Parkinson’s disease increases the risk of perioperative complications after total knee arthroplasty: a nationwide database study

Purpose Therefore, the purpose of this study was to evaluate the short-term perioperative outcomes of PD patients who underwent total knee arthroplasty (TKA). We specifically evaluated: (1) perioperative surgical and medical complications; (2) lengths of stay (LOS); and (3) total hospital charges. Methods The Nationwide Inpatient Sample was used to identify PD patients who underwent TKA between 2002 and 2013. To control for potential confounders, PD TKA and non-PD TKA patients were propensity score matched (1:3) based on age, sex, ethnicity, Charlson Comorbidity Index, and insurance type. A total of 31,979 PD and 95,596 non-PD TKA patients were included. Results PD patients had a 44% higher risk of suffering from any complication (OR 1.44; 95% CI 1.35–1.54), a 45% increased risk for any medical complication (OR 1.45; 95% CI 1.36–1.55), and a 9% higher risk for any surgical complication (OR 1.09; 95% CI 0.84–1.41). Compared to the matched cohort, PD patients had a mean LOS that was 6.5% longer (95% CI 5.46–7.54) and mean total hospital charges that were 3.05% higher (95% CI 1.99–4.11). Conclusions PD patients are more likely to have postoperative complications, longer LOS, and higher costs after TKA than non-PD TKA patients. Since many of these complications can be prevented, a team-based multi-specialty patient optimization is needed. Level of evidence Level III, therapeutic study.