Falls in patients after total hip arthroplasty in Japan

J Orthop Sci. 2015 Jul;20(4):663-8. doi: 10.1007/s00776-015-0715-7. Epub 2015 Mar 24.

Abstract

Background: There have been few reports on falls in patients who have undergone total hip arthroplasty (THA). In the present study, we aimed to investigate the incidence and circumstances of falls in post-THA patients and to identify the factors associated with falling.

Materials and methods: After excluding comorbidities, osteoarthritis without THA, and patients who had undergone THA within the previous 1 year, 214 patients [11 males, 203 females; mean (SD) age, 66.0 (8.7) years] living independently for at least 1 year after THA were analyzed as available data. Using a self-administered questionnaire, we investigated the number and circumstances of falls in the preceding year, as well as functional outcome and ambulatory ability via the Oxford Hip Score. Multivariate logistic regression analysis was used to identify factors influencing falls in post-THA patients.

Results: The incidence of at least one fall in the past year was 36 %. Falls were most often caused by tripping and falling forward during the daytime. In the present study, 37.7 % of falls resulted in injuries and 5.2 % resulted in fractures. Experience of fall was significantly related to medication [odds ratio (OR) 4.09, 95 % confidence interval (CI) 1.90-8.80, P < 0.001] and postoperative duration (OR 0.89, 95 % CI 0.81-0.98, P < 0.05).

Conclusions: Thus, patients have an increased risk for falls and fall-induced injuries after THA. Falls in post-THA patients are associated with medication and shorter postoperative duration. Therefore, it is essential to prevent falls in patients who have undergone THA, particularly during the early postoperative period and among patients administered medications.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Activities of Daily Living
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Postoperative Period
  • Prevalence
  • Risk Assessment / methods*
  • Surveys and Questionnaires