title: Analyzing the History of Falls in Patients with Severe Knee Osteoarthritis.
abstract: BACKGROUND
  One out of three adults over the age of 65 years and one out of two over the age of 80 falls annually. Fall risk increases for older adults with severe knee osteoarthritis, a matter that should be further researched. The main purpose of this study was to investigate the history of falls including frequency, mechanism and location of falls, activity during falling and injuries sustained from falls examining at the same time their physical status. The secondary purpose was to determine the effect of age, gender, chronic diseases, social environment, pain elsewhere in the body and components of health related quality of life such as pain, stiffness, physical function, and dynamic stability on falls frequency in older adults aged 65 years and older with severe knee osteoarthritis.
  
  
  METHODS
  An observational longitudinal study was conducted on 68 patients (11 males and 57 females) scheduled for total knee replacement due to severe knee osteoarthritis (grade 3 or 4) and knee pain lasting at least one year or more. Patients were personally interviewed for fall history and asked to complete self-administered questionnaires, such as the 36-item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and physical performance test was performed.
  
  
  RESULTS
  The frequency of falls was 63.2% for the past year. The majority of falls took place during walking (89.23%). The main cause of falling was stumbling (41.54%). There was a high rate of injurious falling (29.3%). The time patients needed to complete the physical performance test implied the presence of disability and frailty. The high rates of fall risk, the high disability levels, and the low quality of life were confirmed by questionnaires and the mobility test.
  
  
  CONCLUSIONS
  Patients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis, restricted patient's quality of life and increased the fall risk. Therefore, patients with severe knee osteoarthritis should not postpone having total knee replacement, since it was clear that they would face more complicated matters when combining with fractures other serious injuries and disability.
authors.affiliation: Department of Physical Therapy, Amalia Fleming General Hospital, Athens, Greece. ; Department of Physical Education and Sports, Democritus University of Thrace, Komotini, Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Tsonga
authors.affiliation: Department of Physical Education and Sports, Democritus University of Thrace, Komotini, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Michalopoulou
authors.affiliation: Department of Physical Education and Sports, Democritus University of Thrace, Komotini, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Malliou
authors.affiliation: Department of Physical Education and Sports, Democritus University of Thrace, Komotini, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Godolias
authors.affiliation: Department of Anatomy, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Kapetanakis
authors.affiliation: Department of Anatomy, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Grigorios
authors.initials: G
authors.lastname: Gkasdaris
authors.affiliation: Department of Orthopedics, Amalia Fleming General Hospital, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Soucacos
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020370:Osteoarthritis, Knee / Q000453:epidemiology*; D011788:Quality of Life; D012306:Risk
keywords: Fall risk; Falls; Knee osteoarthritis; Quality of life