Changes in Fall Risk After Total Hip Arthroplasty for Dysplastic Hip Osteoarthritis

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Biomechanics

Background:

• Total hip arthroplasty (THA) is a common procedure for dysplastic hip osteoarthritis (DHOA).
• While THA improves hip function, its impact on reducing fall risk in DHOA patients is not well-established.
• Preoperative fall risk assessment is crucial for identifying at-risk individuals.

Purpose of the Study:

• To evaluate the effect of THA on fall risk in patients with DHOA.
• To identify risk factors associated with persistent fall risk after THA in this population.

Main Methods:

• Retrospective cohort study of 85 DHOA patients undergoing THA with preoperative high fall risk (Fall Risk Index 5 items [FRI-5] ≥ 6).
• Patients were categorized into high-risk and low-risk groups based on FRI-5 scores one year postoperatively.
• Evaluated parameters included FRI-5, age, BMI, Harris hip score (HHS), perceived leg length discrepancy (P-LLD), and radiographic measures (SVA, LL). Logistic regression analyzed risk factors.

Main Results:

• Postoperative fall risk significantly decreased (FRI-5: 7.79 to 4.56, p < 0.001) and the number of falls reduced (42.4% to 21.2%, p = 0.005).
• The high-risk group (n=33) was older and had greater postoperative P-LLD compared to the low-risk group (n=52).
• Significant predictors for postoperative fall risk included older age (OR: 1.2), preoperative low lumbar lordosis (OR: 0.944), and postoperative P-LLD (OR: 5.81).

Conclusions:

• THA effectively reduces fall risk in DHOA patients previously identified as high-risk.
• Surgeons should consider age, lumbar lordosis, and leg length discrepancy when planning THA to mitigate postoperative fall risk.