Total hip replacement in patients with Parkinson's disease

Martin Weber, Miguel E. Cabanela, Franklin H. Sim, Frank J. Frassica, Scott W. Harmsen

From 1970 to 1994, 107 total hip arthroplasties (THAs) were performed in 98 patients with Parkinson's disease. The average age of the patients was 72 years. Preoperative diagnoses were osteoarthrosis in 58 hips, failed endoprosthesis in 19, aseptic loosening in ten, femoral neck fracture in 18, and other diagnoses in two. Milder neurological stages I-III were assigned to 96 patients, and tendon release for contracture was performed in eight patients. Of the 38 complications eight were urinary tract infections and six dislocations. Of these 15 occurred in the 58 primary THAs and 23 in the 49 nonprimary THAs. In patients with primary THAs there were no dislocations; however, one of the four postoperative deaths occurred following primary THA. We followed 75 hips for 7 (2-21) years; 51 patients had died by the time of the study. Neurological status deteriorated over time with 57% of patients progressing to functional stages IV or V, although consistent improvement was noted for pain relief. Function was directly related to the stage of the neurological disease.