Preoperative Risk Factors for Postoperative Falls in Persons Undergoing Hip or Knee Arthroplasty: A Longitudinal Study of Data From the Osteoarthritis Initiative.
Daniel L Riddle, Gregory J Golladay
PMID 29407516WHAT IT FOUND
Patients who had fallen in the year before hip or knee replacement, or who reported higher depressive symptoms, were significantly more likely to fall two or more times in the two years after surgery.
Hip replacement carried over double the risk of multiple falls compared to knee replacement.
Key findings
01Having at least one fall in the year before surgery made patients almost four times more likely to fall two or more times postoperatively.
02Higher depressive symptoms and hip arthroplasty (versus knee arthroplasty) were also associated with an increased risk of multiple postoperative falls.
03Preoperative opioid use, age, and sex were not significant predictors of fall risk in the primary analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The primary analysis had a relatively small sample (244 participants), which reduced the power to detect effects for variables like sex and comorbidities. Fall data was self-reported over a 12-month period, which may lead to recall bias or over-reporting of falls that occurred before surgery. The study did not measure lower extremity strength or balance, so it is unclear if these physical factors contributed to the fall risk. The participants were generally healthy with few comorbidities, so results may not apply to more complex patients.
Declared interests
Funded by the National Institutes of Health and private sources. The authors declared no specific conflicts of interest that would compromise the study's integrity.
The easy way to misread this
Do not assume that opioid use or age are the primary drivers of postoperative falls based on this study. The primary analysis found these were not significant predictors; instead, a history of prior falls, depressive symptoms, and the type of surgery (hip vs. knee) were the key risk factors.