Are people following hip and knee arthroplasty at greater risk of experiencing a fall and fracture? Data from the Osteoarthritis Initiative

Smith, Toby; Pearson, Matthew; Latham, Sarah

doi:10.1007/s00402-016-2445-5

Cited by 27 publications

(19 citation statements)

References 31 publications

(29 reference statements)

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“…Several investigators have identified hip abductor muscle strength as a contributing factor to stability during standing and walking. 27,28 Ikeda et al 18 Previous studies reported the prevalence of falls during the first year after THA was 25% to 32% 10,11,29 , which was similar to the results of the present study. Additionally, our findings that falls commonly occurred indoors, during the daytime, and resulted from tripping are consistent with the findings of Ikutomo et al 10 who examined the incidence of falls in patients after THA (50.0% indoors, 66.2% during the daytime, 47.1% because of tripping, and 5.9% had fractures).…”

Section: Discussionsupporting

confidence: 91%

Predictors of falls in patients during the first year after total hip arthroplasty: A prospective cohort study

Ninomiya

Takahira

Ikeda

et al. 2020

Health Science Reports

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Background and Purpose Since falls after total hip arthroplasty (THA) cause severe complications such as dislocation and fractures around the femoral stem, it is important to investigate what factors predict of falls. Thus, investigating predictors of falls in patients waiting for THA would be valuable as it lead to more strategic interventions to prevent these problems. The purpose of this study was to evaluate the predictors of falls in patients during the first year after THA. Methods This is a prospective cohort study. A total of 157 patients who underwent THA for unilateral hip osteoarthritis were analyzed. The incidence of falls during the first year after THA was monitored, and patients were classified into a “faller” and “non‐faller” group. The following factors were compared between the two groups: demographic data (age, sex, body mass index, leg length discrepancy, length of hospital stay, and history of falling), preoperative hip abductor muscle strength, functional performance (single leg stance and maximum walking speed), pain during walking, and physical activity. Results On multivariate logistic regression analysis, preoperative hip abductor muscle strength on the affected side and a history of falling were predictors of falls during the first year after THA. On subsequent receiver operating characteristic curve analysis, preoperative hip abductor muscle strength on the affected side was retained as a significant predictor, with a cut‐off strength of 0.46 Nm/kg differentiating the faller and non‐faller groups with a specificity of 73.6%, specificity of 50.0%, and area under the curve of 70.2%. Conclusions Finding from the present study suggested that clinicians should focus on low preoperative hip abductor muscle strength on the affected side and a history of falling to prevent falls during the first year after THA.

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Section: Discussionsupporting

confidence: 91%

Predictors of falls in patients during the first year after total hip arthroplasty: A prospective cohort study

Ninomiya

Takahira

Ikeda

et al. 2020

Health Science Reports

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“…Two studies used the same cohort; however, had different primary objectives [30, 32]. Six studies were cross-sectional studies [25–30] of which one was an abstract [27], four were prospective cohort studies [18, 31–33], and two were retrospective cohort studies [34, 35] (Additional file 2: Table S1). Eight studies [25–29, 32, 33, 35] had a comparison group, comparing self-reported “fallers” to “non-fallers”.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies used a traditionally accepted definition of falls [25, 26, 30–33], which was “an unexpected event in which the participant comes to rest on the ground, floor, or lower level, not as a result of a major intrinsic event such as a faint or stroke, seizure, or an overwhelming external hazard”. The remaining studies did not explicitly define what constituted a fall in their study population [18, 27–29, 34, 35]. Sample sizes ranged from 31 to 413 participants.…”

Section: Resultsmentioning

confidence: 99%

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Falls and fear of falling in older adults with total joint arthroplasty: a scoping review

Chen

Voaklander

Perry

et al. 2019

BMC Musculoskelet Disord

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BackgroundPatients waiting or recovering from total joint arthroplasty (TJA) are at risk for falls which can lead to restriction of activity and negatively impact recovery. The objective of this scoping review is to critically appraise and synthesize the evidence in the reported number of falls, fear of falling, and risk factors associated with falls in older patients waiting for or recovering from TJA.MethodsSeven electronic databases were searched with no date limits and using language restriction (English). The inclusion criteria were 1) cohorts that included older adults 60+ years of age, 2) reported prevalence of falls, fear of falling, and/or risk factors for falls in patients who were waiting or recovering from TJA and 3) cross-sectional studies, cohort studies, and case control study designs. The quality assessment of selected articles was assessed using the SIGN Guidelines Checklist.ResultsOf the 866 citations identified, 12 studies met the inclusion criteria and were reviewed. Prevalence of falls in pre-operative TJA patients and post-operative TJA patients ranged from 23 to 63%, and 13 to 42%, respectively. Of those five studies that examined fear of falling, pre-operative TJA patients reported greater fear of falling than post-operative patients. Modifiable risk factors for falls included fear of falling, joint range of motion, and depression.ConclusionsAn increased risk of falls in patients with TJA was reported both for patients waiting for and recovering from surgery. A number of modifiable risk factors were identified including fear of falling that could be targeted in fall prevention programs for TJA.

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“…Other knee OA–related outcomes, such as knee arthroplasty and knee instability, have been examined in regard to falls. Interestingly, adults with knee arthroplasty do not appear to have an increased risk of falls compared with adults without knee arthroplasty , whereas knee instability has been shown to be associated with a greater prevalence of recurrent falls . Yet, injurious falls are an outcome of greater clinical and public health relevance .…”

Section: Introductionmentioning

confidence: 99%

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

Barbour

Sagawa

Boudreau

et al. 2019

Arthritis Care & Research

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Are people following hip and knee arthroplasty at greater risk of experiencing a fall and fracture? Data from the Osteoarthritis Initiative

Abstract: There appears a lower chance of experiencing a fracture for people following THA compared to those who have not.

Cited by 27 publications

References 31 publications

Predictors of falls in patients during the first year after total hip arthroplasty: A prospective cohort study

Predictors of falls in patients during the first year after total hip arthroplasty: A prospective cohort study

Falls and fear of falling in older adults with total joint arthroplasty: a scoping review

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

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