Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Total Hip, Knee Arthroplasty in Patients with MS

Int J MS Care; 2018 Sep-Oct; Gutman, et al

Results of a recent study suggest that pain reduction is a realistic outcome of total knee or hip arthroplasty in people with multiple sclerosis (MS) and that improved functional gait outcomes are possible in some patients. Of 40 identified patients who underwent hip or knee replacement, 30 had sufficient data for inclusion in this study. Researchers reviewed their medical records and recorded reasons for surgery, age at surgery, MS characteristics, surgical complications, and ambulatory aid status before and after surgery. They supplemented medical record review with questionnaires regarding preoperative and postoperative pain and satisfaction with surgical outcomes. They found:

  • Median follow-up was 26 months.
  • Complications of surgery were reported in 10 patients (33%), mostly mild and self-limited, although 4 patients (13%) required repeated operation.
  • 6 patients (20%) reported improvements in ambulatory aid use compared with pre-surgery baseline, 10 (33%) worsened, and 14 (47%) were unchanged.
  • In 20 patients who completed the questionnaire, mean ± SD joint pain scores (on 0–10 scale) decreased from 8.6 ± 2.0 preoperatively to 2.9 ± 2.4 postoperatively.
  • 5 patients (25%) were free of joint pain at last follow-up.


Gutman JM, Kim K, Schwarzkopf R, Kister I. Total hip and knee arthroplasty in patients with multiple sclerosis. Int J MS Care. 2018;20(5):244-250. doi:10.7224/1537-2073.2017-093.

This Week's Must Reads

Vegetable/Fruit Intake Benefits Cognitive Function, Neurology; ePub 2018 Nov 21; Yuan, Fondell, et al

Alzheimer Dementia and Age-Related Neuropathologies, Ann Neurol; ePub 2018 Nov 12; Boyle, Yu, et al

Kidney Function and Post-Stroke Mortality Examined, Stroke; ePub 2018 Nov 9; El Husseini, Fonarow, et al

Meditation May Help to Alleviate US Stroke Burden, J Stroke Cerebrovasc Dis; ePub 2018 Nov 24; Ambavane, et al

Must Reads in Multiple Sclerosis

Exposure to Animals Associated with Risk of MS, Mult Scler Relat Disord; ePub 2018 Nov 15; de Jong, et al

White Matter Tract Disruption, Fatigue Examined, Mult Scler Relat Disord; ePub 2018 Nov 9; Fuchs, et al

Coexistence of Multiple Sclerosis, Alzheimer Disease, Mult Scler Relat Disord; ePub 2018 Oct 27; Luczynski, et al

Body Mass Index Linked with Brain Volume Change, Neurology; ePub 2018 Nov 14; Mowry, Azevedo, et al

Detection of Whole Brain, Deep GM Atrophy in MS, PLoS One; ePub 2018 Nov 8; Chu, Kim, et al