title: Bilateral total knee arthroplasty increases the propensity to trip on an obstacle.
abstract: Tripping over an obstacle is the most frequent cause of falls. We examined the effects of total knee arthroplasty on obstacle avoidance success rates in older adults. Obstacle avoidance success rates, body mass index, visual acuity, contrast sensitivity, depth perception, and single-leg stance duration were evaluated in 29 subjects who had bilateral total knee arthroplasties (age range, 72.6 +/- 5.4 years) and 27 age-matched healthy control subjects (age range, 70.6 +/- 5.5 years). The patients who had total knee arthroplasties had a lower obstacle avoidance success rate, lower single-leg stance duration, and greater body mass index than control subjects. Age, contrast sensitivity, and depth perception were not different between patients who had total knee arthroplasties and control subjects. Obstacle avoidance success rates decreased linearly as single-leg stance duration decreased in the control group and across all groups, but not in the group that had total knee arthroplasties. Linear relationships between obstacle avoidance success rates and body mass index existed for all subjects but not for the group that had total knee arthroplasties or the control group individually. Total knee arthroplasty reduces obstacle avoidance success rate, suggesting that persons who have total knee arthroplasties have an increased propensity to trip on an obstacle and fall. Increased body mass index and decreased single-leg stance duration in patients who have total knee arthroplasties are associated with a decreased obstacle avoidance success rate.
authors.affiliation: Motion Analysis Laboratory, Section of Orthopaedic Surgery and Rehabilitation Medicine, Department of Surgery, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
authors.forename: Andreas C
authors.initials: AC
authors.lastname: Mauer
authors.forename: Louis F
authors.initials: LF
authors.lastname: Draganich
authors.forename: Nirav
authors.initials: N
authors.lastname: Pandya
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hofer
authors.forename: Gary A
authors.initials: GA
authors.lastname: Piotrowski
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007720:Knee Prosthesis / Q000009:adverse effects*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery; D010465:Perception / Q000502:physiology; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D017678:Sex Distribution