Symptoms of Knee Instability as Risk Factors for Recurrent Falls

Abstract

Objectives Whether knee instability contributes to the increased risk of falls and fractures observed in persons with knee osteoarthritis (OA) has not been studied. We examined the association of knee buckling with the risk of falling and fall-related consequences in older adults with, or at high risk for, knee OA. Methods At the 60 month visit of the Multicenter Osteoarthritis Study, men and women ages 55 to 84 were asked about knee buckling in the past 3 months and whether they fell when a knee buckled. Falls and fall-related injuries in the past 12 months and balance confidence were assessed at 60 and 84 months. Multivariate logistic regression was used to assess the association of knee buckling with falls and their consequences. Results 1,842 subjects (59% women, mean [SD] age= 66.9 [7.8] and BMI= 30.3 [5.7]) were included. At 60 months 16.8% reported buckling and at 84 months 14.1% had recurrent (≥2) falls. Bucklers at 60 months had a 1.6 to 2.5-fold greater odds of recurrent falls, fear of falling and poor balance confidence at 84 months. Those who fell when a knee buckled at baseline had a 4.5-fold, 2-fold and 3-fold increased odds two years later of recurrent falls, significant fall injuries and fall injuries that limited activity, respectively, and were 4 times more likely to have poor balance confidence. Conclusion Interventions that reduce knee buckling may help prevent falls, fall-related injuries and adverse psychological consequences of falls in persons with knee OA.

Risk Factors for Falls in Adults with Knee Osteoarthritis: A Systematic Review

“…Thus, the more recent article was retained. A total of 11 articles met the inclusion criteria, 9 records from the initial search and 2 from the updated search . Manual searching did not yield any additional records for inclusion.…”

“…Table shows the summary of characteristics of the 11 included studies, conducted across different countries. There were five cross‐sectional and six prospective study designs included in this review . The number of participants in each study varied between 30 and 684 participants for the cross‐sectional studies, and between 940 and 20 409 participants for the longitudinal cohort studies .…”

“…Overall, studies included more female (91.34%) than male (8.66%) participants with four studies including only female participants . For the diagnosis of knee OA, 54% of the included studies used ACR clinical criteria, whereas the remainder used self‐reported OA and radiographic changes …”

“…Eight (73%) studies reported a definition of a fall . However, the fall definition was inconsistent across the studies.…”

Postural Stability Is Affected in Older Males with Haemophilia—A Matched Control Study

“…It has been reported that older people with osteoarthritis of the knee have a two-fold increase in their likelihood of having a fall and those with osteoarthritis of the ankle have significantly poorer balance than those without osteoarthritis of the ankle joint [8,9]. Although the underlying mechanism is not known, it is thought that muscle weakness and altered proprioception may play a role.…”