The Outcomes of Total Hip Replacement in Patients with Parkinson's Disease: Comparison of the Elective and Hip Fracture Groups.

INTRODUCTION: The aim of the study was to compare the clinical outcomes following elective and traumatic total hip arthroplasty in Parkinson's disease patients. MATERIALS AND METHODS: Ten patients with osteoarthritis comprise the elective group (mean age at operation 74 years; mean follow-up 82 months). Thirteen patients with femoral fracture comprise the hip fracture group (mean age 76 years; mean follow-up 54 months). All patients were followed up at 6 and 36 months postoperatively and at the time of the latest follow-up. RESULTS: Despite the significant improvement in Merle d'Aubigné-Postel and pain scores, disability related to Parkinson's disease increased during the follow-up. Whereas more than 1/3 of hip fracture patients and all elective patients walked independently at 36 months after total hip arthroplasty, 43% of living patients from both groups were able to walk independently at the time of the latest follow-up. The medical complications were seen mainly in patients with hip fracture. CONCLUSIONS: Excellent pain relief with preserved walking ability without support of another person and acceptable complication profile was observed in Parkinson's disease patients at 36 months after elective total hip arthroplasty. This procedure may be indicated in Parkinson's disease patients after careful and individualized planning.

Comparative outcomes of total knee arthroplasty on physically active and passive patients.

The physical activity of the population is decreasing due to an increase in sedentary lifestyles. The aim of the study was to analyze midterm results of total knee arthroplasty according to the lifelong physical activity of the patients. We evaluated 37 patients (23 women, 14 men), with age average 70.0 years (range 53-87). We divided the patients according to lifelong physical activity. The active group included 11 patients with any history of physical activity and the passive included 26 patients with a sedentary lifestyle. No intergroup differences existed in age, gender or preoperative Knee Score. The active group had a higher postoperative Knee Score 90.5 (+/- 5.0) compared to the passive 87.4 (+/- 5.0). Pain after arthroplasty was experienced significantly more in the active group. Between the active 87.3 (+/- 9.3) and passive 67.5 (+/- 16.7) groups we measured a statistically significant difference in the improvement of Functional Score - ability to walk and climb stairs. Sedentary lifestyle affects the clinical outcomes of total knee arthroplasty. This data is demonstrating that physical activity ameliorate functional postoperative results.