Changes of the Incidence of falls in Patients with Rheumatoid Arthritis after Orthopaedic Lower Limb Surgery

Abstract

Introduction: Orthopaedic lower limb surgeries are often performed for joint pain or destruction in rheumatoid arthritis (RA), however, there were few studies for incidences and risk factors of falls after lower limb surgeries in RA. The aim of current study was to examine the incidences of falls and to analyze the risk factors for falls in patients with RA after lower limb surgeries. Methods: Self-reported questionnaires were completed by 141 patients. The incidence of falls in patients who underwent lower limb surgeries (71 cases, 1 surgery) were compared to patients with no history of surgery. Results: The incidence rate of falls in surgery group was significantly fewer when compared to no-surgery group (9.8% vs. 38.6%, p<0.01). Among the patients with history of surgery, DAS 28-CRP (4) and tender joint counts were significantly higher in the fall group than in the no-fall group. After the surgery, the frequency of falls decreased in 30% of the patients. Walking ability improved in 34% of the patients after surgery. Tender joint counts and DAS28- CRP(4) were significant risk factors for falls, on the other hand, the history of lower limb surgery was protective factor against falls (OR 0.04, p<0.01). Conclusion: The walking ability clearly improved after surgery in one third of the patients, which may resulted in decreased incidence of falls. Several patients had high disease activity even after surgery, which may be the reason why the frequency of falls increased in 6% of the patients after surgery.