Risk Factors for Falls in Adults with Knee Osteoarthritis: A Systematic Review

Objective: To examine the evidence of risk factors for falls in adults with knee osteoarthritis (OA). TYPE: Systematic Review.

Methodology: A systematic literature search was performed in 9 electronic databases from inception to July 2016. Two reviewers screened articles using set inclusion and exclusion criteria. Observational study designs that included participants with knee OA and history of falls were considered. Results reported as odds ratios, relative risks, prevalence ratios, or hazard ratios were extracted to identify the potential risk factors for falls. Included articles were assessed for methodological quality and level of evidence.

Synthesis: The electronic data search yielded 4382 studies related to falls and knee OA. A total of 11 studies were included in the review. The risk factors for falls in individuals with knee OA included impaired balance, muscle weakness, presence of comorbidities, and increasing number of symptomatic joints. The presence of knee pain was also identified as a risk factor for falls; however, the strength of evidence was rated as "conflicting" because of the inconsistency of the findings. Limited evidence was found for knee instability, impaired proprioception, and use of walking aids.

Conclusion: This review provides evidence of risk factors for falls in individuals with knee OA. Despite the limited to moderate evidence, identification of these risk factors may be valuable for both clinicians and fall prevention program developers. Further studies are warranted to determine which of these risk factors for falls are modifiable in a knee OA population.

Level of evidence: I.