Carbo, L., Yacuzzi, C., & Corinaldesi, E. (2014). Total knee arthroplasty in Parkinson’s disease patients. Preliminary results. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 79(2), 99-106. https://doi.org/10.15417/224
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Clinical Research
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2001;110(6):33-40
Mov Disord 2005;20(11):1449-54.
2. Barbosa ER, Limongi JC, Cummings JL. Parkinson’s disease. Psychiatr Clin North Am 1997;20(4):769-90.
3. Weintraub D, Comella CL, Horn S. Parkinson’s disease: Part 1. Pathophysiology, symptoms, burden, diagnosis, and
assessment. Am J Manag Care 2008;14(2):S40-S48.
4. Wood BH, Bilcough JA, Walker RW, Bowron A. Incidence and prediction of falls in Parkinson’s disease: a prospective
multidisciplinary study. J Neurol Neurosurg Psychiatry 2002;72:721-5.
5. Leibson CL, Maraganore DM, Bower JH, Ransom JE, O’Brien PC, Rocca WA. Comorbid conditions associated with
Parkinson’s disease: A population-based study. Mov Disord 2006;21(4):446-55.
6. Geller JA, Macaulay W, Brown AR, Cote LJ, Kiernan HA. Total knee arthroplasty and Parkinson disease: enhancing
outcomes and avoiding complications. J Am Acad Orthop Surg 2010;18:687-94.
7. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop 1989;(248):13-14.
8. Bellamy N, Buchanan WW. A preliminary evaluation of the dimensionality and clinical importance of pain and disability in
osteoarthritis of the hip and knee. Clin Rheumatol 1986;5:231-41.
9. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967;17(5):427-42.
10. Duffy GP, Trousdale RT. Total knee arthroplasty in patients with Parkinson’s disease. J Arthroplasty 1996;11(8):899-904.
11. Vince KG, Insall JN, Bannerman CE. Total knee arthroplasty in the patient with Parkinson’s disease. J Bone Joint Surg Br
1989;71(1):51-4.
12. Mehta S, VanKleunen JP, Robert E, Booth RE, Lotke PA, Lonner JH. Total knee arthroplasty in patients with Parkinson’s
disease: Impact of early postoperative neurologic intervention. Am J Orthop 2008;37(10):513-6.
13. Oni OO, Mackenney RP. Total knee replacement in patients with Parkinson’s disease. J Bone Joint Surg Br 1985;67(3):424-5.
14. Erceg M, Maricevic A. Recurrent posterior dislocation following primary posterior-stabilized total knee arthroplasty. Croat Med
J 2000;41(2):207-9.
15. Coughlin L, Templeton J. Hip fractures in patients with Parkinson’s disease. Clin Orthop 1980;148:192-5.
16. Eventov I, Moreno M, Geller E, Tardiman R, Salama R. Hip fractures in patients with Parkinson’s syndrome. J Trauma
1983;23:98-101.
17. Whittaker RP, Abeshaus MM, Scholl HW, Chung SM. Fifteen years’ experience with metallic endoprosthetic replacement of
the femoral head for femoral neck fractures. J Trauma 1972;12:799-806.
18. Weber M, Cabanela ME, Franklin H, Frassica SFJ, Scott W. Total hip replacement in patients with Parkinson’s disease.
International Orthopaedics (SICOT) 2002;26:66-8.
19. Evans JR, Mason SL, Williams-Gray CH, Foltynie T, Brayne C, Robbins TW, et al. The natural history of treated
Parkinson´s disease in an incident, community base cohort. J Neurol Neurosurg Psychiatry 2011;82:1112-8.
20. Fahn S, Elton RL. Development Committee UPDRS: Unified Parkinson’s Disease Rating Scale. En: Fahn S, Marsden CD,
Goldstein M, Teychenne P (eds.) Recent Developments in Parkinson’s Disease. New York, NY: MacMillan; 1986:153-63.
21. Brosseau L, Milne S, Wells G, Tugwell P, Robinson V, Casimiro L, et al. Efficacy of continuous passive motion following total
knee arthroplasty: A metaanalysis. J Rheumatol 2004;31(11):2251-64.
106 Bonifacio y cols. Rev Asoc Argent Ortop Traumatol
22. Fast A, Mendelsohn E, Sosner J. Total knee arthroplasty in Parkinson’s disease. Arch Phys Med Rehabil 1994;75(11):1269-70.
23. Goetz CG, Tanner CM, Levy M, Wilson RS, Garron DC. Pain in Parkinson´s disease. Mov Disord 1986;1(1):45-9.
24. Waseem S, Gwinn-Hardy K. Pain in Parkinson´s disease; common yet seldom recognized symptom is treatable. Postgrad Med
2001;110(6):33-40