Total shoulder arthroplasty may be recommended for Parkinson’s disease and shoulder osteoarthritis patients. However, the short- and long-term outcomes of total shoulder arthroplasty in this population are still unknown. A retrospective matched case-control analysis was conducted using data extracted from the PearlDiver Mariner administrative database from 2010 to 2018. Patients receiving total shoulder arthroplasty were matched (1:10) based on age, gender, Elixhauser comorbidity index, diabetes, chronic renal disease, obesity, coronary artery disease, and congestive heart failure. Multivariate regressions were used to compare the incidence of adverse events after ninety days. Based on the occurrence of revision surgery, implant survival was also examined by Researchers for up to five years. A log-rank test was used to compare Kaplan Meier implant survival curves. Researchers matched 478 Parkinson’s disease patients with 4,715 Parkinson’s disease patients. Patients with Parkinson’s disease exhibited significantly more significant risks of prosthetic dislocation (Odds Ratio=3.07, p=0.001) after controlling for demographic and comorbid variables, but no elevated odds of other 90-day adverse events.
A five-year follow-up was available for 428 (89.5%) of persons with Parkinson’s disease and 3,794 (80.5%) of those without Parkinson’s disease. The Parkinson’s disease cohort had 97.2% implant survival, while the matching control cohort had 97.7% implant survival (not statistically different, p=0.463). Patients with Parkinson’s disease who receive total shoulder arthroplasty have a three-fold higher risk of periprosthetic dislocation in the 90-day postoperative interval than patients without Parkinson’s disease, but similar rates of other short-term adverse events and implant survival at 5 years. As a result, surgeons should be aware of the short-term risk of implant instability but should be confident in the long-term success of whole shoulder implants in patients with Parkinson’s disease.
Reference:www.jshoulderelbow.org/article/S1058-2746(22)00195-1/fulltext#relatedArticles
