# Parkinson’s Disease Patients Face Higher 90-Day Readmission, Reoperation, and Infection Risk Following Total Knee Arthroplasty

## TL;DR

Parkinson’s disease patients are more likely to be readmitted after knee replacement surgery, often due to infections and needing more procedures.

## Contribution

This study identifies higher readmission and complication risks for Parkinson’s patients after TKA using a large national database.

## Key findings

- PD patients had a 13.0% readmission rate compared to 7.3% in non-PD patients.
- Infection-related readmissions were more common in PD patients (4.1% vs 2.2%).
- Readmission costs were higher for PD patients ($63,023 vs $48,855).

## Abstract

Parkinson’s disease (PD) is an increasingly common comorbidity in patients undergoing total knee arthroplasty (TKA), yet its impact on readmissions remains poorly defined.

Using the Nationwide Readmissions Database 2020-2022, we identified elective, primary TKA cases. Patients with oncologic diagnoses, COVID-19-related admissions, acute fractures, and contralateral knee arthroplasty were excluded. Only the first readmission within 90 days was analyzed. Propensity score matching (1:1) was performed for demographics, comorbidities, hospital factors, and primary payer. The primary outcome was 90-day readmission. Secondary outcomes included infection-related readmissions, surgical procedures during readmission, readmission length of stay, readmission costs, and in-hospital mortality.

After matching, 7286 patients were included (3675 PD vs 3611 non-PD). PD patients had a significantly higher 90-day readmission rate (13.0% vs 7.3%; P < .01). Infection-related readmissions (4.1% vs 2.2%; P < .01) and surgical procedures during readmission (7.5% vs 4.1%; P < .01) were more frequent in PD patients. Readmission length of stay was longer (5.9 vs 4.1 days; P < .01), and readmission costs were higher ($63,023 vs $48,855; P < .01). In-hospital mortality during readmission was also higher in PD patients (0.3% vs 0.1%; P < .01).

PD is associated with a significantly higher risk of 90-day readmission following TKA, with readmissions frequently involving infection-related complications and surgical intervention. These findings highlight the importance of tailored perioperative care and enhanced postdischarge monitoring in this vulnerable population.

Level III.