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- Title
Pre-operative predictors of post-operative falls in people undergoing total hip and knee replacement surgery: a prospective study.
- Authors
Levinger, Pazit; Wee, Elin; Margelis, Soula; Menz, Hylton; Bartlett, John; Bergman, Neil; McMahon, Stephen; Hill, Keith; Menz, Hylton B; Bartlett, John R; Bergman, Neil R; Hill, Keith D
- Abstract
<bold>Introduction: </bold>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.<bold>Materials and Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
TOTAL hip replacement; TOTAL knee replacement; ACCIDENTAL falls; SURGICAL complications; OSTEOARTHRITIS; LOGISTIC regression analysis; LONGITUDINAL method
- Publication
Archives of Orthopaedic & Trauma Surgery, 2017, Vol 137, Issue 8, p1025
- ISSN
0936-8051
- Publication type
journal article
- DOI
10.1007/s00402-017-2727-6