title: Total knee arthroplasty in patients with Parkinson's disease: impact of early postoperative neurologic intervention.
abstract: The impact of Parkinson's disease (PD) on the outcomes of total knee arthroplasty (TKA) is not well understood. The purpose of this study was to evaluate whether early medical management of PD affects TKA outcomes. We retrospectively reviewed the cases of 34 patients (39 knees) who had PD and underwent TKA. Patients received a preoperative/immediate-postoperative neurologic consultation (n = 13) or a delayed consultation (n = 21). Clinical outcomes and functional recovery were assessed with the Knee Society scoring system and the Unified Parkinson's Disease Rating Scale (UPDRS). There were no significant preoperative differences between the 2 cohorts. Mean follow-up was 36 months. Compared with the delayed-consultation group, the preoperative/immediate-postoperative consultation group had a 2.5-day shorter length of stay after surgery and 19 points more improvement in Knee Society Pain and Function scores. In addition, there was statistically significant improvement in UPDRS Severity scores in the preoperative/immediate consultation group but not in the delayed-consultation group. Early neurologic consultation in patients with PD can significantly decrease length of stay and improve early outcomes after TKA.
authors.affiliation: Hospital of the University of Pennsylvania, Philadelphia, PA 19107, USA.
authors.forename: Samir
authors.initials: S
authors.lastname: Mehta
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Vankleunen
authors.forename: Robert E
authors.initials: RE
authors.lastname: Booth
authors.forename: Paul A
authors.initials: PA
authors.lastname: Lotke
authors.forename: Jess H
authors.initials: JH
authors.lastname: Lonner
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D015897:Comorbidity; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy; D010300:Parkinson Disease / Q000453:epidemiology; D016059:Range of Motion, Articular; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome