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    Pre-operative predictors of post-operative falls in people undergoing total hip and knee replacement surgery: a prospective study

    Access Status
    Fulltext not available
    Authors
    Levinger, P.
    Wee, E.
    Margelis, S.
    Menz, H.
    Bartlett, J.
    Bergman, N.
    McMahon, S.
    Hill, Keith
    Date
    2017
    Type
    Journal Article
    
    Metadata
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    Citation
    Levinger, P. and Wee, E. and Margelis, S. and Menz, H. and Bartlett, J. and Bergman, N. and McMahon, S. et al. 2017. Pre-operative predictors of post-operative falls in people undergoing total hip and knee replacement surgery: a prospective study. Archives of Orthopaedic and Trauma Surgery. 137 (8): pp. 1025-1033.
    Source Title
    Archives of Orthopaedic and Trauma Surgery
    DOI
    10.1007/s00402-017-2727-6
    ISSN
    0936-8051
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/54309
    Collection
    • Curtin Research Publications
    Abstract

    Introduction: 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. Materials and methods: 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. Results: 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, χ2 = 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. Conclusion: 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.

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