Giorgio di Laura Frattura1, Giuseppe Filardo2, Dario Giunchi1, Augusto Fusco3,4, Stefano Zaffagnini5, Christian Candrian1. 1. Ospedale Regionale di Lugano - EOC - Via Tesserete, 46 - Lugano, Switzerland. 2. Rizzoli Orthopaedic Institute - Via Di Barbiano, 1/10 - Bologna, Italy. 3. Neuromotor Rehabilitation, CDC Salus Infirmorum, Via della Lucchina, 41 - 00135, Rome, Italy. 4. Human Sciences ana Promotion of Quality of Life Department, Open University San Raffaele, Via di Val Cannuta, 247, Rome, Italy. 5. II Orthopaedic and Traumatologic Clinic - Rizzoli Orthopaedic Institute - Via Di Barbiano, 1/10 -Via G. C. Pupilli, 1 - 40136, Bologna, Italy.
Abstract
OBJECTIVES: Falls occur frequently in patients with impaired ambulation and may dramatically affect the elderly population. Aim was to document the incidence of falls in knee osteoarthritis (OA) patients undergoing total knee arthroplasty (TKA), and to identify factors and treatments that may influence the risk of falls. METHODS: A systematic literature search was conducted on three medical electronic databases, PubMed, PeDRO, and Cochrane Collaboration. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used. Risk of bias analysis and best evidence synthesis were performed. The main aspects related to falls were analyzed: prevalence, risk factors, correlation with clinical outcome, effect of treatments. RESULTS: The systematic review identified 11 papers on 1237 patients. Pre-operative fall prevalence ranged from 23% to 63%, while post-operative values ranged from 12% to 38%. Moderate evidence was found on no influence of clinical scales, no BMI differences between "faller" and "non-faller", and on influence of limited pre-operative range of motion. Conflicting evidence was found for sex, history of previous falls, age, kyphosis, muscle weakness, fear of falling, depression, balance, gait impairment. No evidence was found for the effectiveness of surgical or rehabilitative strategies on falls reduction. CONCLUSIONS: OA patients undergoing TKA are at high risk of falls, which is reduced but still present after surgery. Although some risk factors were identified, there are no studies demonstrating the possibility of reducing the incidence of this deleterious event, which warrants further research efforts to better manage this fragile population of elderly patients.
OBJECTIVES: Falls occur frequently in patients with impaired ambulation and may dramatically affect the elderly population. Aim was to document the incidence of falls in knee osteoarthritis (OA) patients undergoing total knee arthroplasty (TKA), and to identify factors and treatments that may influence the risk of falls. METHODS: A systematic literature search was conducted on three medical electronic databases, PubMed, PeDRO, and Cochrane Collaboration. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used. Risk of bias analysis and best evidence synthesis were performed. The main aspects related to falls were analyzed: prevalence, risk factors, correlation with clinical outcome, effect of treatments. RESULTS: The systematic review identified 11 papers on 1237 patients. Pre-operative fall prevalence ranged from 23% to 63%, while post-operative values ranged from 12% to 38%. Moderate evidence was found on no influence of clinical scales, no BMI differences between "faller" and "non-faller", and on influence of limited pre-operative range of motion. Conflicting evidence was found for sex, history of previous falls, age, kyphosis, muscle weakness, fear of falling, depression, balance, gait impairment. No evidence was found for the effectiveness of surgical or rehabilitative strategies on falls reduction. CONCLUSIONS: OA patients undergoing TKA are at high risk of falls, which is reduced but still present after surgery. Although some risk factors were identified, there are no studies demonstrating the possibility of reducing the incidence of this deleterious event, which warrants further research efforts to better manage this fragile population of elderly patients.
Authors: Hamid R Fallah Yakhdani; Hamid Abbasi Bafghi; Onno G Meijer; Sjoerd M Bruijn; Nicolette van den Dikkenberg; Antoon B Stibbe; Barend J van Royen; Jaap H van Dieën Journal: Clin Biomech (Bristol, Avon) Date: 2010-01-08 Impact factor: 2.063
Authors: M Moutzouri; N Gleeson; E Billis; E Tsepis; I Panoutsopoulou; J Gliatis Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-10-19 Impact factor: 4.342