BackgroundOne out of three adults over the age of 65 years and one out of two over the age of 80 falls annually. Fall risk increases for older adults with severe knee osteoarthritis, a matter that should be further researched. The main purpose of this study was to investigate the history of falls including frequency, mechanism and location of falls, activity during falling and injuries sustained from falls examining at the same time their physical status. The secondary purpose was to determine the effect of age, gender, chronic diseases, social environment, pain elsewhere in the body and components of health related quality of life such as pain, stiffness, physical function, and dynamic stability on falls frequency in older adults aged 65 years and older with severe knee osteoarthritis.MethodsAn observational longitudinal study was conducted on 68 patients (11 males and 57 females) scheduled for total knee replacement due to severe knee osteoarthritis (grade 3 or 4) and knee pain lasting at least one year or more. Patients were personally interviewed for fall history and asked to complete self-administered questionnaires, such as the 36-item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and physical performance test was performed.ResultsThe frequency of falls was 63.2% for the past year. The majority of falls took place during walking (89.23%). The main cause of falling was stumbling (41.54%). There was a high rate of injurious falling (29.3%). The time patients needed to complete the physical performance test implied the presence of disability and frailty. The high rates of fall risk, the high disability levels, and the low quality of life were confirmed by questionnaires and the mobility test.ConclusionsPatients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis, restricted patient's quality of life and increased the fall risk. Therefore, patients with severe knee osteoarthritis should not postpone having total knee replacement, since it was clear that they would face more complicated matters when combining with fractures other serious injuries and disability.

Background:Total Knee Arthroplasty (TKA)1 is a common surgical treatment for severe knee Osteoarthritis (OA)2, which generally improves pain, physical function, quality of life and possibly fall risk. Fall risk increases for older adults with severe knee OA; however it has not been studied extensively whether this parameter is improved after TKA.Objective:To investigate: a) the history and frequency of falls, including mechanism or causes of falls, injuries sustained from falls reported, activity during falling and location of falls and, b) the factors affecting falls, a year after TKA in elderly patients with severe knee OA.Patients and Method:An observational prospective longitudinal study of 68 patients (11 males and 57 females) was conducted. The frequency of falls was recorded every month after knee replacement for a year period. A year after the TKA patients completed self-administered questionnaires (SF-36, Womac, FOF, ABC, PASE) and were assessed in physical performance tests (TUG and BBS).Results:There was significant improvement in falls frequency (p<0.001), differentiation of falling status to the benefit of non fallers (p<0.001) and risk of serious injuries (p<0.001). The factors that affected falling status was history of falls (p<0.0005), fear of falls (p<0.017) and advanced age, marginally (p<0.097).Conclusion:TKA generally improved a lot of aspects in patients’ life. One of these was the reduction of fall risk, which always co-exists in this population and can cause devastating problems threatening the benefits of the procedure.

TKA positively affected FOF and gradually reduced the FOF rate over a year period after TKA in an elderly population.