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Year : 2019  |  Volume : 9  |  Issue : 1  |  Page : 60-68

Total hip arthroplasty in patients with Parkinson's disease

1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
2 Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
3 Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA

Correspondence Address:
Dr. Colin T Penrose
Department of Orthopaedic Surgery, Medical Center, Duke University, Durham, North Carolina
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DORJ.DORJ_10_19

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Purpose of Study: The purpose of this study was to evaluate the incidence of dislocations, infections, revisions, and other medical and surgical complications in patients with Parkinson's disease (PD), who undergo total hip arthroplasty (THA) compared to a control group without PD. Materials and Methods: Medicare patient data from 2005 to 2011 were retrospectively reviewed using the PearlDiver Technologies software (West Conshohocken, Pennsylvania, USA). Administrative coding and Boolean language were used to identify 6587 patients with PD diagnosed prior to THA and compared to a cohort containing all Medicare patients with a THA between 2005 and 2011 without any history of PD (767,991 patients). Statistical analysis was used to compare the number of patients with common comorbidities and medical and surgical complications. Systematical review of the literature on PD and THA was also performed. Results: Patients with PD had a higher rate of medical complications, including pneumonia, urinary tract infection, and sepsis at 30 days postoperatively. At 90 days and final follow-up, they had a higher rate of postoperative complications including dislocation, prosthetic joint infection, and risk of revision. Conclusion: PD is a progressive neurodegenerative disorder that affects the musculoskeletal system, and patients with PD often require surgical intervention for hip pain from a fracture, post-traumatic arthritis, or osteoarthritis. This study demonstrates the increased risk for several postoperative complications in patients with PD undergoing THA. It highlights the importance of an individualized risk-benefit analysis and multidisciplinary management before proceeding with arthroplasty for patients with PD.

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