Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Aug 24;15(3):903-908.
doi: 10.1016/j.jor.2018.08.026. eCollection 2018 Sep.

Risk of falls in patients with knee osteoarthritis undergoing total knee arthroplasty: A systematic review and best evidence synthesis

Giorgio di Laura Frattura  1 , Giuseppe Filardo  2 , Dario Giunchi  1 , Augusto Fusco  3   4 , Stefano Zaffagnini  5 , Christian Candrian  1
Affiliations
Review

Risk of falls in patients with knee osteoarthritis undergoing total knee arthroplasty: A systematic review and best evidence synthesis

Giorgio di Laura Frattura et al. J Orthop. .

Erratum in

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.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Flow diagram explaining the process of identification, screening, eligibility and inclusion of the studies.
Fig. 2
Fig. 2
Risk of bias and a best evidence synthesis based on the algorithm developed by van Tulder et al. and Eijgenraam et al.
See this image and copyright information in PMC

References

    1. Heiden T.L., Lloyd D.G., Ackland T.R. Knee extension and flexion weakness in people with knee osteoarthritis: is antagonist cocontraction a factor? J Orthop Sports Phys Ther. 2009;39(11):807–815. - PubMed
    1. Losina E. Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med. 2009;169(12):1113–1121. discussion 1121-2. - PMC - PubMed
    1. Deirmengian C.A., Lonner J.H. What's new in adult reconstructive knee surgery. J Bone Joint Surg Am. 2013;95(2):184–190. - PubMed
    1. Bruyere O. Health-related quality of life after total knee or hip replacement for osteoarthritis: a 7-year prospective study. Arch Orthop Trauma Surg. 2012;132(11):1583–1587. - PubMed
    1. Matsumoto H. Incidence and risk factors for falling in patients after total knee arthroplasty compared to healthy elderly individuals. Yonago Acta Med. 2014;57(4):137–145. - PMC - PubMed

LinkOut - more resources