Source: Spinal Cord  |  Posted 4 years ago

By Jill Stein

SAN DIEGO, CA -- February 15, 2007 -- Total joint arthroplasty can be a safe and effective treatment for osteoarthritis in patients with sequelae of poliomyelitis, according to data presented here at the 2007 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Harish S. Hosalkar, MD, resident, orthopaedic surgery division, University of Pennsylvania, Philadelphia, Pennsylvania, reported results in 19 patients with poliomyelitis who underwent 21 joint replacement procedures for pain and arthritis. The procedures included 10 knee arthroplasties, 9 hip arthroplasties, and 2 shoulder arthroplasties.

All patients underwent detailed muscle testing and methodological preoperative assessment and planning.

Results showed that all patients had complete pain relief, Dr. Hosalkar said in a presentation on February 15[^]th[].

While 7 of the 17 patients with lower extremity procedures were able to ambulate independently preoperatively, all patients were able to ambulate independently postoperatively. The ambulatory function score improved a mean of 2.9 pre- to 4.0 postsurgery ([]P[] < .01).

In the 10 patients who underwent total knee arthroplasty, the Knee Society Score improved from 28 to 88 ([]P[] < .01).

In the 9 patients who had total hip arthroplasty, the mean Harris Hip Score increased from 94 to 173 ([]P[] < .05).

In the 2 patients who underwent shoulder arthroplasty, the American Shoulder and Elbow Surgeons' functional score improved from 15 and 18 to 24 and 28, respectively.

Functional level improved an average of 1 grade in all patients after surgery.

No patient had intraoperative or perioperative complications nor was there any X-ray evidence of loosening or prosthetic wear at the final follow-up at a mean of 92 months.

All 19 patients said they were completely satisfied with their results and said that, if given a choice, they would opt for surgery again.

Dr. Hosalkar said that the most important finding in this study was the improvement in ambulatory function since a key concern of patients with sequelae of poliomyelitis or postpolio syndrome is whether or not they can ambulate independently.

Careful preoperative planning and a comprehensive postoperative rehabilitation program are necessary for a successful outcome, he said.

He also noted that surgical treatment should represent only one component of a comprehensive plan that includes activity modification, appropriate use of orthoses, environmental modification, rehabilitation and education.

Finally, he said that the study is the single largest prospective series of adults with poliomyelitis who underwent joint arthroplasties for osteoarthritis at a tertiary level neuron-orthopedic center performed by a single orthopedic surgeon.

[Presentation title: Outcomes of Total Joint Arthroplasties in Adults With Sequelae of Poliomyelitis. Abstract 326]