Tsonga Theano, Michalopoulou Maria, Kapetanakis Stylianos, Giovannopoulou Eirini, Malliou Paraskevi, Godolias George, Soucacos Panagiotis
Department of Physical Therapy, Amalia Fleming General Hospital, Melissia, Athens, Greece & Department of Physical Education and Sports, Democritus University of Thrace, Greece.
Department of Physical Education and Sports, Democritus University of Thrace, Greece.
J Orthop Surg (Hong Kong). 2016 Dec;24(3):302-306. doi: 10.1177/1602400306.
To evaluate the regression of fear of falling (FOF) and identify its risk factors in patients with severe knee osteoarthritis before and one year after total knee arthroplasty (TKA).
11 men and 57 women with a mean age of 73 years and a mean body mass index of 30.36 kg/m2 who had severe (grade 3 or 4) knee osteoarthritis and knee pain of ≥1 year were included. Two weeks before and one year after TKA, patients were asked about their FOF status and falls history. Patients were asked to complete the Physical Activity Scale for the Elderly, Short Form 36 (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires. Clinical performance was assessed using the Berg Balance Scale and Timed Up and Go (TUG) test.
Of the 68 patients, 56 (82.4%) had FOF preoperatively and 30 (44.1%) had FOF one year after TKA (p<0.001). The strongest predictors for FOF preoperatively were fallers (odds ratio [OR]=9.83, p=0.028), mental component summary (MCS) score of SF-36 (OR=0.88, p=0.024), and TUG (OR=3.4, p=0.013). The strongest predictors for FOF one year postoperatively were fallers (OR=16.51, p=0.041), patients with ≥2 chronic diseases (OR=17.33, p=0.011), physical function score of WOMAC (OR=1.015, p=0.005), and MCS score of SF-36 (OR=0.86, p=0.015).
TKA positively affected FOF and gradually reduced the FOF rate over a year period after TKA in an elderly population.
评估重度膝关节骨关节炎患者全膝关节置换术（TKA）前及术后一年恐惧跌倒（FOF）情况的改善，并确定其危险因素。
纳入11名男性和57名女性，平均年龄73岁，平均体重指数为30.36kg/m²，患有重度（3级或4级）膝关节骨关节炎且膝关节疼痛≥1年。在TKA前两周和术后一年，询问患者的FOF状况和跌倒史。要求患者完成老年人身体活动量表、简明健康调查问卷（SF-36）以及西安大略和麦克马斯特大学骨关节炎指数（WOMAC）问卷。使用伯格平衡量表和计时起立行走测试（TUG）评估临床性能。
68例患者中，56例（82.4%）术前存在FOF，30例（44.1%）术后一年存在FOF（p<0.001）。术前FOF的最强预测因素为有跌倒史者（优势比[OR]=9.83，p=0.028）、SF-36的心理综合评分（MCS）（OR=0.88，p=0.024）以及TUG（OR=3.4，p=0.013）。术后一年FOF的最强预测因素为有跌倒史者（OR=16.51，p=0.041）、患有≥2种慢性病的患者（OR=17.33，p=0.011）、WOMAC的身体功能评分（OR=1.015，p=0.005）以及SF-36的MCS评分（OR=0.86，p=0.015）。
TKA对FOF有积极影响，在老年人群中TKA术后一年期间FOF发生率逐渐降低。
