Current Knee Osteoarthritis and Non-Surgically Related Falls Injuries Studies: What Prevails, What is Needed, and Why

Osteoarthritis, a widespread joint disease, commonly resulting in considerable pain and functional disability among older adults, especially at the knee joint, is often exacerbated by falls and fall injuries, also common among the older population. But what does the research show specifically? This report aimed to update what is known about the risk factors for falls in the context of knee osteoarthritis, and what strategies have been proposed to reduce falls risk among this sizeable older adult patient population. Using key electronic data bases, clinical studies published between January 1, 2016 and October 20, 2020 concerning possible explanations for why certain adults with knee osteoarthritis appear to be prone to falling and further injury and disability, along with available falls prevention intervention approaches for this group were sought. Articles fulfilling the eligibility criteria for the review were carefully examined and reported in narrative form. The search results revealed very few recent studies outlining reasons for the extent to which sizeable knee osteoarthritis cases may fall on a single or multiple occasions. Those that do generally fail to employ prospective well-powered research designs, comparable samples, objective or standardized assessment procedures, or well-grounded reasons for the highly varied array of possible falls risk determinants examined. Even when multiple potential falls explanatory risk factors are studied, the diverse results obtained provide little consensus as to why a proportion of adults with knee osteoarthritis are prone to falls, while other are not. At the same time, a substantive body of highly varied approaches for offsetting falls risk among this patient group that have been proposed appear to assume certain falls risk factors are clinically significant, while neglecting others, despite any uniform consensus on this issue. Their current practicality for impacting falls risk is also questionable given the numerous 2020 Covid-19 pandemic-associated practice changes.

Keywords: elderly, falls, fall injuries, falls risk, knee, muscle, osteoarthritis, pain; proprioception, prevention.