Knee or Hip Replacements Cut People's Risk for Falls: Study

MONDAY, Oct. 26, 2020 -- People who have total joint replacement, or total joint arthroplasty (TJA), experience fewer falls than those who don't undergo the surgery, a new study finds.

"Osteoarthritis (OA) is the degeneration of the cartilage in our joints over the years," said lead author Dr. Ran Schwarzkopf, an orthopedic surgeon at NYU Langone Health in New York City. "As the wear and tear increases, patients lose their range of motion. They cannot turn their toes as easily, flex their hips or lift their legs high enough to avoid obstacles due to physical limitations as well as pain, resulting in falls and fragility fractures."

TJA is surgery to restore function -- typically by replacing a damaged joint with an artificial one.

For the study, recently published in the Journal of the American Academy of Orthopaedic Surgeons, Schwarzkopf and his team used a New York database on nearly 500,000 OA patients. Patients had either total hip or total knee replacements, and their fall rates were compared to those who didn't have the surgeries.

"Those who had TJA fell far less than those who did not," Schwarzkopf said in a journal news release. "From that, we concluded that TJA for patients that have OA is protective against future falls."

TJA decreases pain, increases range of motion and agility and leads to more successful physical therapy. Mentally, patients also have less fear of falling, leading to more stability and confidence, according to the researchers.

"TJA will allow patients to go back to the daily activities they may have avoided due to pain and restricted range of motion," Schwarzkopf said. "They are able to go back to the point in their lives when they can do activities, such as hiking, riding a bicycle or even walking their dog, without having to think about whether it will cause them physical pain or rely as heavily on ambulatory aids and caregivers."

Not everyone needs joint replacement surgery, however. OA can be treated with anti-inflammatory drugs, walking aids and exercises to increase strength, Schwarzkopf said. Only if patients are unable to live with the symptoms is surgery recommended.

Schwarzkopf offered these safety tips to help prevent falls:

• Cover sharp corners of tables or counters.
• Remove loose rugs.
• Install handrails in bathrooms and near staircases.
• Install motion-activated night lights.
• Encourage use of wearable or portable communication devices.

Posted: October 2020