Reduction of Falls and Factors Affecting Falls a Year After Total Knee Arthroplasty in Elderly Patients with Severe Knee Osteoarthritis

T. Tsonga1, 2, M. Michalopoulou2, S. Kapetanakis3, *, E. Giovannopoulou4, P. Malliou2, G. Godolias2, P. Soucacos5
1 Department of Physical Therapy, Amalia Fleming General Hospital, Athens, Greece
2 Department of Physical Education and Sports, Democritus University of Thrace, PC 69100, Komotini, Greece
3 Medical School, Democritus University of Thrace, PC 68100, Alexandroupolis, Greece
4 Department of Anatomy, Medical School, Democritus University of Thrace, PC 68100, Alexandroupolis, Greece
5 Department of Orthopaedics, Amalia Fleming General Hospital, PC 15127, Melissia, Athens, Greece

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© Tsonga et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Medical School of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, PC 68100, Greece; Tel: +30-6972707384; Fax: +30-25410-67200; E-mail:



Total Knee Arthroplasty (TKA)1 is a common surgical treatment for severe knee Osteoarthritis (OA)2, which generally improves pain, physical function, quality of life and possibly fall risk. Fall risk increases for older adults with severe knee OA; however it has not been studied extensively whether this parameter is improved after TKA.


To investigate: a) the history and frequency of falls, including mechanism or causes of falls, injuries sustained from falls reported, activity during falling and location of falls and, b) the factors affecting falls, a year after TKA in elderly patients with severe knee OA.

Patients and Method:

An observational prospective longitudinal study of 68 patients (11 males and 57 females) was conducted. The frequency of falls was recorded every month after knee replacement for a year period. A year after the TKA patients completed self-administered questionnaires (SF-36, Womac, FOF, ABC, PASE) and were assessed in physical performance tests (TUG and BBS).


There was significant improvement in falls frequency (p<0.001), differentiation of falling status to the benefit of non fallers (p<0.001) and risk of serious injuries (p<0.001). The factors that affected falling status was history of falls (p<0.0005), fear of falls (p<0.017) and advanced age, marginally (p<0.097).


TKA generally improved a lot of aspects in patients’ life. One of these was the reduction of fall risk, which always co-exists in this population and can cause devastating problems threatening the benefits of the procedure.

Keywords: Elderly, Falls, Health realted quality of life, Knee, Severe osteoarthritis, Total knee arthroplasty.