Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
Osteoarthritis Cartilage. 2019 Jul;27(7):979-993. doi: 10.1016/j.joca.2019.04.006. Epub 2019 Apr 24.
Falls are common after total hip arthroplasty (THA) and total knee arthroplasty (TKA). While previous studies have investigated various risk factors for falls in patients following THA and TKA, no systematic reviews have summarized these risk factors. Therefore, the current systematic review aimed to summarize evidence regarding risk factors for falls in patients after THA and/or TKA.
MEDLINE, EMBASE, CINAHL, SPORTDiscus, and Physiotherapy Evidence Database (from inception to June 30, 2018) were searched. The methodological quality and quality of evidence of the included studies were assessed by two independent reviewers. Relevant data regarding participants' characteristics, study design, follow-up time points, and identified risk factors were extracted. Meta-analyses and narrative syntheses were performed.
Twelve studies with a total of 1,292,689 participants were included. Twenty-nine identified risk factors for post-THA/TKA falls were classified into either inpatient or post-discharge risk factors. Key risk factors for both post-THA and/or post-TKA inpatient falls that showed moderate level of evidence included: postoperative complications or comorbidities and revision THA/TKA. Likewise, risk factors for post-discharge falls after THA and/or TKA that demonstrated moderate level of evidence included: medications, psychiatric diseases, living alone, prior history of TKA, falls history and female gender. The quality of the included studies varied and sample sizes were not justified.
This review summarized both non-modifiable and modifiable risk factors for post-THA/TKA falls. Our findings highlight the importance of developing strategies to lower the falls risk among patients following THA/TKA.
全髋关节置换术（THA）和全膝关节置换术（TKA）后常发生跌倒。虽然先前的研究已经调查了 THA 和 TKA 后患者跌倒的各种风险因素，但没有系统评价总结这些风险因素。因此，本系统评价旨在总结 THA 和/或 TKA 后患者跌倒风险因素的证据。
检索 MEDLINE、EMBASE、CINAHL、SPORTDiscus 和 Physiotherapy Evidence Database（从成立到 2018 年 6 月 30 日）。两名独立评审员评估纳入研究的方法学质量和证据质量。提取有关参与者特征、研究设计、随访时间点和确定的风险因素的相关数据。进行了荟萃分析和叙述性综合。
纳入了 12 项研究，共有 1292689 名参与者。将 29 个与 THA/TKA 后跌倒相关的风险因素分为住院期间或出院后风险因素。住院期间发生 THA/TKA 后跌倒的高证据水平的关键风险因素包括：术后并发症或合并症以及翻修 THA/TKA。同样，THA 和/或 TKA 后出院后跌倒的风险因素包括：药物、精神疾病、独居、既往 TKA 史、跌倒史和女性。纳入研究的质量存在差异，样本量也没有得到证明。
本综述总结了 THA/TKA 后跌倒的不可变和可改变的风险因素。我们的研究结果强调了制定策略以降低 THA/TKA 后患者跌倒风险的重要性。
