title: Surgical outcomes of primary hip and knee replacements in patients with Parkinson's disease: a nationwide registry-based case-controlled study.
abstract: We evaluated the duration of hospitalisation, occurrence of infections, hip dislocations, revisions, and mortality following primary hip and knee replacement in 857 patients with Parkinson's disease and compared them with 2571 matched control patients. The data were collected from comprehensive nationwide Finnish health registers. The mean follow-up was six years (1 to 13). The patients with Parkinson's disease had a longer mean length of stay (21 days [1 to 365] vs 13 [1 to 365] days) and an increased risk for hip dislocation during the first post-operative year (hazard ratio (HR) 2.33, 95% confidence intervals (CI) 1.02 to 5.32). There was no difference in infection and revision rates, and one-year mortality. In longer follow-up, patients with Parkinson's disease had higher mortality (HR 1.94, 95% CI 1.68 to 2.25) and only 274 (34.7%) were surviving ten years after surgery. In patients with Parkinson's disease, cardiovascular and psychiatric comorbidity were associated with prolonged hospitalisation and cardiovascular diseases also with increased mortality.
authors.affiliation: Coxa, Hospital for Joint Replacement, P.O. Box 652, Biokatu 6b, Tampere, 33101, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Jämsen
authors.forename: T
authors.initials: T
authors.lastname: Puolakka
authors.forename: M
authors.initials: M
authors.lastname: Peltola
authors.forename: A
authors.initials: A
authors.lastname: Eskelinen
authors.forename: M U K
authors.initials: MU
authors.lastname: Lehto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000401:mortality; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006617:Hip Dislocation / Q000209:etiology; D006622:Hip Prosthesis / Q000009:adverse effects; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D007720:Knee Prosthesis / Q000009:adverse effects; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000401:mortality / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000150:complications / Q000401:mortality / Q000601:surgery; D010300:Parkinson Disease / Q000150:complications* / Q000401:mortality; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000401:mortality; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Joint replacement; Parkinson’s disease; Revision; Hip dislocation; Mortality; Arthroplasty register