Knee Scooter–Related Injuries: A Survey of Foot and Ankle Orthopedic Surgeons

Abstract

Background: Knee scooters (“scooters”) are a commonly used device to facilitate postoperative adherence to weightbearing restrictions. Although high rates of falls have been reported, little is known about injuries related to scooter use. Methods: We analyzed survey responses from 316 of 2046 members (15%) of the American Orthopaedic Foot & Ankle Society in May-June 2019 describing (1) frequency of scooter recommendation; (2) indications for which they recommended scooters; (3) characteristics of patients for whom they recommended scooters; (4) prevalence, anatomic locations, mechanisms, and sequelae of scooter-related injuries; and (5) characteristics of patients with scooter-related injuries. Descriptive statistics and χ2 goodness-of-fit tests were performed (alpha = .05). Results: Mean frequency with which respondents recommended scooters in particular was 69%. Respondents most often recommended scooters after hindfoot arthrodesis (97% [305/316]), ankle arthrodesis (96% [302/316]), and for total nonweightbearing (64% [202/316]) and to patients who were overweight (vs obese) or aged 45-75 years. Mean prevalence of scooter-related injuries was 2.5%. The most common injury mechanism was making a sharp turn (reported by 62% [103/166]). Thirty-four percent (56/166) of respondents with injured patients said patients underwent surgery to treat scooter-related injuries. Patients with scooter-related injuries were more often women, >44 years old, obese, and sedentary. Conclusion: Scooters were commonly recommended postoperatively, most often for total nonweightbearing after hindfoot or ankle arthrodesis, and most often in overweight adults or those aged 45-75 years. Mean reported prevalence of scooter-related injuries was 2.5%. Female sex, older age, obesity, and sedentary lifestyle were associated with scooter-related injury. Level of Evidence: Level IV, retrospective case series.

Functional, Spiroergometric, and Subjective Comparisons Between Forearm Crutches and Hands-Free Single Crutches in a Crossover Study

“…Moreover, obstacles such as stairs cannot be overcome without assistance. 5 , 12 , 16 , 26 An alternative that combines unloading without crutches and high mobility is an HFSO ( Figure 1 ) that promises higher patient satisfaction and comfort. 12 , 17 The mode of action of such an orthosis is based on the orthosis being applied with the knee bent at 90 degrees on the affected operated side.…”

Prehabilitation for Patients Undergoing Elective Foot and Ankle Surgery: A Contemporary Review

“…Postoperative falls may lead to complications such as fracture, revision surgeries, hospital readmissions, unnecessary emergency department visits, or health care provider evalautions. 53 , 73 , 102 The incidence of falls in the first year following discharge for total knee or hip arthroplasty has been reported to be as high as 43%. 50 A more recent study on foot and ankle surgery reported a 29% incidence of falls in the first 6 weeks after discharge.…”

“… 108 In a survey of American Orthopaedic Foot & Ankle Society surgeons, the prevalence of postoperative knee scooter–related injuries was estimated to be 2.5%, and 34% of those injuries were treated operatively. 73 Despite the apparent risk associated with knee scooter use, patients report very high satisfaction scores and continue to prefer knee scooters over conventional ambulatory aids. 88 , 102 , 111 There have been no studies investigating the effect of preoperative physical therapy, ambulatory aid training, patient education or other preventative strategies on fall risk after foot and ankle surgery.…”

Lower Extremity Assistive Devices (LEADs): A Contemporary Literature Review

“…41 Roughly 50% of the surgeons had prescribed an RKS with a mean reported complication rate of 2.5%. 41 This is substantially lower than the 43% fall rate cited by Yeoh et al 55 The high complication rate of 43% in the series by Yeoh et al may be attributable to 67% of their patients not receiving training or education on the RKS prior to use and the inherent reporting bias of survey studies. 55 Risk factors identified by Rahman et al 41 were female gender, age >44 years, obesity, and sedentary lifestyle.…”

“…They found that the majority of foot and ankle surgeons were using the RKS for patients who were made nonweightbearing after arthrodesis and fracture fixation. 41 Roughly 50% of the surgeons had prescribed an RKS with a mean reported complication rate of 2.5%. 41 This is substantially lower than the 43% fall rate cited by Yeoh et al 55 The high complication rate of 43% in the series by Yeoh et al may be attributable to 67% of their patients not receiving training or education on the RKS prior to use and the inherent reporting bias of survey studies.…”