Yoshinori Hiyama and Shuichi Okada
Objective: Falls are among the most common causes of injury in elderly people, whereas little is known about the risk of falls during the early months after hospital discharge in people undergoing Total Knee Arthroplasty (TKA). Therefore, this study aimed to assess risk of falling in patients during the early months after TKA.
Methods: Seventy patients undergoing primary TKA for knee osteoarthritis participated in this study. The risk of falling as assessed using knee Range Of Motion (ROM), the knee extension strength, 10-m walking test, Timed Up & Go (TUG) test, and Sit-to-Stand test findings and falls efficacy using the modified Falls Efficacy Scale (mFES) were evaluated 1 month before surgery, on the day of hospital discharge (5 days after surgery), and 1, 2, and 3 months after surgery.
Results: Of the 70 patients, 3 (4.3%) reported falls in the first 3 months after surgery. Patients who underwent TKA experienced an expected worsening of knee ROM, knee extension strength, and performance on the 10-m walking, TUG, and Sit-to-Stand tests on the day of discharge (p<0.001). All measures of physical function were comparable to the preoperative levels 3 months after surgery. The mFES scores displayed no significant differences among the assessments performed before surgery, on the day of discharge, and 1, 2, and 3 months after surgery.
Conclusion: Despite worsening of physical function after TKA, patients displayed similar falls efficacy to that observed preoperatively. These results indicated that patients undergoing TKA might underestimate their risk of falls during the early months after hospital discharge despite the likelihood of an increased risk of falls because of declines in physical function including strength, gait ability, and mobility. The clinical implication of this finding is that falls prevention interventions are needed prior to hospital discharge.