scholarly journals Outcomes of primary total knee arthroplasty in patients with Parkinson’s disease: A Case Control Comparison Study

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0020
Author(s):  
David Parker ◽  
Eugene Wong
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Range Of Motion ◽  
Primary Total Knee Arthroplasty ◽  
Control Group ◽  
Range Of Movement ◽  
Superficial Infection ◽  
Total Knee ◽  
The Difference

Introduction and Aims: There is considerable debate and a paucity of evidence regarding whether Total Knee Replacement (TKR) is of benefit in patients with Parkinson’s disease (PD) and knee osteoarthritis, and whether PD would compromise the outcome of TKR. Therefore, we aimed to compare the effect of TKR on range of motion and Oxford Knee Scores (OKS) between PD patients and age-matched controls at 1 year follow-up. Methods: A cohort of 45 knees from 35 patients was identified as having a confirmed diagnosis of Parkinson’s disease and received a primary TKR between January 2004 and December 2015, which was extracted from a clinical database (Socrates, v3.5, Orthosoft, AUS) maintained by two orthopaedic surgeons in two hospitals. An age-matched control group (mean age: 73 years) of 45 knees from 41 patients without Parkinson’s disease was randomly computer-generated from the same database. The indication for TKR in both groups was osteoarthritis, an independent assessment of each knee to meet appropriate selection criteria for TKR, as well as preoperative physician review for medical comorbidities. Outcome measures analysed in the study were the difference in pre-operative range of motion (RoM) and 12-point Oxford Knee Scores and at 1-year follow-up respectively. Postoperative complications and revisions were also recorded during the follow-up period. Results: In the PD group, RoM improved from a mean of 100 degrees preoperatively to 114 degrees at 12 months, compared to the control group which improved from a mean of 102 degrees to 114 degrees respectively. OKS in the Parkinson’s group improved from a mean of 23 preoperatively to 38 at 12 months compared to 23 preoperatively and 40 at 12 months in the control group. After adjusting for sex, we found that the difference in the ROM and OKS between the Parkinson’s and control groups was not significantly different (p = 0.9725; 0.6450 respectively). Furthermore, in all Parkinson’s patients the minimal clinically important difference for OKS (≥6) was achieved at 1-year follow-up (4). There were no mortalities during the study follow-up period, with 4 complications in the PD group (DVT, superficial infection) and two in the control group (DVT, bowel pseudo-obstruction). Conclusions: This study demonstrates that TKR provides comparable outcomes with regard to range of movement and ambulatory function in patients with Parkinson’s disease who are also suffering from severe osteoarthritis. We also feel that TKR has an acceptable complication profile in this subgroup of patients. The presence of PD does not appear to compromise the outcome of TKR in these patients, and the same indications for TKR should therefore apply as for the general OA population.

scholarly journals Cruciate Retaining compared with Posterior Stabilised Nexgen total knee arthroplasty: results at 10 years in a matched cohort

2017 ◽  
Vol 99 (8) ◽  
pp. 602-606 ◽  
Author(s):  
AIW Mayne ◽  
HP Harshavardhan ◽  
LR Johnston ◽  
W Wang ◽  
A Jariwala
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Functional Score ◽  
Range Of Movement ◽  
Cruciate Retaining ◽  
Score Improvement ◽  
Total Knee

INTRODUCTION Debate has persisted for many years about whether to sacrifice or replace the posterior cruciate ligament when performing total knee arthroplasty. A paucity of long-term follow-up studies comparing outcomes between cruciate-retaining and posterior-stabilised knees exist. We aimed to compare results at ten-year follow-up. METHODS A matched paired study comparing a cohort of 107 Zimmer Nexgen® Cruciate Retaining (CR) patients with a cohort of 107 Nexgen Posterior-Stabilised (PS) knees matched for age, sex, body mass index and preoperative American Knee Society score was undertaken. All patients underwent independent clinical assessment and knee society scoring preoperatively and at 1, 3, 5, 7 and 10 years postoperatively. RESULTS Fifty-three patients (49.5%) in the CR group and 44 patients (41.1%) in the PS group were alive at 10-year follow-up. There were no significant differences between the CR and PS groups with regards to functional assessment (P = 0.95), overall range of movement (P = 0.46) or patient satisfaction (P = 1.0) at 10 years. However, there was a significantly better score improvement in range of movement in PS knees compared with CR knees (P = 0.027). There were six revisions (5.6%) in the PS group and 1 (0.93%) in the CR group (P = 0.12). Both CR and PS knees showed excellent survivorship with no significant difference at 10 years (P = 0.068). CONCLUSIONS There were no significant differences in functional score, overall range of motion or patient satisfaction between the Nexgen cruciate retaining and posterior stabilised total knee arthroplasty at 10-year follow-up. However, PS knees had a greater score improvement in range of motion compared with CR knees.

scholarly journals Comprehensive Evaluation of Factors Affecting Tremor Relapse after MRgFUS Thalamotomy: A Case-Control Study

2021 ◽  
Vol 11 (9) ◽  
pp. 1183
Author(s):  
Federico Bruno ◽  
Alessia Catalucci ◽  
Francesco Arrigoni ◽  
Alessio Gagliardi ◽  
Elena Campanozzi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Comprehensive Evaluation ◽  
Demographic Characteristics ◽  
Control Group ◽  
Factors Affecting ◽  
Gender And Age ◽  
Determining Factors ◽  
Relevant Factors

Objective: To identify possible relevant factors contributing to tremor relapse after MRgFUS thalamotomy in patients with essential tremor (ET) and Parkinson’s disease (PD). Methods: We identified patients with tremor relapse from a series of 79 treatments in a single institution. The demographic and clinical characteristics of the study group patients were compared to those of patients who did not relapse in the same follow-up period. Imaging and procedural factors were compared using a control group matched for clinical and demographic characteristics. Results: Concerning clinical and demographic characteristics, we did not find statistically significant differences in gender and age. Seventy-three percent of patients with tremor relapse were Parkinson’s disease patients. Using MRI, we found larger thalamotomy lesions at the 1-year follow-up in the control group with stable outcomes, compared to patients with tremor relapse. In the tractography evaluation, we found a more frequent eccentric position of the DRTt in patients with tremor relapse. Conclusions: The most relevant determining factors for tremor relapse after MRgFUS thalamotomy appear to be tremor from Parkinson’s disease and inaccurate thalamic targeting. Size of the thalamotomy lesion can also influence the outcome of treatment.

scholarly journals Predictors of Loss of Functional Independence in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up and Comparison with a Control Group

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1801
Author(s):  
Diego Santos García ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores Bartolomé ◽  
Lucía Naya Ríos ◽  
Lucía García Roca ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Independence ◽  
Control Group ◽  
Lemeshow Test ◽  
Group A ◽  
And Control

Background and objective: The aim of this study was to compare the progression of independence in activities of daily living (ADL) in Parkinson’s disease (PD) patients versus a control group, as well as to identify predictors of disability progression and functional dependency (FD). Patients and Methods: PD patients and control subjects, who were recruited from 35 centers of Spain from the COPPADIS cohort between January 2016 and November 2017 (V0), were included. Patients and subjects were then evaluated again at the 2-year follow-up (V2). Disability was assessed with the Schwab & England Activities of Daily Living Scale (S&E-ADLS) at V0 and V2. FD was defined as an S&E-ADLS score less than 80%. Results: In the PD group, a significant decrease in the S&E-ADLS score from V0 to V2 (N = 507; from 88.58 ± 10.19 to 84.26 ± 13.38; p < 0.0001; Cohen’s effect size = −0.519) was observed but not in controls (N = 124; from 98.87 ± 6.52 to 99.52 ± 2.15; p = 0.238). When only patients considered functional independent at baseline were included, 55 out of 463 (11.9%) converted to functional dependent at V2. To be a female (OR = 2.908; p = 0.009), have longer disease duration (OR = 1.152; p = 0.002), have a non-tremoric motor phenotype at baseline (OR = 3.574; p = 0.004), have a higher score at baseline in FOGQ (OR = 1.244; p < 0.0001) and BDI-II (OR = 1.080; p = 0.008), have a lower score at baseline in PD-CRS (OR = 0.963; p = 0.008), and have a greater increase in the score from V0 to V2 in UPDRS-IV (OR = 1.168; p = 0.0.29), FOGQ (OR = 1.348; p < 0.0001) and VAFS-Mental (OR = 1.177; p = 0.013) (adjusted R-squared 0.52; Hosmer and Lemeshow test = 0.94) were all found to be independent predictors of FD at V2. Conclusions: In conclusion, autonomy for ADL worsens in PD patients compared to controls. Cognitive impairment, gait problems, fatigue, depressive symptoms, more advanced disease, and a non-tremor phenotype are independent predictors of FD in the short-term.

Constipation Predicts Cognitive Decline in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-up and Comparison with a Control Group

2021 ◽  
pp. 1-17
Author(s):  
Diego Santos García ◽  
Lucía García Roca ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores Bartolomé ◽  
Lucía Naya Ríos ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Rating Scale ◽  
Cognitive Status ◽  
Control Group ◽  
Cognitive Changes ◽  
Non Motor Symptoms

Background: Constipation has been linked to cognitive impairment development in Parkinson’s disease (PD). Objective: Our aim was to analyze cognitive changes observed in PD patients and controls from a Spanish cohort with regards to the presence or not of constipation. Methods: PD patients and controls recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were followed-up during 2 years. The change in cognitive status from baseline (V0) to 2-year follow-up was assessed with the PD-CRS (Parkinson’s Disease Cognitive Rating Scale). Subjects with a score ≥1 on item 21 of the NMSS (Non-Motor Symptoms Scale) at baseline (V0) were considered as “with constipation”. Regression analyses were applied for determining the contribution of constipation in cognitive changes. Results: At V0, 39.7% (198/499) of PD patients presented constipation compared to 11.4% of controls (14/123) (p < 0.0001). No change was observed in cognitive status (PD-CRS total score) neither in controls without constipation (from 100.24±13.72 to 100.27±13.68; p = 0.971) and with constipation (from 94.71±10.96 to 93.93±13.03; p = 0.615). The PD-CRS total score decreased significantly in PD patients with constipation (from 89.14±15.36 to 85.97±18.09; p < 0.0001; Coehn’s effect = –0.35) compared to patients without constipation (from 93.92±15.58 to 93.14±17.52; p = 0.250) (p = 0.018). In PD patients, to suffer from constipation at V0 was associated with a decrease in the PD-CRS total score from V0 to V2 (β= –0.1; 95% CI, –4.36 – –0.27; p = 0.026) and having cognitive impairment at V2 (OR = 1.79; 95% CI, 1.01 – 3.17; p = 0.045). Conclusion: Constipation is associated with cognitive decline in PD patients but not in controls.

scholarly journals Levodopa–carbidopa intrajejunal infusion in Parkinson’s disease: untangling the role of age

2020 ◽  
Author(s):  
Francesca Morgante ◽  
Valentina Oppo ◽  
Margherita Fabbri ◽  
Enrica Olivola ◽  
Chiara Sorbera ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Control Group ◽  
Motor Symptoms ◽  
Study Visit ◽  
Non Motor Symptoms

Abstract Objectives Levodopa–Carbidopa Intrajejunal gel (LCIG) infusion is an effective intervention for people with advanced Parkinson’s disease (PD). Although age may not be a limiting factor for LCIG implant, no data are available on late elderly PD (LE-PD) subjects. In this cross-sectional, we aimed to demonstrate if older age may impact on quality of life (QoL), motor and non-motor symptoms severity, and profile of side effects in PD treated with LCIG. Methods Out of 512 PD subjects treated with LCIG at 9 Italian PD centers, we selected 25 LE-PD defined as age ≥ 80 years at last follow-up who were available to attend the study visit. Twenty-five PD patients (Control-PD, defined as age < 75 years at last follow-up) matched to LE-PD by disease and LCIG duration served as control group. The following motor and non-motor variables were ascertained: quality of life (PDQ-8), time spent in ON, wearing-off Questionnaire, Unified PD Rating Scale, freezing of gait questionnaire, Parkinson’s disease sleep scale-2, Non Motor Symptoms Scale (NMSS), and MOCA. Results No statistically significant differences were found between LE-PD and Control-PD on PDQ-8 and several motor and non-motor variables. LE-PD had less frequent and milder impulsive–compulsive behaviors and milder dyskinesia. At multivariable regression, worse quality of life was associated with UPDRS-III and NMSS scores but not to age at study visit and age at LICG implant. Rate of adverse effects was similar in both groups. Drop-out rate calculated in the whole PD cohort was comparable between the two groups. Conclusion Our data provide evidence that valuable LCIG infusion might be achieved in late elderly PD.

scholarly journals Predictors of clinically significant quality of life impairment in Parkinson’s disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Santos García D. ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores ◽  
Guillermo Muñoz ◽  
Jose M. Paz González ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Independent Living ◽  
Motor Impairment ◽  
Control Group ◽  
Health Related Qol ◽  
Clinically Significant

AbstractQuality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.

Early Outpatient Physical Therapy May Improve Range-of-Motion in Primary Total Knee Arthroplasty

2017 ◽  
Vol 30 (07) ◽  
pp. 618-621 ◽  
Author(s):  
Tanner McGinn ◽  
Morad Chughtai ◽  
Anton Khlopas ◽  
Paige Grasmick ◽  
Arun Mullaji ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Manipulation Under Anesthesia ◽  
Total Knee ◽  
Primary Total Knee ◽  
Flexion And Extension

AbstractKnee stiffness is a relatively common complication following a primary total knee arthroplasty (TKA). Following this procedure, rehabilitation is essential to maintain, improve, and prevent the loss of knee range-of-motion (ROM). Currently, there is a paucity of studies describing whether the timing of physical therapy (PT) post-TKA plays a role in ROM outcomes. Therefore, the purpose of this study was to compare (1) flexion and (2) extension ROM at final follow-up of TKA patients who either began outpatient physical therapy (OPT) within 6 weeks or after 6 weeks of their TKA. Surgical records from all TKAs performed at one institution (three surgeons) between January 2013 and December 2014 (n = 485) were analyzed. Their mean age was 63 years (range, 32–90 years). Patients were stratified into two cohorts: patients who had OPT within 6 weeks (n = 411) and those who started after 6 weeks (n = 74). The t-tests were used to compare mean flexion and extension ROM at final follow-up. The patients who attended OPT within 6 weeks had a significantly higher mean flexion ROM at their final clinical visit ([mean, 114 degrees; range, 60–140 degrees] versus [mean, 111degrees; range, 80–130 degrees]). There was a lower mean extension in the patients who attended PT earlier as compared with those who attended it later (0.7 vs. 1.5 degrees). Patients who attended OPT within 6 weeks of TKA had a better mean flexion and extension ROM as compared with those who started after 6 weeks. Attending PT earlier may allow a patient to have better ROM and decreased stiffness. Because stiffness recalcitrant to PT is usually treated with manipulation under anesthesia (MUA), attending PT earlier and improving ROM may potentially allow post-TKA patients to avoid undergoing manipulation under anesthesia. Further work is needed to validate these findings. Future studies should be prospective with larger cohorts.

scholarly journals Gene variants and expression changes of SIRT1 and SIRT6 in peripheral blood are associated with Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rita Maszlag-Török ◽  
Fanni A. Boros ◽  
László Vécsei ◽  
Péter Klivényi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Peripheral Blood ◽  
Histone Deacetylases ◽  
Mrna Level ◽  
Control Group ◽  
Mrna Levels ◽  
Cellular Functions ◽  
Hungarian Population ◽  
The Difference

AbstractParkinson’s disease (PD) is a neurodegenerative disease caused by complex interaction between genetic and environmental factors. There is a growing body of evidence of the involvement of sirtuins (SIRTs) in disease pathomechanism. SIRTs are NAD+-dependent histone deacetylases which take part in various cellular functions. However, available data of the relationship between SIRT gene polymorphisms and PD is limited. Our aim was to investigate the possible association of 10 SNPs identified within non-mitochondrial SIRTs, SIRT1, -2 and -6 with the risk of PD in Hungarian population, and to compare the expression level of these SIRTs between healthy controls and PD patients. Our results showed that rs3740051 and rs3818292 of SIRT1 and rs350843, rs350844, rs107251, rs350845 and rs350846 of SIRT6 show weak association with PD risk. On the contrary rs12778366 and rs3758391 of SIRT1 and rs10410544 of SIRT2 did not show association with PD. Moreover, we detected that mRNA level of SIRT1 was down-regulated, and mRNA level of SIRT6 was up-regulated, while SIRT2 mRNA level was not altered in the peripheral blood of PD patients as compared to controls. The difference in both cases was more pronounced when comparing the early-onset PD group to the control cohort. Nevertheless, mRNA level changes did not show any association with the presence of any of the investigated SNPs either in the PD or in the control group. In conclusion, our findings suggest that non-mitochondrial sirtuins, SIRT1 and -6 but not SIRT2 might contribute to the pathogenesis of PD in the Hungarian population both via their altered mRNA levels and via gene alterations identified as specific SNPs.

scholarly journals Diplopia Is Frequent and Associated with Motor and Non-Motor Severity in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2380
Author(s):  
Diego Santos García ◽  
Lucía Naya Ríos ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores Bartolomé ◽  
Lucía García Roca ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Control Group ◽  
Factors Associated ◽  
Lemeshow Test ◽  
Disease Rating ◽  
Non Motor Symptoms ◽  
Spanish Cohort

Background and objective: Diplopia is relatively common in Parkinson’s disease (PD) but is still understudied. Our aim was to analyze the frequency of diplopia in PD patients from a multicenter Spanish cohort, to compare the frequency with a control group, and to identify factors associated with it. Patients and Methods: PD patients who were recruited from January 2016 to November 2017 (baseline visit; V0) and evaluated again at a 2-year ± 30 days follow-up (V2) from 35 centers of Spain from the COPPADIS cohort were included in this longitudinal prospective study. The patients and controls were classified as “with diplopia” or “without diplopia” according to item 15 of the Non-Motor Symptoms Scale (NMSS) at V0, V1 (1-year ± 15 days), and V2 for the patients and at V0 and V2 for the controls. Results: The frequency of diplopia in the PD patients was 13.6% (94/691) at V0 (1.9% in controls [4/206]; p < 0.0001), 14.2% (86/604) at V1, and 17.1% (86/502) at V2 (0.8% in controls [1/124]; p < 0.0001), with a period prevalence of 24.9% (120/481). Visual hallucinations at any visit from V0 to V2 (OR = 2.264; 95%CI, 1.269–4.039; p = 0.006), a higher score on the NMSS at V0 (OR = 1.009; 95%CI, 1.012–1.024; p = 0.015), and a greater increase from V0 to V2 on the Unified Parkinson’s Disease Rating Scale–III (OR = 1.039; 95%CI, 1.023–1.083; p < 0.0001) and Neuropsychiatric Inventory (OR = 1.028; 95%CI, 1.001–1.057; p = 0.049) scores were independent factors associated with diplopia (R2 = 0.25; Hosmer and Lemeshow test, p = 0.716). Conclusions: Diplopia represents a frequent symptom in PD patients and is associated with motor and non-motor severity.

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