Holzapfel Dominik Emanuel, Kappenschneider Tobias, Schuster Marie Farina, Pagano Stefano, Azar Fady, Holzapfel Sabrina, Meyer Matthias
Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany.
Department of Neonatology, University Children´S Hospital Regensburg, Hospital St. Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany.
Int Orthop. 2025 Mar;49(3):559-572. doi: 10.1007/s00264-024-06398-9. Epub 2025 Jan 24.
The outcome of elective total joint arthroplasty (TJA) in patients with Parkinson's disease (PD) is controversial due to the concomitant risk profile. This study investigated postoperative complications and revision rates following total hip (THA) and knee arthroplasty (TKA) in patients with PD.
Ninety-six patients with PD undergoing THA or TKA were matched 1:1 with non-PD patients using propensity score matching for age, sex and comorbidity (Charlson Comorbidity index, CCI). Rates of revisions, medical and surgical complications were compared. Univariate and multivariate regression analyses were calculated.
PD patients exhibited higher rates of revision-surgeries within 90 days (13.5% vs. 5.2%; p = 0.048), medical complications (68.8% vs. 43.8%; p < 0.001) and surgical complications (40.6% vs. 21.9%; p = 0.005). Multivariate regression analysis confirmed PD as a significant risk factor for complications and long-term revision-surgeries.
PD increases the risk of adverse outcomes following THA and TKA. Improvements in pre-operative planning and post-operative care are critical to the improvement of outcomes in this vulnerable population.
由于存在伴随风险，帕金森病（PD）患者择期全关节置换术（TJA）的结果存在争议。本研究调查了PD患者全髋关节置换术（THA）和膝关节置换术（TKA）后的术后并发症和翻修率。
采用倾向评分匹配法，根据年龄、性别和合并症（Charlson合并症指数，CCI），将96例行THA或TKA的PD患者与非PD患者进行1:1匹配。比较翻修率、医疗和手术并发症发生率。进行单因素和多因素回归分析。
PD患者在90天内的翻修手术率较高（13.5%对5.2%；p = 0.048）、医疗并发症发生率较高（68.8%对43.8%；p < 0.001）和手术并发症发生率较高（40.6%对21.9%；p = 0.005）。多因素回归分析证实PD是并发症和长期翻修手术的重要危险因素。
PD增加了THA和TKA后不良结局的风险。改善术前规划和术后护理对于改善这一脆弱人群的结局至关重要。
