Outcomes of total joint arthroplasties in adults with post-polio syndrome: results from a tertiary neuro-orthopaedic center

Background Patients with paralytic poliomyelitis or post-polio syndrome can develop osteoarthritis with time. Most clinicians are hesitant to offer joint arthroplasty as an option because long-term outcomes are unknown. The purpose of this study was to determine the feasibility of performing total joint arthroplasties in arthritic hips and knees in adult patients with post-polio syndrome and to evaluate outcomes. Methods All adult patients with post-polio syndrome who had lower extremity joint arthroplasty for osteoarthritis at our institution were reviewed. A detailed physical examination, manual muscle testing, joint range of motion, spine evaluation, gait evaluation and orthotic assessment were performed on all patients. Appropriate scoring systems were used to evaluate the outcomes, including the Harris Hip Scoring System (HHSS) and the Knee Society Scores (KSS). Results Seventeen symptomatic patients with osteoarthritis underwent 19 joint arthroplasties. Mean age at surgery was 66.5 years. All patients experienced notable pain relief after surgery. The mean KSS improved from 28 to 88 (10 cases) and the mean HHSS improved from 94 to 173 ( nine cases). The functional ambulation level improved an average of one grade in all patients. No radiographic evidence of loosening or wear of the prosthesis was observed at final follow-up (mean 92 months; 26-180). Conclusions Total joint arthroplasty can be a safe and effective treatment for osteoarthritis in patients with post-polio syndrome with predictable resolution of pain, improved function and preservation of muscle strength.