Gait Abnormality Predicts Falls in Women After Total Hip Arthroplasty

Abstract

BackgroundPatients who undergo total hip arthroplasty (THA) have an increased risk of falls during the first year postoperatively. However, risk factors for falls after THA remain unclear. We investigated the relationship between gait abnormality and falls during the first year after THA. MethodsWe conducted a prospective cohort study of 286 patients with severe hip osteoarthritis who underwent THA and examined fall history during the first year postoperatively. Baseline characteristics including age, body mass index, number of prescribed medications, comorbidities, and history of falling in the past year were evaluated as covariates and determined using a self-administered questionnaire and interview preoperatively. We assessed functional outcomes, including passive range of motion of the hip joint (flexion, extension, abduction, and adduction), muscle strength (hip abduction and knee extension), gait velocity, and gait abnormality, at 3 weeks postoperatively. Cox proportional hazard regression models were used to analyze the relationship between the presence of gait abnormality and falls. ResultsOne hundred sixty-two women were included. The incidence of at least 1 fall during the first year after THA was 31.5%. Cox proportional hazard regression models showed that the presence of gait abnormality (hazard ratio, 2.91; 95% confidence interval, 1.55-5.48; P < .001) was significantly associated with falls during the first year postoperatively. ConclusionThe presence of gait abnormality is a useful screening tool to predict future falls in women after THA. Clinicians should assess gait abnormality to identify patients who may require fall prevention measures and continuous rehabilitation to improve gait abnormality.