Analyzing the History of Falls in Patients with Severe Knee Osteoarthritis

Abstract

BackgroundOne out of three adults over the age of 65 years and one out of two over the age of 80 falls annually. Fall risk increases for older adults with severe knee osteoarthritis, a matter that should be further researched. The main purpose of this study was to investigate the history of falls including frequency, mechanism and location of falls, activity during falling and injuries sustained from falls examining at the same time their physical status. The secondary purpose was to determine the effect of age, gender, chronic diseases, social environment, pain elsewhere in the body and components of health related quality of life such as pain, stiffness, physical function, and dynamic stability on falls frequency in older adults aged 65 years and older with severe knee osteoarthritis.MethodsAn observational longitudinal study was conducted on 68 patients (11 males and 57 females) scheduled for total knee replacement due to severe knee osteoarthritis (grade 3 or 4) and knee pain lasting at least one year or more. Patients were personally interviewed for fall history and asked to complete self-administered questionnaires, such as the 36-item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and physical performance test was performed.ResultsThe frequency of falls was 63.2% for the past year. The majority of falls took place during walking (89.23%). The main cause of falling was stumbling (41.54%). There was a high rate of injurious falling (29.3%). The time patients needed to complete the physical performance test implied the presence of disability and frailty. The high rates of fall risk, the high disability levels, and the low quality of life were confirmed by questionnaires and the mobility test.ConclusionsPatients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis, restricted patient's quality of life and increased the fall risk. Therefore, patients with severe knee osteoarthritis should not postpone having total knee replacement, since it was clear that they would face more complicated matters when combining with fractures other serious injuries and disability.

Reduction of Falls and Factors Affecting Falls a Year After Total Knee Arthroplasty in Elderly Patients with Severe Knee Osteoarthritis

“…In total, a year after surgery, 15 patients reported 20 falls, which defines the percentage of patients who had a fall a year after surgery at 22.1% (p<0.001), (Table 2 ). On the contrary, in the pre-operative measurement the proportion was 63.2% [13]. …”

“…The study was approved by the medical council of the hospital and the Ethics Committee and lasted 2 years. Some parts of the methodology and clinical characteristics of patients in this article were used in the methodology described in the article of the same authors concerning patients with severe knee OA (Tsonga et al ., 2015) [13]. …”

Physical and Psychological Factors Affecting Falls in Older Patients with Arthritis

“…A large amount of research has presumed that patients with arthritis are susceptible to falls. For example, OA is a major predisposing factor for increased falls [9][10][11][12], and RA, the second most common type of arthritis after OA, is also reported to increase the risk of falls [13][14][15].…”

Knee Osteoarthritis and the Risk of Medically Treated Injurious Falls Among Older Adults: A Community‐Based US Cohort Study

“…Multiple cross‐sectional studies have examined the association between knee OA and falls, yielding primarily null associations . Several studies have examined the association between baseline knee OA and risk of incident falls, with some indicating an increase in the risk of falls and others finding a null result . Knee OA severity appears to impact the risk of falls, with greater severity linked to a higher rate of falls .…”