Pazit Levinger1,2, Elin Wee3, Soula Margelis3, Hylton B Menz3, John R Bartlett4, Neil R Bergman4, Stephen McMahon5, Keith D Hill6. 1. Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia. Pazit.levinger@vu.edu.au. 2. Faculty of Health Sciences, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, 3086, Australia. Pazit.levinger@vu.edu.au. 3. Faculty of Health Sciences, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, 3086, Australia. 4. Warringal Private Medical Centre, Heidelberg, VIC, 3084, Australia. 5. The Avenue Hospital, Windsor, VIC, 3181, Australia. 6. School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, 6845, Australia.
Abstract
INTRODUCTION: Pain and disability often persist following hip (THR) and knee replacement (TKR) surgery predisposing patients to increased risk of falling. This study identified pre-operative predictors for post-operative falls in TKR and THR patients, and the incidence and circumstances of falls in the 12 months post-surgery. MATERIALS AND METHODS: A survey was undertaken of patients before THR and TKR, and was repeated 12 months post-operation. The survey included (1) medical history and medications usage, (2) pain and function, (3) health-related and physical activity and (4) fear of falls and history of falls questionnaires. Patients were classified as 'fallers' (≥1 fall) or 'non-fallers' based on prospectively documented falls in the 12 months post-surgery. Binary logistic regression was conducted to identify independent pre-operative predictors of incident falls status. RESULTS: Eighty-two of the 243 participants (33.7%) reported ≥1 fall in the 12 months post-operatively [60 (34.1%) patients following TKR and 22 (32.8%) following THR]. The logistic regression model was statistically significant, χ 2 = 24.731, p < 0.001, the model explaining 22% of the variance in falls, and correctly classifying 73.7% of cases as fallers or non-fallers. Reduced SF-36v2 general health sub-scale, increased planned physical activity and previous falls in the preceding year were predictors of falls. Those reporting ≥1 fall pre-operatively were three times more likely to fall post-operatively. CONCLUSION: People awaiting hip or knee joint replacement surgery might present with complex conditions that predispose them to greater risk of falling post-operation. Review of general health and history of falling is recommended pre-operatively to identify patients at risk.
INTRODUCTION:Pain and disability often persist following hip (THR) and knee replacement (TKR) surgery predisposing patients to increased risk of falling. This study identified pre-operative predictors for post-operative falls in TKR and THRpatients, and the incidence and circumstances of falls in the 12 months post-surgery. MATERIALS AND METHODS: A survey was undertaken of patients before THR and TKR, and was repeated 12 months post-operation. The survey included (1) medical history and medications usage, (2) pain and function, (3) health-related and physical activity and (4) fear of falls and history of falls questionnaires. Patients were classified as 'fallers' (≥1 fall) or 'non-fallers' based on prospectively documented falls in the 12 months post-surgery. Binary logistic regression was conducted to identify independent pre-operative predictors of incident falls status. RESULTS: Eighty-two of the 243 participants (33.7%) reported ≥1 fall in the 12 months post-operatively [60 (34.1%) patients following TKR and 22 (32.8%) following THR]. The logistic regression model was statistically significant, χ 2 = 24.731, p < 0.001, the model explaining 22% of the variance in falls, and correctly classifying 73.7% of cases as fallers or non-fallers. Reduced SF-36v2 general health sub-scale, increased planned physical activity and previous falls in the preceding year were predictors of falls. Those reporting ≥1 fall pre-operatively were three times more likely to fall post-operatively. CONCLUSION:People awaiting hip or knee joint replacement surgery might present with complex conditions that predispose them to greater risk of falling post-operation. Review of general health and history of falling is recommended pre-operatively to identify patients at risk.
Entities:
Keywords:
Falls; Hip replacement; Knee replacement; Osteoarthritis
Authors: Giorgio di Laura Frattura; Giuseppe Filardo; Dario Giunchi; Augusto Fusco; Stefano Zaffagnini; Christian Candrian Journal: J Orthop Date: 2018-08-24
Authors: Antonio Klasan; Martin Bäumlein; Philipp Dworschak; Christopher Bliemel; Thomas Neri; Markus D Schofer; Thomas J Heyse Journal: Bone Joint Res Date: 2019-11-02 Impact factor: 5.853