Predictors of falls in patients during the first year after total hip arthroplasty: A prospective cohort study

• Main Authors: Kazunari Ninomiya, Naonobu Takahira, Takashi Ikeda, Koji Suzuki, Ryoji Sato, Kazuo Hirakawa
• Format: Article
• Language: English
• Published: Wiley 2020-09-01
• Series: Health Science Reports
• Subjects: falls; joint replacement; muscle strength; risk factor
• Online Access: https://doi.org/10.1002/hsr2.184

Abstract Background and Purpose Since falls after total hip arthroplasty (THA) cause severe complications such as dislocation and fractures around the femoral stem, it is important to investigate what factors predict of falls. Thus, investigating predictors of falls in patients waiting for THA would be valuable as it lead to more strategic interventions to prevent these problems. The purpose of this study was to evaluate the predictors of falls in patients during the first year after THA. Methods This is a prospective cohort study. A total of 157 patients who underwent THA for unilateral hip osteoarthritis were analyzed. The incidence of falls during the first year after THA was monitored, and patients were classified into a “faller” and “non‐faller” group. The following factors were compared between the two groups: demographic data (age, sex, body mass index, leg length discrepancy, length of hospital stay, and history of falling), preoperative hip abductor muscle strength, functional performance (single leg stance and maximum walking speed), pain during walking, and physical activity. Results On multivariate logistic regression analysis, preoperative hip abductor muscle strength on the affected side and a history of falling were predictors of falls during the first year after THA. On subsequent receiver operating characteristic curve analysis, preoperative hip abductor muscle strength on the affected side was retained as a significant predictor, with a cut‐off strength of 0.46 Nm/kg differentiating the faller and non‐faller groups with a specificity of 73.6%, specificity of 50.0%, and area under the curve of 70.2%. Conclusions Finding from the present study suggested that clinicians should focus on low preoperative hip abductor muscle strength on the affected side and a history of falling to prevent falls during the first year after THA.