Chen Serena Kuangyi, Voaklander Don, Jhangri Gian S, Jones C Allyson
School of Public Health, University of Alberta, Edmonton, Canada.
Department Physical Therapy, University of Alberta, Edmonton, Canada.
Musculoskeletal Care. 2025 Mar;23(1):e70055. doi: 10.1002/msc.70055.
Falls in older adults are a public health concern, yet little is known about falls in adults with hip or knee total joint arthroplasty (TJA) who may be at a higher risk than the general population. The study objectives were to compare the number of fallers and fear of falling in TJA patients to age and sex matched community controls, and determine whether the type of risk factors for falls reported in TJA differed from the community group.
A cross sectional comparative study was conducted with patients waiting or recovering from TJA and age and sex matched comparison group of older adults residing in the community. Reported falls and risk factors for falling were compared to age and sex matched controls from the community. Fear of falling was measured using the Activities-specific Balance Confidence (ABC) Scale. Logistic regression was used to determine risk factors associated with falls in TJA and community participants.
Of the 198 TJA participants, 29% (n = 57) reported falls within the past 12 months compared to 24% (n = 24) of 100 participants in the control group (p = 0.36). Of those who fell, 25 (44%) were recurrent fallers in the TJA cohort compared with 6 (25%) in the community cohort. Eleven participants reported falls after TJA surgery. Fear of falling was greater in the TJA group (ABC score, mean ± SD: 67.1 ± 24.4) than in the community group (88.1 ± 14.9) (p < 0.001).
Although the number of participants who reported falls was comparable in both groups, the TJA group had more recurrent falls, different risk factors for falls, and more fear of falling. Fall prevention programs should be embedded in pre-operative programs for patients undergoing surgery for TJA.
老年人跌倒问题备受公共卫生关注，但对于接受髋或膝关节全关节置换术（TJA）的成年人跌倒情况知之甚少，这类人群可能比普通人群面临更高的跌倒风险。本研究旨在比较TJA患者与年龄和性别匹配的社区对照人群中跌倒者的数量以及对跌倒的恐惧程度，并确定TJA患者报告的跌倒风险因素类型是否与社区组不同。
对等待TJA手术或术后康复的患者以及年龄和性别匹配的社区老年人对照组进行横断面比较研究。将报告的跌倒情况和跌倒风险因素与社区中年龄和性别匹配的对照组进行比较。使用特定活动平衡信心（ABC）量表测量对跌倒的恐惧程度。采用逻辑回归分析确定TJA患者和社区参与者中与跌倒相关的风险因素。
在198名TJA参与者中，29%（n = 57）报告在过去12个月内有跌倒，而对照组100名参与者中有24%（n = 24）报告有跌倒（p = 0.36）。在跌倒者中，TJA队列中有25人（44%）为反复跌倒者，而社区队列中有6人（25%）。11名参与者在TJA手术后报告有跌倒。TJA组对跌倒的恐惧程度高于社区组（ABC评分，均值±标准差：67.1±24.4）（社区组为88.1±14.9）（p < 0.001）。
尽管两组报告跌倒的参与者数量相当，但TJA组反复跌倒的情况更多，跌倒风险因素不同，且对跌倒的恐惧程度更高。应将跌倒预防计划纳入TJA手术患者的术前计划中。
