Yoon Jung-Ro, Yoon Tae-Hyuck, Lee Seung Hoon
Department of Orthopedic Surgery, Veterans Health Service Medical Center, 53 Jinhwang-do-ro 61-gil, Gangdong-gu, 05368, Seoul, Korea.
Knee Surg Relat Res. 2023 Feb 14;35(1):6. doi: 10.1186/s43019-023-00179-1.
The purpose of this systematic review was to determine the effect of Parkinson's disease (PD) on clinical outcomes and complications after total knee arthroplasty (TKA). Our systematic review was conducted to answer the following questions: (1) does TKA negatively affect clinical outcomes in patients with PD? and (2) does TKA cause more complications in patients with PD?
A rigorous and systematic approach was used, and each selected study was evaluated for methodological quality. Data on study design, total number of cases enrolled, follow-up duration, PD severity, clinical outcome, and complications after TKA were analyzed.
Fourteen studies were included. Nine studies reported clinical scores. TKA significantly increased knee and functional scores in the PD group. However, compared with knee and functional scores in the non-PD group, the increase in scores in the PD group was not statistically significant, but tended to be less than that in the non-PD group. Eleven studies reported complications. In six studies, there was no difference in the complication rate between the PD and non-PD group or did not include a control group. In five studies, the PD group had higher medical complication rates and similar or higher surgical complication rates than the non-PD group.
Patients with PD who underwent TKA showed satisfactory functional improvement and pain reduction. However, these outcomes were not as good as those in the non-PD group. The PD group had a higher probability of occurrence of medical complications than the non-PD group. Further, the PD group had a similar or higher surgical complication rate than the non-PD group.
本系统评价旨在确定帕金森病（PD）对全膝关节置换术（TKA）后临床结局和并发症的影响。我们进行本系统评价以回答以下问题：（1）TKA是否会对PD患者的临床结局产生负面影响？以及（2）TKA是否会在PD患者中导致更多并发症？
采用严谨且系统的方法，对每项入选研究的方法学质量进行评估。分析了关于研究设计、纳入病例总数、随访时长、PD严重程度、临床结局以及TKA后并发症的数据。
纳入了14项研究。9项研究报告了临床评分。TKA显著提高了PD组的膝关节和功能评分。然而，与非PD组的膝关节和功能评分相比，PD组评分的增加无统计学意义，但往往低于非PD组。11项研究报告了并发症。在6项研究中，PD组和非PD组之间的并发症发生率无差异或未设对照组。在5项研究中，PD组的医疗并发症发生率高于非PD组，手术并发症发生率与非PD组相似或更高。
接受TKA的PD患者显示出令人满意的功能改善和疼痛减轻。然而，这些结局不如非PD组。PD组发生医疗并发症的可能性高于非PD组。此外，PD组的手术并发症发生率与非PD组相似或更高。
