title: Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength.
abstract: OBJECTIVE
  Knee pain and disability can persist following knee replacement surgery which may place patients at increased risk of falls. This study investigated the falls risk and the occurrence of falls of people with knee osteoarthritis (OA) before and at 12 months following knee replacement surgery.
  
  
  METHODS
  Thirty-five patients with knee OA were tested prior to undergoing knee replacement surgery and at 12 months following surgery using the short form Physiological Profile Assessment, which incorporates tests of vision, lower limb proprioception, knee extension strength, reaction time and postural sway. Physical activity, number of falls, fear of falling, pain, disability and health-related quality of life were also assessed.
  
  
  RESULTS
  No significant differences were found between the number of falls pre- and post-surgery (n.s.), with 48.5 and 40% reporting at least one fall in the 12 months before and following the surgery, respectively. Improvements in knee strength, reaction time and fear of falling were evident following surgery, with no improvement in lower limb proprioception. Self-reported pain, function and stiffness were significantly improved, but health-related quality of life deteriorated following the surgery.
  
  
  CONCLUSIONS
  The number of falls experienced following knee replacement surgery remained relatively high, which may be attributed to the persistence of impaired lower limb proprioception. Although knee replacement surgery improves function and alleviates pain, people who undergo this procedure may need to engage in rehabilitation following the surgery to reduce the risk of falling.
  
  
  METHODS
  Therapeutic study investigating the result of treatment on patient outcomes, Level IV.
authors: Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, VIC 3086, Australia. p.levinger@latrobe.edu.au
authors: Pazit
authors: P
authors: Levinger
authors: Hylton B
authors: HB
authors: Menz
authors: Adam D
authors: AD
authors: Morrow
authors: Elin
authors: E
authors: Wee
authors: Julian A
authors: JA
authors: Feller
authors: John R
authors: JR
authors: Bartlett
authors: Neil
authors: N
authors: Bergman
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D015444:Exercise; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D010147:Pain Measurement; D011434:Proprioception; D011788:Quality of Life; D018570:Risk Assessment; D057566:Self Report; D012720:Severity of Illness Index; D016896:Treatment Outcome