Annette Swinkels1, John H Newman, Theresa J Allain. 1. Faculty of Health and Life Sciences, University of West of England, Blackberry Hill, Bristol BS16 1DD, UK. annette.swinkels@uwe.ac.uk
Abstract
BACKGROUND: knee arthritis is a risk factor for falling. Increasing numbers of people are receiving total knee arthroplasty (TKA) but the natural history of falling before and after TKA is unknown. OBJECTIVE: to prospectively monitor falls in pre- and post-operative TKA patients and to identify independent risk factors for post-operative falling. DESIGN: a prospective observational study with a 1-year follow-up. PARTICIPANTS: community-dwelling older people recruited from a regional orthopaedic centre. METHODS: consecutive patients added to the TKA waiting list who completed monthly falls diaries, pre-operatively and 1 year post-operatively. Data on knee status (WOMAC: pain, stiffness and function), balance confidence (the Activities Balance Confidence Scale-UK-ABC-UK) and mood (Geriatric Depression Scale-GDS) were collected at quarterly intervals. RESULTS: ninety-nine patients received a primary TKA. 24.2% fell in the last pre-operative quarter (24 patients reported 44 falls) and this decreased to 11.7-11.8% in the first four post-operative quarters. 45.8% of people who fell pre-operatively fell again in the first post-operative year. Higher pre-operative GDS scores and a history of falling were significant independent predictors of post-operative falling. CONCLUSION: a recent history of falling is common in people undergoing TKA and approximately 45% of patients fall again in the year following surgery. Patients being considered for TKA should be asked about falls history and undergo falls risk assessment and intervention.
BACKGROUND: knee arthritis is a risk factor for falling. Increasing numbers of people are receiving total knee arthroplasty (TKA) but the natural history of falling before and after TKA is unknown. OBJECTIVE: to prospectively monitor falls in pre- and post-operative TKA patients and to identify independent risk factors for post-operative falling. DESIGN: a prospective observational study with a 1-year follow-up. PARTICIPANTS: community-dwelling older people recruited from a regional orthopaedic centre. METHODS: consecutive patients added to the TKA waiting list who completed monthly falls diaries, pre-operatively and 1 year post-operatively. Data on knee status (WOMAC: pain, stiffness and function), balance confidence (the Activities Balance Confidence Scale-UK-ABC-UK) and mood (Geriatric Depression Scale-GDS) were collected at quarterly intervals. RESULTS: ninety-nine patients received a primary TKA. 24.2% fell in the last pre-operative quarter (24 patients reported 44 falls) and this decreased to 11.7-11.8% in the first four post-operative quarters. 45.8% of people who fell pre-operatively fell again in the first post-operative year. Higher pre-operative GDS scores and a history of falling were significant independent predictors of post-operative falling. CONCLUSION: a recent history of falling is common in people undergoing TKA and approximately 45% of patients fall again in the year following surgery. Patients being considered for TKA should be asked about falls history and undergo falls risk assessment and intervention.
Authors: Pazit Levinger; Hylton B Menz; Adam D Morrow; Elin Wee; Julian A Feller; John R Bartlett; Neil Bergman Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-10-18 Impact factor: 4.342
Authors: Abderrahman Ouattas; Elizabeth Wellsandt; Nathaniel H Hunt; C Kent Boese; Brian A Knarr Journal: Clin Biomech (Bristol, Avon) Date: 2019-06-14 Impact factor: 2.063
Authors: Vanessa L Kronzer; Rose D Tang; Allison P Schelble; Arbi Ben Abdallah; Troy S Wildes; Sherry L McKinnon; Furqaan Sadiq; Nan Lin; Daniel L Helsten; Anshuman Sharma; Susan L Stark; Michael S Avidan Journal: Anesthesiology Date: 2016-08 Impact factor: 7.892