scholarly journals The Outcomes of Total Hip Replacement in Patients with Parkinson’s Disease: Comparison of the Elective and Hip Fracture Groups

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Pavel Šponer ◽  
Tomáš Kučera ◽  
Michal Grinac ◽  
Aleš Bezrouk ◽  
Daniel Waciakowski
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Walking Ability ◽  
Fracture Group ◽  
Total Hip ◽  
Elective Group

Introduction. The aim of the study was to compare the clinical outcomes following elective and traumatic total hip arthroplasty in Parkinson’s disease patients. Materials and Methods. Ten patients with osteoarthritis comprise the elective group (mean age at operation 74 years; mean follow-up 82 months). Thirteen patients with femoral fracture comprise the hip fracture group (mean age 76 years; mean follow-up 54 months). All patients were followed up at 6 and 36 months postoperatively and at the time of the latest follow-up. Results. Despite the significant improvement in Merle d’Aubigné-Postel and pain scores, disability related to Parkinson’s disease increased during the follow-up. Whereas more than 1/3 of hip fracture patients and all elective patients walked independently at 36 months after total hip arthroplasty, 43% of living patients from both groups were able to walk independently at the time of the latest follow-up. The medical complications were seen mainly in patients with hip fracture. Conclusions. Excellent pain relief with preserved walking ability without support of another person and acceptable complication profile was observed in Parkinson’s disease patients at 36 months after elective total hip arthroplasty. This procedure may be indicated in Parkinson’s disease patients after careful and individualized planning.

scholarly journals TOTAL HIP ARTHROPLASTY IN PATIENTS WITH PARKINSON'S DISEASE

2013 ◽  
Vol 56 (3) ◽  
pp. 110-116 ◽  
Author(s):  
Pradeep George Mathew ◽  
Pavel Šponer ◽  
Tomáš Kučera ◽  
Michal Grinac ◽  
Jiří Knížek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Soft Tissues ◽  
Total Duration ◽  
Walking Distance ◽  
Locomotor System ◽  
Total Hip

The aim of this study is to evaluate the results of total hip arthroplasty in patients with Parkinson’s disease during a period of five years, focusing on the assessment of the risks and benefits of surgery. During this period we performed total hip arthroplasty in 14 patients (15 hips) with Parkinson’s disease. Patients were evaluated by subjective symptoms and objective findings, with a focus on the use of support while walking and walking distance, severity of Parkinson’s disease before surgery and at the time of the last follow-up. During the postoperative period, the following parameters were assessed: length of ICU stay, mobilization, complications, the total duration of hospitalization and follow-up care after discharge.Of the 11 patients (12 hips) followed-up 1–5 years with an average of 3 years after operation 8 cases showed progression of neurological disability. 5 patients (6 hips) showed an increased dependence on the use of support when walking and reduced distance that the patient was able to walk. Subjectively, 10 hip joints were completely painless and 2 patients complained of only occasional mild pain in the operated hip. Complications that were encountered were urinary tract infection (5 patients), cognitive impairment (3 patients) and pressure ulcer (2 patients). We did not observe any infection or dislocation of the prosthesis. Three patients fell and fractured the femur and 3 patients in our cohort died during follow up.Implantation of total replacement is possible with judicious indication after careful evaluation of neurological finding in patients with minimal or mild functional impairment of the locomotor system. Prerequisite for a good result is precise surgical technique and optimal implant position with balanced tension of the muscles and other soft tissues around the hip.

scholarly journals Study of functional outcome of total hip arthroplasty in a series of cases of hip pathologies done in rural population

2016 ◽  
Vol 2 (4) ◽  
pp. 269
Author(s):  
Rahul Kadam ◽  
Pankaj Bansal ◽  
Abhay Chhallani
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Rural Population ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Walking Ability ◽  
Total Hip ◽  
Medical College

<p class="abstract"><strong>Background:</strong> The objective of the study was to assess the functional outcome of total hip arthroplasty (THA) done in a series of cases of hip pathologies rural population.</p><p class="abstract"><strong>Methods:</strong> A retrospective randomized controlled study conducted in 50 cases of hip arthritis (38 males and 12 females)  treated with uncemented THA for an average follow-up of  2 years  at department of orthopedics MGM Medical College, Kamothe, Navi Mumbai. Harris hip scoring system was used for the functional scoring and the postoperative radiographs were assessed by Gruen zones for the femoral component and DeLee and Charnley zones for the acetabular component. All patients were evaluated pre operatively and post operatively 3 months 6 months, 12months, 2years with Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> 81% of our patients scored 85 points or better for a rating of excellent by Harris hip score system. 90% patients had little /no pain post operatively, whereas walking ability improved and was unlimited in 80% of the patients post operatively. Harris hip score improved from 40 to 80. 80.5% -excellent, 13.80% -good, 5.7% -fair results. Poor results were not seen in any patient.</p><p class="abstract"><strong>Conclusions:</strong> THR provided excellent pain relief, adequate stability, and remarkable range of motion in severely painful, refractory hip. A significant improvement was seen at two year follow-up. </p>

Parkinson's Disease Is Associated with Increased Complications, Readmission Rates, and Costs of Care after Total Hip Arthroplasty: A Matched-Cohort Analysis

2020 ◽  
Vol 4 (03) ◽  
pp. 149-154
Author(s):  
Simon Katz ◽  
Kevin B. Marchand ◽  
Rushabh M. Vakharia ◽  
Hiba Anis ◽  
Nipun Sodhi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Medical Complications ◽  
Administrative Claims ◽  
Matched Cohort ◽  
Readmission Rates ◽  
Total Hip ◽  
Costs Of Care

AbstractStudies investigating the impact of Parkinson's disease (PD) on patients undergoing primary total hip arthroplasty (THA) are limited. Therefore, the purpose of this study was to investigate whether PD patients undergoing primary THA are at increased risk of: (1) medical complications; (2) implant-related complications; (3) readmissions; and (4) costs. A query was performed using an administrative claims database. Matched non-PD patients undergoing primary THA served as a control group. Non-PD patients undergoing primary THA served as a matching cohort. The query yielded 39,184 patients (PD = 9,796; control = 29,388). Pearson's chi-square tests, logistic regression analyses, and Welch's t-tests were used to test for significance between the cohorts. Patients who have PD were found to have increased odds (4.64 vs. 1.15%; odds ratio [OR]: 4.19, 95% confidence interval [CI]: 3.60–4.87, p < 0.0001) of medical complications compared with the matched cohort. PD patients had greater odds of implant-related complications (7.12 vs. 3.99; OR: 1.84, p < 0.0001). PD patients also had significantly higher odds of 90-day readmission (19.83 vs. 15.29%; OR: 1.37, 95% CI: 1.29–1.45, p < 0.0001) and incurred greater 90-day costs of care ($20,143 vs. $16,905, p < 0.0001). The results of the study demonstrate that PD is an independent risk factor for medical complications, implant-related complications, readmission rates, and increased costs of care following a primary THA. The findings of this study should be used in risk stratification and should inform physician–patient discussion but should not be arbitrarily used to deny access to care.

scholarly journals Clinical outcomes in elective total hip arthroplasty in Parkinson’s disease: a systematic review of the literature

2020 ◽  
Vol 5 (12) ◽  
pp. 856-865
Author(s):  
Andreas Fontalis ◽  
Eustathios Kenanidis ◽  
Katharine Bennett-Brown ◽  
Eleftherios Tsiridis
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Muscle Tone ◽  
Perioperative Complications ◽  
Cochrane Central Register ◽  
Total Hip

Parkinson’s disease (PD) poses a significant challenge for the arthroplasty surgeon, owing to excessive muscle tone, higher fracture risk and poor bone quality. Several studies have reported high mortality, early failure and perioperative complications associated with hip fracture surgery in PD; however, no higher-level evidence exists regarding elective hip arthroplasty. The aim of our study was to perform a systematic review to evaluate the evidence basis and clinical outcomes pertaining to patients with underlying Parkinson’s disease undergoing elective total hip arthroplasty (THA). We searched MEDLINE, EMBASE and The Cochrane Central Register of Controlled Trials to identify studies evaluating the safety and clinical outcomes of THA in patients suffering from Parkinson’s. Our review conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ten studies encompassing 49,730 patients were included in our systematic review. Qualitative synthesis demonstrated comparable results between PD patients and controls with respect to one-year mortality and surgical site infections. PD patients experienced more medical complications, had a longer hospital stay and worse long-term implant survival. Some studies also reported a higher rate of dislocation, periprosthetic fractures and aseptic loosening. Decisions about the optimal articulation, the utilization of cemented components, dual-mobility cups or constrained liners were not uniform among included studies. THA in patients with Parkinson’s disease can offer significant functional gains and pain relief. Surgical considerations pertain to the approach and ways to address instability, whereas emphasis should be placed on appropriate counselling and exploring whether potential improvement of life quality outweighs the risks. Cite this article: EFORT Open Rev 2020;5:856-865. DOI: 10.1302/2058-5241.5.200034

Total hip arthroplasty in Parkinson’s disease patients: a propensity score-matched analysis with minimum 2-year surveillance

2019 ◽  
Vol 30 (6) ◽  
pp. 684-689 ◽  
Author(s):  
Neil V Shah ◽  
Maximillian Solow ◽  
Joshua D Lavian ◽  
Lee R Bloom ◽  
Preston W Grieco ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
General Population ◽  
Total Hip Arthroplasty ◽  
Propensity Score ◽  
Hip Arthroplasty ◽  
Control Group ◽  
Stepwise Logistic Regression ◽  
Total Hip ◽  
Increased Risk

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.

scholarly journals Cementless total hip arthroplasty after failed internal fixation of acetabular fractures: A single center experience of 25 consecutive patients

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902091066
Author(s):  
Min Uk Do ◽  
Won Chul Shin ◽  
Nam Hoon Moon ◽  
Suk-Woong Kang ◽  
Kuen Tak Suh
Keyword(s):  
Total Hip Arthroplasty ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Walking Ability ◽  
Total Hip ◽  
The Mean

Purpose: Total hip arthroplasty (THA) is an available surgical option for failed acetabular fracture, previously managed by open reduction and internal fixation. This study aimed to report the postoperative outcomes of cementless THA in patients with this condition. Materials and Methods: Between November 2000 and September 2016, 25 consecutive cementless THAs for failed internal fixation after acetabular fractures with a minimum follow-up of 2 years were analyzed. The mean age at the time of surgery was 58 years (36–85 years), and the time elapsed between fracture and THA was 70 months (7–213 months). Clinical and radiologic evaluations were performed on all patients. Results: Clinically, the mean Harris hip score at the last follow-up was 88 points. Walking ability recovered to pre-injury status in 92% patients, and activities of daily living recovered in 96% patients. Radiographically, none of the acetabular cups showed evidence of migration and loosening during the mean follow-up of 50 months. All cases showed stable femoral stem fixation at the last follow-up. Dislocation occurred in three cases (12%). Conclusion: Outcomes of cementless THA after failed internal fixation for acetabular fractures were satisfactory. However, a relatively high incidence of postoperative dislocation is still a concern.

scholarly journals Small-head metal on metal total hip arthroplasty is associated with a high rate of complication and reoperation at mid-term follow-up

2021 ◽  
Vol 9 ◽  
pp. 205031212110147
Author(s):  
Nobuhiko Sumiyoshi ◽  
Kazuhiro Oinuma ◽  
Yoko Miura
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Adverse Reactions ◽  
Small Diameter ◽  
High Rate ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal ◽  
Small Head

Background: Adverse reactions to metal debris are significant complications after metal-on-metal total hip arthroplasty. Recently, late appearances of adverse reactions to metal debris and subsequent need for reoperations have been reported with small-diameter head metal-on-metal devices. We retrospectively investigated mid-term clinical outcomes of small-head metal-on-metal total hip arthroplasty. Methods: We reviewed 159 hips in 139 patients who had a small-head metal-on-metal total hip arthroplasty (M2a Taper; Biomet, Warsaw, IN) with a minimum 5-year follow-up and documented postoperative complications. Results: Focal osteolysis in either the femur or acetabulum was observed in 12 hips (7.5%, 44 months after surgery on average), with pseudotumor observed in 8 hips (5%, 120 months after surgery on average). Four hips (2.5%) had dislocations (84 months after surgery on average) and six hips (3.8%, 122 months after surgery on average) underwent reoperation. Conclusion: Small-head metal-on-metal total hip arthroplasty is associated with a high degree of complications at mid-term follow-up period. Considering this, we discourage the use of metal-on-metal total hip arthroplasty regardless of head size.

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