Incidence and Determinants of Falls Following Hip and Knee Joint Arthroplasty: A Systematic Review and Meta-Analysis

Hip and knee joint arthroplasty is a common procedure. The true incidence and predictors of postoperative falls remain uncertain. The aim of this systematic review and meta-analysis is to (1) determine the overall incidence of falls post hip and knee joint arthroplasty, (2) identify risk factors associated with these falls, and (3) evaluate the effectiveness of fall prevention strategies and interventions in reducing fall incidence. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in PROSPERO. This research was conducted using PubMed, Google Scholar, Web of Science, ScienceDirect, and Wiley Online Library. Two independent reviewers screened studies by title, abstract, and full text. The quality of the included articles was assessed using the Methodological Index for Non-Randomized Studies (MINORS). A total of 1,282 publications were identified, leading to the review of 988 patients aged between 60 and 88 years, reviewed for this systematic review from seven full-text articles. Fall incidence post total knee arthroplasty (TKA) varied, with five reporting increased rates (36%, 32.9%, 38.2%, 22.1%, and 32%) and two indicating a decrease (50% and 26.4% reduction). All studies emphasized the role of postoperative limitations and psychological factors on fall risk. Additionally, patients living alone had higher odds of falling, highlighting the need for targeted postoperative care. While fall incidence post hip and knee arthroplasty varies, improvements in quality of life and functional outcomes following surgery are reported. Future research should focus on larger sample sizes, control groups, objective assessments, extended follow-up periods, and various joint replacements.