Document Type

Conference Proceeding

Publication Date

3-10-2025

Abstract

INTRODUCTION: Pre-operative falls are common in patients undergoing primary hip or knee arthroplasty and pre-dispose patients to poor outcomes. However, this relationship in those undergoing revision hip and knee arthroplasty (rTHA, rTKA) is unclear. This study sought to study the relationship between a pre-operative fall history and post-operative patient complications in patients undergoing rTKA or rTHA. METHODS: The National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing aseptic rTKA or rTHA. The variable for a fall history was available in 2021. Fall history was defined as a patient with a fall in the 6- months prior to surgery. Patients undergoing revision for fracture were excluded. Demographic, comorbid, and operative variables were collected. Post-operative complications were identified and included 30-day readmission, an extended length of stay (LOS), and discharge to a skilled nursing facility (SNF). Chi-square analysis and multivariate logistic regression was used to compare post-operative complications. RESULTS: 621 patients undergoing rTKA and 627 undergoing rTHA were identified meeting inclusion and exclusion criteria. 13.5% of patients undergoing rTKA had a fall history and 123 19.6% of patients undergoing rTHA had a fall history. Differences in pre-operative patient variables for rTKA and rTHA are displayed in Table 1 and Table 2, respectively. On univariate analysis, patients with a fall history had higher rates of readmissions, extended LOS, and a discharge to a skilled nursing facility (Table 3). On multivariate analysis, patients undergoing rTKA with a fall history had a 2.74 (1.63-4.56) times increased odds of an extended LOS and a 3.10 (1.82-5.27) times increased odds of discharge to a SNF (Table 4). Patients undergoing rTHA with a fall history had a 2.86 (1.84-4.24) times increased odds of an extended LOS and a 3.21 (2.04-5.03) times increased odds of discharge to a SNF. There was no difference in 30-day readmissions on multivariate analysis in the rTKA or rTHA cohorts (Table 4). DISCUSSION AND CONCLUSION: A pre-operative fall is common in patients undergoing revision joint arthroplasty. These patients are at a significantly increased odds of an extended LOS and discharge to a SNF. Patients with a fall history may not be adequately prepared for the early post-operative rehabilitation process after revision joint arthroplasty.

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AAOS American Academy of Orthopaedic Surgeons 2025 Annual Meeting, March 10-14, 2025, San Diego, CA

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