Effects of total knee arthroplasty on balance and fall risk in elderly patients with severe gonarthrosis: An age- and sex-matched comparative study

Abstract

Background: Falls are a severe cause of morbidity and mortality in elderly patients, and gonarthrosis causes a tendency to fall. Total knee arthroplasty (TKA) is a widely used successful surgical procedure for end-stage gonarthrosis. Aims: To investigate whether there is a difference in the frequency of falls, balance and fall risk, and clinical and radiological results in patients with end-stage gonarthrosis with and without TKA. Patients and Methods: This was a single-center, retrospective, case-control study with age- and gender-matched groups. A total of 100 patients over 60 years of age, with end-stage gonarthrosis and who met the inclusion criteria were included in the study. Fall risk was analyzed using the Berg Balance Scale (BBS), TUG tests, and the ITAKI Fall Risk Test. Knee varus angles were measured using standing long-leg radiographs, and radiological gonarthrosis grading was performed. Pain levels and quality of life were assessed using the VAS and WOMAC. Each patient's knee extensor muscle strength and range of motion were measured. Results: WOMAC, ITAKI, TUG test, and VAS scores were significantly higher in the control group than in the TKA group. BBS scores were significantly lower in the control group. Although the number of falls was high in the control group, there was no statistically significant difference between the two groups. Conclusion: The results of this study showed that total knee arthroplasty provided statistically significant improvement in the clinical, radiological, and fall risk results of the patients. Although there was a decrease in the frequency of falls compared to the control group, it was statistically insignificant. In addition, in our study, it was evaluated that the most important risk factor for falling was advanced age.