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Treatment to reduce knee buckling may help prevent falls

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Symptoms of knee instability in older adults may indicate an increased risk of falling that can be treated as a preventive measure, according to a US study.

The study authors said their findings indicated that determining effective treatments for knee instability should be an important priority as clinicians care for aging patients.

“Health professionals should query their patients with knee osteoarthritis about instability, buckling, and falls, and work with them to take preventive”

Michael Nevitt

Dr Michael Nevitt, from the University of California, and colleagues studied 1,842 people who were an average of 67 years old at the start and who had, or were at high risk for, knee osteoarthritis.

At the end of five years, 16.8% reported knee buckling, and at the end of 7 years, 14.1% had recurrent falls, according to the study published in the journal Arthritis Care & Research.

Those who reported bucking at year five had a 1.6- to 2.5-times higher likelihood of recurrent falls, fear of falling, and poor balance confidence at year seven.

In addition, those who fell when a knee buckled at the start of the study had a 4.5-times, two-times, and three-times higher likelihood two years later of recurrent falls, significant fall injuries, and fall injuries that limited activity, respectively, and they were four-times more likely to have poor balance.

Dr Nevitt highlighted that falls, injury from falls and poor balance confidence were “extremely common and debilitating problems in older people”.

He said: “The present study has demonstrated for the first time that knee instability and knee buckling are important causes of these problems in the very large segment of the older population suffering from knee pain.

“Fortunately, it may be possible to treat knee instability and prevent knee buckling with targeted exercises,” he said. “Joint replacement surgery can also improve knee stability.”

Dr Nevitt added that pain was the predominant symptom of knee osteoarthritis, and symptoms of instability such as knee buckling and falls may be overlooked by treating professionals.

“The most important immediate impact of these findings on patient care is that health professionals should query their patients with knee osteoarthritis about instability, buckling, and falls, and work with them to take preventive actions, including proper use of walking aids, leg strengthening, and appropriate footwear,” he said.

 

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