The effect of Parkinson’s disease on total knee arthroplasty: a systematic review and meta-analysis

PURPOSE: The purpose of this systematic review was to determine the effect of Parkinson’s disease (PD) on clinical outcomes and complications after total knee arthroplasty (TKA). Our systematic review was conducted to answer the following questions: (1) does TKA negatively affect clinical outcomes in patients with PD? and (2) does TKA cause more complications in patients with PD? METHODS: A rigorous and systematic approach was used, and each selected study was evaluated for methodological quality. Data on study design, total number of cases enrolled, follow-up duration, PD severity, clinical outcome, and complications after TKA were analyzed. RESULTS: Fourteen studies were included. Nine studies reported clinical scores. TKA significantly increased knee and functional scores in the PD group. However, compared with knee and functional scores in the non-PD group, the increase in scores in the PD group was not statistically significant, but tended to be less than that in the non-PD group. Eleven studies reported complications. In six studies, there was no difference in the complication rate between the PD and non-PD group or did not include a control group. In five studies, the PD group had higher medical complication rates and similar or higher surgical complication rates than the non-PD group. CONCLUSIONS: Patients with PD who underwent TKA showed satisfactory functional improvement and pain reduction. However, these outcomes were not as good as those in the non-PD group. The PD group had a higher probability of occurrence of medical complications than the non-PD group. Further, the PD group had a similar or higher surgical complication rate than the non-PD group.