Inpatient knee pain after hip fracture surgery affects gait speed in older adults: A retrospective chart‐referenced study

Abstract

Aim Post‐hip fracture knee pain (PHFKP) develops in 28–37.4% of patients with hip fracture and contributes to prolonged hospitalization. Although reduced balance and gait speed contribute to falls, the effects of PHFKP remain unclear. This study aimed to clarify whether PHFKP is a factor in balance and gait speed. Methods We retrospectively reviewed the medical records of patients after hip fracture. Development of PHFKP, basic information, and physical function were examined. Berg balance scale (BBS) and maximum walking speed (MWS) were collected at discharge. These parameters were compared with the presence or absence of PHFKP. In addition, multiple analyses were conducted with BBS and MWS as dependent variables and PHFKP as one of the independent variables. Results Of the 146 patients enrolled, 43 (29.5%) developed PHFKP, and 37.2% of patients with PHFKP showed residual symptoms at discharge. Intensity of PHFKP was mostly mild to moderate. The PHFKP group showed an extended length of stay (+13.3 days) and a tendency toward more discharges to facilities compared with the control group. Knee extension range of motion limitation, knee extensor strength, and BBS did not differ between groups, while MWS was significantly lower in the PHFKP group (0.85 ± 0.32 m/s vs. 1.07 ± 0.39 m/s). Multiple analyses showed that development of PHFKP was not associated with BBS, but was associated with decreased MWS (standardized beta = −0.202, P = 0.005). Conclusions PHFKP was identified as an independent factor in gait speed decline. PHFKP patients should be monitored for reduced gait speed during rehabilitation. Geriatr Gerontol Int 2021; 21: 830–835.

Predictors of post‐hip fracture knee pain in hospitalized older adults with intertrochanteric femoral fracture

“…Developing PHFKP did not affect FIM score at discharge but significantly increased the length of hospital stay (+6.8 days). Although this result is supported by previous studies, [4][5][6] caution should be exercised in generalizing our results, which were based on univariate analysis only. Obesity has been reported to increase the risk of postoperative comorbidities and prolonged hospital stay, 29 and the results of this study showed that the PHFKP group had a higher BMI.…”

“…We investigated the development of PHFKP for 1 week from admission. This was done for two reasons: (1) 85%-90% of PHFKP development has been reported to occur immediately after admission, 5,6 and (2) to minimize the temporal discrepancy between the time point and the admission assessment. KE-ROM was measured by a physical therapist using a goniometer in the admission assessment.…”

“…Recently, post‐hip fracture knee pain (PHFKP) has been reported to develop in 28%–37.4% of patients during rehabilitation and is associated with worse treatment prognosis 3‐5 . Furthermore, the development of PHFKP during hospitalization affects rehabilitation outcomes, including reduced gait speed, 6 increased facility discharges, 6 and prolonged hospitalization 3,5,6 . Risk factors for PHFKP have been reported to include knee osteoarthritis (OA) 4 and intertrochanteric femoral fracture 3‐5 …”

“…[3][4][5] Furthermore, the development of PHFKP during hospitalization affects rehabilitation outcomes, including reduced gait speed, 6 increased facility discharges, 6 and prolonged hospitalization. 3,5,6 Risk factors for PHFKP have been reported to include knee osteoarthritis (OA) 4 and intertrochanteric femoral fracture. [3][4][5] Knee OA is a disease that causes knee pain in older adults, and as discussed later, alignment and other physical parameters are related to the severity of symptoms, which can be helpful in considering factors for PHFKP.…”

Association between General Anesthesia and the Occurrence of Cerebrovascular Accidents in Hip Fracture Patients

“…However, elderly patients with hip fracture usually have poor body tolerance and a high rate of perioperative complications, among which cerebrovascular accidents are one of the most serious ones and also the leading cause of postoperative death [ 19 ]. Studies have shown many risk factors affecting cerebrovascular accidents, and currently, the well-established ones include history of cerebrovascular accidents, history of hypertension, general anesthesia, anesthetic drug dosage, and intraoperative blood pressure [ 20 , 21 ], in which general anesthesia is closely related to factors such as anesthetic drug dosage and intraoperative blood pressure, and therefore, it may be one of the most critical elements affecting cerebrovascular accidents.…”