1
|
Call CM, McGrory BJ, Thompson EA, Sommer LG, Savadove TS. Treatment of Postoperative Instability Following Total Knee Arthroplasty in Patients With Parkinson's Disease. Arthroplast Today 2024; 25:101273. [PMID: 38229869 PMCID: PMC10790002 DOI: 10.1016/j.artd.2023.101273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/27/2023] [Accepted: 10/19/2023] [Indexed: 01/18/2024] Open
Abstract
Acute postoperative posterior total knee arthroplasty (TKA) dislocation is rare in primary surgery but has been associated with Parkinson's disease (PD). We present a 77-year-old woman with knee arthritis and PD who sustained an acute, recurrent TKA posterior dislocation, recalcitrant to polyethylene upsizing. Transient stability was obtained for a period of 1 year after postoperative hamstring injection with botulinum toxin A and short-term immobilization. Spontaneous instability recurred after 1 year, and stability was obtained with revision to a more constrained construct and has been monitored over a period of 2 years. This is the first report demonstrating the use of botulinum toxin A for acute posterior TKA instability associated with PD. We endorse the necessity of increased constraint to maintain long-term stability in patients with Parkinson's disease.
Collapse
Affiliation(s)
- Catherine M. Call
- Tufts University School of Medicine, Boston, MA, USA
- Division of Joint Replacement Surgery, Maine Medical Center, Portland, ME, USA
| | - Brian J. McGrory
- Tufts University School of Medicine, Boston, MA, USA
- Division of Joint Replacement Surgery, Maine Medical Center, Portland, ME, USA
| | - Erica A. Thompson
- Department of Rehabilitation, Maine Medical Center, Portland, ME, USA
| | - Lydia G. Sommer
- Department of Rehabilitation, Maine Medical Center, Portland, ME, USA
| | - Thomas S. Savadove
- Department of Physical Medicine and Rehabilitation, Maine Medical Center, Portland, ME, USA
| |
Collapse
|
2
|
Díaz-Dilernia F, García-Mansilla A, Nicolino T, Costantini J, Carbo L. [Translated article] Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T418-T425. [PMID: 37311479 DOI: 10.1016/j.recot.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/03/2023] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION Thanks to improvements in the medical treatment of Parkinson's disease (PD), the life expectancy of these patients has increased, but the overall outcome after total knee arthroplasty (TKA) is controversial. We aim to analyse a series of patients with PD, evaluating their clinical status, functional results, complications and survival rates after TKA. METHODS We retrospectively studied 31 patients with PD operated between 2014 and 2020. The mean age was 71 years (SD±5.8). There were 16 female patients. The mean follow-up was 68.2 months (SD±36). We used the knee scoring system (KSS) and the visual analogue scale (VAS) for the functional evaluation. The modified Hoehn and Yahr scale was used to assess the severity of PD. All complications were recorded, and survival curves were performed. RESULTS The mean postoperative KSS evaluation had an increase of 40 points [35 (SD±15) vs 75 (SD±15) (p<.001)]. The mean postoperative VAS decreased 5 points [8 (SD±2) vs 3 (SD±2) (p<.001)]. Thirteen patients reported being very satisfied, 13 were satisfied, and only 5 were poorly satisfied. Seven patients suffered surgical complications, and 4 patients had recurrent patellar instability. At a mean 68.2 months follow-up, the overall survival rate was 93.5%. When considering the secondary patellar resurfacing as the endpoint, the survival rate was 80.6%. CONCLUSIONS In this study, TKA was associated with excellent functional outcomes in patients with PD. At a mean 68.2 months follow-up, TKA had excellent survivorship in the short term, with recurrent patellar instability as the most common complication. Even though these findings confirm the effectiveness of TKA in this population, a thorough clinical evaluation and multidisciplinary approach are needed to decrease the likelihood of complications.
Collapse
Affiliation(s)
- F Díaz-Dilernia
- Sunnybrook Health Sciences Centre/Holland Orthopaedic & Arthritic Centre, Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - A García-Mansilla
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - T Nicolino
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J Costantini
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - L Carbo
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
3
|
Díaz-Dilernia F, García-Mansilla A, Nicolino T, Costantini J, Carbo L. Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:418-425. [PMID: 37031862 DOI: 10.1016/j.recot.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION Thanks to improvements in the medical treatment of Parkinson's disease (PD), the life expectancy of these patients has increased, but the overall outcome after total knee arthroplasty (TKA) is controversial. We aim to analyse a series of patients with PD, evaluating their clinical status, functional results, complications and survival rates after TKA. METHODS We retrospectively studied 31 patients with PD operated between 2014-2020. The mean age was 71 years (SD±5.8). There were 16 female patients. The mean follow-up was 68.2 months (SD±36). We used the Knee Scoring System (KSS) and the Visual Analog Scale (VAS) for the functional evaluation. The Modified Hoehn and Yahr Scale was used to assess the severity of PD. All complications were recorded, and survival curves were performed. RESULTS The mean postoperative KSS evaluation had an increase of 40 points [35 (SD±15) vs 75 (SD±15) (P<.001)]. The mean postoperative VAS decreased 5 points [8 (SD±2) vs 3 (SD±2) (P<.001)]. Thirteen patients reported being very satisfied, 13 were satisfied, and only 5 were poorly satisfied. Seven patients suffered surgical complications, and 4 patients had recurrent patellar instability. At a mean 68.2 months follow-up, the overall survival rate was 93.5%. When considering the secondary patellar resurfacing as the endpoint, the survival rate was 80.6%. CONCLUSIONS In this study, TKA was associated with excellent functional outcomes in patients with PD. At a mean 68.2 months follow-up, TKA had excellent survivorship in the short term, with recurrent patellar instability as the most common complication. Even though these findings confirm the effectiveness of TKA in this population, a thorough clinical evaluation and multidisciplinary approach are needed to decrease the likelihood of complications.
Collapse
Affiliation(s)
- F Díaz-Dilernia
- Sunnybrook Health Sciences Centre/Holland Orthopaedic & Arthritic Centre, Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canadá.
| | - A García-Mansilla
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - T Nicolino
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J Costantini
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - L Carbo
- Unidad de Cirugía de Rodilla, Departamento de Ortopedia, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
4
|
Fan Z, Weiguang G, Yubao M, Shuyan Q. Effect of different Intensity Electrotherapy on Functional Recovery
in Patients with Knee Osteoarthritis. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2023. [DOI: 10.1055/a-2047-4009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Objective To explore the effects of different-intensity intermediate
frequency therapy on functional recovery of patients with knee
osteoarthritis.
Methods Three-band electromagnetic waves of constant amplitude
intermediate frequency electrotherapy group (Group A), interference
electrotherapy group (Group B) and modulated intermediate frequency
electrotherapy group (Group C) were used to treat knee osteoarthritis (KOA)
patients, 20 min/time, 1 time/day and 5
days/week for four weeks. Other rehabilitation items were performed the
same way. The rehabilitation therapy were evaluated by VAS score, Timed Up and
Go test and balance ability.
Results After 4 weeks of treatment, the treatment effects of the three
groups were all significant compared with the pre-treatment. Among the three
groups, the treatment effect of Group B was better than that of the other two
groups, and there was no significant difference in the treatment effect between
Group A and Group C.
Conclusion According to thee. g.results, it is possible that the
interference current is of a great action depth, and the
"endogenous" low-frequency modulated intermediate frequency
current possesses the advantages of both low and intermediate frequency, so with
the intermediate frequency current getting through the high resistance of skin,
the current effect of the low and intermediate frequency in the deep part of the
human body can be achieved.
Collapse
Affiliation(s)
- Zhijiao Fan
- Rehabilitation Treatment Center of Beijing Rehabilitation Hospital,
Capital Medical University, Beijing, China
| | - Gao Weiguang
- Rehabilitation Department, Hangzhou Wenhui University, Hangzhou,
China
| | - Ma Yubao
- Musculoskeletal Rebabilitation Center of Beijing Rehabilitation
Hospital, Capital Medical University, Beijing, China
| | - Qie Shuyan
- Rehabilitation Treatment Center of Beijing Rehabilitation Hospital,
Capital Medical University, Beijing, China
| |
Collapse
|
5
|
Rodríguez-Merchán EC, Kalbakdij-Sánchez C. The impact of Parkinson's disease on results of primary total knee arthroplasty. EFORT Open Rev 2022; 7:701-709. [PMID: 36287105 PMCID: PMC9619389 DOI: 10.1530/eor-22-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Parkinson’s disease (PD) is a common neurodegenerative disorder. When patients with PD undergo total knee arthroplasty (TKA) for knee osteoarthritis, poorer knee function and poorer quality of life are obtained than in matched cohorts (MCs). However, the degree of patient satisfaction is usually high. The mean length of stay is 6.5% longer in patients with PD than in MCs. Compared with MCs, patients with PD undergoing TKA have a 44% higher risk of complications. In patients with PD, the overall complication rate is 26.3% compared with 10.5% in MCs; the periprosthetic joint infection rate is 6.5% in patients with PD vs 1.7% in MCs; and the periprosthetic fracture rate is 2.1% in patients with PD vs 1.7% in MCs. The 90-day readmission rate is 16.29% in patients with PD vs 12.66% in MCs. More flexion contractures occur in patients with PD. The rate of medical complications is 4.21% in patients with PD vs 1.24% in MCs, and the rate of implant-related complications is 5.09% in patients with PD vs 3.15% in MCs. At 5.3 years’ mean follow-up, the need for revision surgery is 23.6%. The 10-year implant survival, taking revision of any of the components as an endpoint, is 89.7% in patients with PD vs 98.3% in MCs.
Collapse
Affiliation(s)
- E Carlos Rodríguez-Merchán
- Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain,Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain,Correspondence should be addressed to E C Rodríguez-Merchán;
| | - Carlos Kalbakdij-Sánchez
- Department of Orthopaedic Surgery, Emirates Specialty Hospital, Dubai Healthcare City, Dubai, UAE
| |
Collapse
|
6
|
Zong Y, Hao C, Zhang Y, Wu S. Quality of life assessment after total knee arthroplasty in patients with Parkinson's disease. BMC Musculoskelet Disord 2022; 23:230. [PMID: 35264128 PMCID: PMC8908622 DOI: 10.1186/s12891-022-05176-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background The number of Parkinson’s patients (PD) undergoing total knee arthroplasty (TKA) is increasing. The purpose of the study was to characterize quality of life (QOL) outcomes for patients with coexisting PD and knee osteoarthritis (KOA) following TKA. Methods Patients with coexisting PD and KOA undergoing TKA between June 2014 and June 2020 were included. These patients were matched to controls with KOA alone by age, gender, basic social background information and Knee society score (KSS). The primary measure was to assess the QOL by the absolute changes in the EuroQOL5-Dimensions (EQ-5D), Pain and Disability Questionnaire (PDQ), and Patient Health Questionnaire-9(PHQ-9) at the last follow-up (LFU). Secondary measures were changes in QOL that exceeded the minimum clinically important difference value (MCID). Data on the health status and QOL of all patients were collected. Simple and multivariate regression analysis was used to evaluate the impact of PD on their QOL. Results Twelve KOA patients with PD were compared with 48 controls. Control patients experienced QOL improvement across all three measures:EQ-5D index (0.545–0.717, P < 0.01), PDQ (81.1–52.3, P < 0.01) and PHQ-9(8.22–5.91, P < 0.01) were significantly improved at the LFU; while in patients with PD, only PDQ (91.0–81.4, P = 0.03) slightly improved. There were significant differences in the improvement of QOL between PD patients and the control group through EQ-5D (0.531 vs.0.717, P < 0.01) and PDQ (81.4vs.52.3, P < 0.01) at the LFU. Conclusion TKA has no benefit of QOL beyond a slight improvement in pain-related disability in the KOA patients with PD.
Collapse
Affiliation(s)
- Yaqi Zong
- Department of Orthopedics, Bao Di Clinical College of Tianjin Medical University, Bao Di Hospital, 8 Guangchuan Road, Baodi District, Tianjin, 301800, Tianjin, China
| | - Congqiang Hao
- Department of Orthopedics, Bao Di Clinical College of Tianjin Medical University, Bao Di Hospital, 8 Guangchuan Road, Baodi District, Tianjin, 301800, Tianjin, China
| | - Yingjian Zhang
- Department of Orthopedics, Bao Di Clinical College of Tianjin Medical University, Bao Di Hospital, 8 Guangchuan Road, Baodi District, Tianjin, 301800, Tianjin, China
| | - Shuwen Wu
- Department of Orthopedics, Bao Di Clinical College of Tianjin Medical University, Bao Di Hospital, 8 Guangchuan Road, Baodi District, Tianjin, 301800, Tianjin, China.
| |
Collapse
|
7
|
Tueth LE, Duncan RP. Musculoskeletal pain in Parkinson's disease: a narrative review. Neurodegener Dis Manag 2021; 11:373-385. [PMID: 34410146 PMCID: PMC8515213 DOI: 10.2217/nmt-2021-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022] Open
Abstract
The prevalence of musculoskeletal (MSK) pain in people with Parkinson's disease (PD) is higher than that of age-matched controls. In this review, we outline what is known about MSK pain in PD, focusing on the neck, shoulder, knee, hip and low back. We also compare what is known about MSK pain in PD to what is known in older adults without PD. Finally, we outline areas of for future research related to MSK pain in people with PD.
Collapse
Affiliation(s)
- Lauren Elizabeth Tueth
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
| | - Ryan P Duncan
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
- Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
| |
Collapse
|