Objective: The objective of the study was to evaluate whether Parkinson’s disease (PD) is associated with long-term risks of vascular events (cardiovascular and cerebrovascular) and periprosthetic complications (PPF and PJI) following total knee arthroplasty (TKA), and whether these risks vary by the diagnosis-to-surgery interval.

Background: PD is commonly encountered among patients undergoing TKA. However, the relationship between postoperative complications and the time from PD diagnosis remains uncertain. We investigated the association between PD and the risk of cardiovascular and cerebrovascular events, PPF, and PJI after TKA, specifically analyzing the impact of the diagnosis-to-surgery interval.

Method: We queried the National Health Insurance Service database to identify patients who underwent unilateral TKA. We excluded patients with a follow-up <5 years or a history of cardiovascular or cerebrovascular disease. PD was defined by diagnostic codes combined with the use of PD-related medication. Patients were categorized into a non-PD and a pre-TKA PD (Pre-PD) groups, stratified by the diagnosis-to-TKA interval (≤5 vs. >5 y). Each Pre-PD group was propensity score–matched 1:1 to the non-PD group. Outcomes were analyzed using Kaplan–Meier curves and Cox regression models, employing prespecified time-window analyses to evaluate time-varying associations.

Results: In the matched analysis, Pre-PD was associated with a higher five-year risk of cerebrovascular events (adjusted hazard ratio [aHR], 1.11; 95% CI, 1.07–1.16; p < 0.001) but not with cardiovascular events, PPF, or PJI. In interval-stratified analyses, cardiovascular risk increased only in the ≤5y subgroup (aHR 1.05; 95% CI, 1.00–1.10; p = 0.042), whereas the risk in the >5y subgroup did not reach statistical significance. Cerebrovascular risk was elevated in the ≤ 5y subgroup (aHR 1.14; 95% CI, 1.09–1.20; p < 0.001), but not in the >5y subgroup.

Conclusion: PD is associated with a higher risk of cerebrovascular events after TKA, whereas the risk of periprosthetic complications is not elevated. The increase in cardiovascular risk was confined to patients undergoing TKA within five years of PD diagnosis. These findings support tailored postoperative surveillance with particular attention to cerebrovascular events and early cardiovascular risk in this population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-duration-at-total-knee-arthroplasty-and-5-year-vascular-and-periprosthetic-outcomes-a-nationwide-matched-cohort-study/