Parkinson's Disease Patients Face Higher 90-Day Readmission, Reoperation, and Infection Risk Following Total Knee Arthroplasty.

BACKGROUND

Parkinson's disease (PD) is an increasingly common comorbidity in patients undergoing total knee arthroplasty (TKA), yet its impact on readmissions remains poorly defined.

METHODS

Using the Nationwide Readmissions Database 2020-2022, we identified elective, primary TKA cases. Patients with oncologic diagnoses, COVID-19-related admissions, acute fractures, and contralateral knee arthroplasty were excluded. Only the first readmission within 90 days was analyzed. Propensity score matching (1:1) was performed for demographics, comorbidities, hospital factors, and primary payer. The primary outcome was 90-day readmission. Secondary outcomes included infection-related readmissions, surgical procedures during readmission, readmission length of stay, readmission costs, and in-hospital mortality.

RESULTS

After matching, 7286 patients were included (3675 PD vs 3611 non-PD). PD patients had a significantly higher 90-day readmission rate (13.0% vs 7.3%; P < .01). Infection-related readmissions (4.1% vs 2.2%; P < .01) and surgical procedures during readmission (7.5% vs 4.1%; P < .01) were more frequent in PD patients. Readmission length of stay was longer (5.9 vs 4.1 days; P < .01), and readmission costs were higher ($63,023 vs $48,855; P < .01). In-hospital mortality during readmission was also higher in PD patients (0.3% vs 0.1%; P < .01).

CONCLUSIONS

PD is associated with a significantly higher risk of 90-day readmission following TKA, with readmissions frequently involving infection-related complications and surgical intervention. These findings highlight the importance of tailored perioperative care and enhanced postdischarge monitoring in this vulnerable population.

LEVELS OF EVIDENCE: Level III.