Survival of total knee arthroplasty in patients with Parkinson’s disease: a registry study

TL;DR

Patients with Parkinson’s disease undergoing knee replacement surgery have lower implant survival rates compared to those without the disease.

Contribution

This study identifies the impact of Parkinson’s disease and implant design on the long-term survival of knee implants.

Findings

PD patients had a 2.7 times higher risk of implant failure after adjusting for age and gender.

Constrained implant designs were associated with a 1.7 times higher risk of failure in PD patients.

At 13 years, implant survival was 88.8% in PD patients versus 94.3% in the control group.

Abstract

This study compared the demographics and outcomes of patients with Parkinson’s disease (PD) undergoing total knee arthroplasty (TKA) to those without PD. Additionally, it aimed to assess the impact of implant design on TKA survival in PD patients.

Using data from the Emilia Romagna Registry of Orthopedic Prosthetic Implants, 551 TKA procedures in patients with PD were identified and compared to 52,022 TKAs in patients without PD. Kaplan-Meier survivorship analysis was used to compare implant survival, with revision surgery as the endpoint. Cox multivariate analysis was performed to assess the influence of age, gender, PD diagnosis, and implant design on implant failure.

The average age of PD patients was 72.2 years, with 66.2% being female. Implant survival was significantly lower in the PD group compared to the control group (p < 0.001). At 13 years, the survival rate was 88.8% in the PD group and 94.3% in the control group. PD patients had a 2.7 times higher risk of implant failure after adjusting for age and gender. Constrained implant designs were associated with a 1.7 times higher risk of failure compared to non-constrained designs in PD patients.

PD negatively affects implant survival in patients undergoing TKA. Careful consideration should be given to patient selection and implant design in this patient population.

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