The effect of primary total knee arthroplasty on the incidence of falls and balance-related functions in patients with osteoarthritis

Hai-Bo Si, Yi Zeng, Jian Zhong, Zong-Ke Zhou, Yan-Rong Lu, Jing-Qiu Cheng, Ning Ning, Bin Shen, Hai-Bo Si, Yi Zeng, Jian Zhong, Zong-Ke Zhou, Yan-Rong Lu, Jing-Qiu Cheng, Ning Ning, Bin Shen

Abstract

Knee osteoarthritis (OA) is an established risk factor for falls and balance impairment. This study investigated the incidence of falls, balance-related outcomes and risk factors for falls before and after primary total knee arthroplasty (TKA). Three hundred seventy-six OA patients scheduled to undergo TKA were included. Falls data within the preoperative, first postoperative and second postoperative years were collected, balance-related functions were assessed using the Assessment of Quality of Life (AQoL), WOMAC, Falls Efficacy Scale International (FES-I), Activities-specific Balance Confidence (ABC), knee extension strength, Berg Balance Scale (BBS) and Timed Up and Go (TUG) before surgery and 1 and 2 years after surgery. Compared with preoperative values, the incidence of falls significantly decreased (14.89%, 6.23% and 3.14% within the preoperative, first postoperative and second postoperative years, respectively) and the AQoL, WOMAC, FES-I, ABC, knee extension strength, BBS and TUG significantly improved after TKA. Logistic regression analysis revealed that Kellgren-Lawrence grade ≥ 3 of the contralateral knee was an independent risk factor for falls before and after TKA. Conclusively, primary TKA is associated with a reduced incidence of falls and improved balance-related functions, and the contralateral knee should be considered in the design of fall-prevention strategies in patients with OA.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the study. (a) Reasons for exclusion were patients undergoing bilateral TKA or undergoing TKA because of rheumatoid or traumatic arthritis. (b) Reasons for exclusion were patients who did not understand the nature of the study, refused to participate, were illiterate, or were physically or mentally unable to complete the questionnaires. (c) Patients who were included but were lost by the yearly follow-up because of various reasons, such as traffic or health problems.
Figure 2
Figure 2
Comparisons of balance-related outcomes between fallers and non-fallers. AQoL, Assessment of Quality of Life; WOMAC, Western Ontario and McMaster University Osteoarthritis Index; FES-I, Falls Efficacy Scale International; ABC, Activities-specific Balance Confidence; BH, Body Height (m); BM, Body Mass (kg); BBS, Berg Balance Scale; TUG, Timed Up and Go. *Compared with non-fallers, P < 0.05.

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