Summary of best evidence for fall prevention after total hip arthroplasty in elderly patients_West China Medical Journal

Authors：

MA Yanfei ,  NING Ning , ZHOU Zongke , CHEN Jiali , HOU Ailin , LI Peifang , HU Rong

Department of Orthopedic Surgery, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

NING Ning, Email: gkningning@126.com

Keywords：

Total hip arthroplasty; fall; elderly; evidence summary; evidence-based nursing

DOI：

10.7507/1002-0179.202305061

Video：

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Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.

Citation： MA Yanfei, NING Ning, ZHOU Zongke, CHEN Jiali, HOU Ailin, LI Peifang, HU Rong. Summary of best evidence for fall prevention after total hip arthroplasty in elderly patients. West China Medical Journal, 2024, 39(10): 1585-1591. doi: 10.7507/1002-0179.202305061 Copy

1.	谷斌. 渐进式平衡训练在全髋关节置换术后康复早期的应用研究. 南京: 南京中医药大学, 2020.
2.	许梦瑶. 八卦掌锻炼对老年人跌倒风险的影响研究. 北京: 首都体育学院, 2022.
3.	张雪梅. 积极老龄化视角下社区老年健康教育供给研究——以柳州 L 社区为例. 南宁: 广西大学, 2021.
4.	Ikutomo H, Nagai K, Tagomori K, et al. Incidences and circumstances of falls among women following total hip arthroplasty on long-term follow-up. J Orthop Sci, 2023, 28(3): 577-582.
5.	施小明. 应加强老年健康关键因素与相关机制研究. 中华医学杂志, 2022, 102(2): 85-89.
6.	Hill AM, Ross-Adjie G, McPhail SM, et al. Incidence and associated risk factors for falls in older adults after elective total knee replacement surgery: a prospective cohort study. Am J Phys Med Rehabil, 2022, 101(5): 454-459.
7.	Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
8.	胡雁, 郝玉芳. 循证护理学. 北京: 人民卫生出版社, 2018: 56-67.
9.	汪洋. Cochrane 偏倚风险评估工具简介. 中国全科医学, 2019, 22(11): 1322.
10.	王春青, 胡雁. JBI 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 2015(11): 964-967.
11.	北京医院, 国家老年医学中心, 中国老年保健医学研究会老龄健康服务与标准化分会, 等. 居家(养护)老年人跌倒干预指南. 中国老年保健医学, 2018, 16(3): 32-34.
12.	Crandall M, Duncan T, Mallat A, et al. Prevention of fall-related injuries in the elderly: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg, 2016, 81(1): 196-206.
13.	Kim KI, Jung HK, Kim CO, et al. Evidence-based guidelines for fall prevention in Korea. Korean J Intern Med, 2017, 32(1): 199-210.
14.	National Institute for Health and Care Excellence. Falls: assessment and prevention of falls in older people. London: National Institute for Health and Care Excellence, 2013.
15.	Tseng MY, Liang J, Shyu YI, et al. Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: a prospective randomized controlled trial. BMC Musculoskelet Disord, 2016, 17: 114.
16.	Shyu YI, Liang J, Tseng MY, et al. Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: a randomised controlled trial. Int J Nurs Stud, 2016, 56: 54-62.
17.	Ikutomo H, Nagai K, Tagomori K, et al. Gait abnormality predicts falls in women after total hip arthroplasty. J Arthroplasty, 2018, 33(10): 3215-3219.
18.	Yau DT, Chung RC, Pang MY. Knee muscle strength and visual acuity are the most important modifiable predictors of falls in patients after hip fracture surgery: a prospective study. Calcif Tissue Int, 2013, 92(3): 287-295.
19.	中华中医药学会骨伤科分会髋关节功能障碍诊疗指南制定工作组. 中医骨伤科临床诊疗指南·人工髋关节置换围手术期康复专家共识. 康复学报, 2017, 27(4): 1-6.
20.	中国康复医学会老年康复专业委员会专家共识组, 上海市康复医学会专家共识组. 预防老年人跌倒康复综合干预专家共识. 老年医学与保健, 2017, 23(5): 349-352.
21.	广东省药学会. 老年人药物相关性跌倒预防管理专家共识. 今日药学, 2019, 29(10): 649-659.
22.	US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA, 2018, 319(16): 1696-1704.
23.	Chang CJ, Lin NL, Lee MS, et al. Recovery of posture stability at different foot placements in patients who underwent minimally invasive total hip arthroplasty: a one-year follow-up study. Biomed Res Int, 2015, 2015: 463792.
24.	Di Monaco M, Vallero F, De Toma E, et al. Adherence to recommendations for fall prevention significantly affects the risk of falling after hip fracture: post-hoc analyses of a quasi-randomized controlled trial. Eur J Phys Rehabil Med, 2012, 48(1): 9-15.
25.	中国老年医学学会. 老年医学科多学科门诊服务模式与规范. 中华老年医学杂志, 2021, 40(8): 987-990.
26.	毛一晴, 康定鼎, 张博文, 等. 国内外多学科团队诊疗模式研究进展. 中国医院, 2022, 26(3): 18-21.
27.	周洋洋, 倪英杰, 李荥娟, 等. 老年股骨颈骨折治疗研究进展. 中国修复重建外科杂志, 2019, 33(8): 1033-1040.
28.	Loizzo M, Gallo F, Caruso D. Reducing complications and overall healthcare costs of hip fracture management: a retrospective study on the application of a diagnostic therapeutic pathway in the Cosenza general hospital. Ann Ig, 2018, 30(3): 191-199.
29.	芮云峰, 邱晓东, 邹继红, 等. 多学科协作诊疗模式在老年髋部骨折的临床应用. 中国修复重建外科杂志, 2019, 33(10): 1276-1282.
30.	Bartlett AS, Parton S, Lattuca J. Physical therapy self-management strategies for a patient with a total hip replacement and heart failure: a case report. Home Healthc Now, 2018, 36(5): 304-311.
31.	丁晔, 何晓红. 多元化健康教育对骨科术后患者深静脉血栓认知水平及健康行为的影响. 海军医学杂志, 2020, 41(3): 343-345.
32.	符美玲, 苏飞月, 赵庆华, 等. 患者安全文化建设实践研究. 中国卫生质量管理, 2021, 28(5): 75-78.
33.	赵瑞萍, 李澍, 张鹏, 等. 基于 HFMEA 的医院公共区域公用设施患者安全流程再造. 中国医院管理, 2021, 41(11): 57-59.
34.	郭丽敏, 杨思源, 贾媛, 等. 术后跌倒恐惧对髋关节置换患者结局指标的影响. 长春中医药大学学报, 2020, 36(6): 1272-1274, 1278.
35.	徐程, 徐姝娟, 陈思仙, 等. 皖南地区三级甲等医院护士对患者安全态度现状及影响因素分析. 职业与健康, 2022, 38(4): 488-491, 496.

1. 谷斌. 渐进式平衡训练在全髋关节置换术后康复早期的应用研究. 南京: 南京中医药大学, 2020.
2. 许梦瑶. 八卦掌锻炼对老年人跌倒风险的影响研究. 北京: 首都体育学院, 2022.
3. 张雪梅. 积极老龄化视角下社区老年健康教育供给研究——以柳州 L 社区为例. 南宁: 广西大学, 2021.
4. Ikutomo H, Nagai K, Tagomori K, et al. Incidences and circumstances of falls among women following total hip arthroplasty on long-term follow-up. J Orthop Sci, 2023, 28(3): 577-582.
5. 施小明. 应加强老年健康关键因素与相关机制研究. 中华医学杂志, 2022, 102(2): 85-89.
6. Hill AM, Ross-Adjie G, McPhail SM, et al. Incidence and associated risk factors for falls in older adults after elective total knee replacement surgery: a prospective cohort study. Am J Phys Med Rehabil, 2022, 101(5): 454-459.
7. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
8. 胡雁, 郝玉芳. 循证护理学. 北京: 人民卫生出版社, 2018: 56-67.
9. 汪洋. Cochrane 偏倚风险评估工具简介. 中国全科医学, 2019, 22(11): 1322.
10. 王春青, 胡雁. JBI 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 2015(11): 964-967.
11. 北京医院, 国家老年医学中心, 中国老年保健医学研究会老龄健康服务与标准化分会, 等. 居家(养护)老年人跌倒干预指南. 中国老年保健医学, 2018, 16(3): 32-34.
12. Crandall M, Duncan T, Mallat A, et al. Prevention of fall-related injuries in the elderly: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg, 2016, 81(1): 196-206.
13. Kim KI, Jung HK, Kim CO, et al. Evidence-based guidelines for fall prevention in Korea. Korean J Intern Med, 2017, 32(1): 199-210.
14. National Institute for Health and Care Excellence. Falls: assessment and prevention of falls in older people. London: National Institute for Health and Care Excellence, 2013.
15. Tseng MY, Liang J, Shyu YI, et al. Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: a prospective randomized controlled trial. BMC Musculoskelet Disord, 2016, 17: 114.
16. Shyu YI, Liang J, Tseng MY, et al. Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: a randomised controlled trial. Int J Nurs Stud, 2016, 56: 54-62.
17. Ikutomo H, Nagai K, Tagomori K, et al. Gait abnormality predicts falls in women after total hip arthroplasty. J Arthroplasty, 2018, 33(10): 3215-3219.
18. Yau DT, Chung RC, Pang MY. Knee muscle strength and visual acuity are the most important modifiable predictors of falls in patients after hip fracture surgery: a prospective study. Calcif Tissue Int, 2013, 92(3): 287-295.
19. 中华中医药学会骨伤科分会髋关节功能障碍诊疗指南制定工作组. 中医骨伤科临床诊疗指南·人工髋关节置换围手术期康复专家共识. 康复学报, 2017, 27(4): 1-6.
20. 中国康复医学会老年康复专业委员会专家共识组, 上海市康复医学会专家共识组. 预防老年人跌倒康复综合干预专家共识. 老年医学与保健, 2017, 23(5): 349-352.
21. 广东省药学会. 老年人药物相关性跌倒预防管理专家共识. 今日药学, 2019, 29(10): 649-659.
22. US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA, 2018, 319(16): 1696-1704.
23. Chang CJ, Lin NL, Lee MS, et al. Recovery of posture stability at different foot placements in patients who underwent minimally invasive total hip arthroplasty: a one-year follow-up study. Biomed Res Int, 2015, 2015: 463792.
24. Di Monaco M, Vallero F, De Toma E, et al. Adherence to recommendations for fall prevention significantly affects the risk of falling after hip fracture: post-hoc analyses of a quasi-randomized controlled trial. Eur J Phys Rehabil Med, 2012, 48(1): 9-15.
25. 中国老年医学学会. 老年医学科多学科门诊服务模式与规范. 中华老年医学杂志, 2021, 40(8): 987-990.
26. 毛一晴, 康定鼎, 张博文, 等. 国内外多学科团队诊疗模式研究进展. 中国医院, 2022, 26(3): 18-21.
27. 周洋洋, 倪英杰, 李荥娟, 等. 老年股骨颈骨折治疗研究进展. 中国修复重建外科杂志, 2019, 33(8): 1033-1040.
28. Loizzo M, Gallo F, Caruso D. Reducing complications and overall healthcare costs of hip fracture management: a retrospective study on the application of a diagnostic therapeutic pathway in the Cosenza general hospital. Ann Ig, 2018, 30(3): 191-199.
29. 芮云峰, 邱晓东, 邹继红, 等. 多学科协作诊疗模式在老年髋部骨折的临床应用. 中国修复重建外科杂志, 2019, 33(10): 1276-1282.
30. Bartlett AS, Parton S, Lattuca J. Physical therapy self-management strategies for a patient with a total hip replacement and heart failure: a case report. Home Healthc Now, 2018, 36(5): 304-311.
31. 丁晔, 何晓红. 多元化健康教育对骨科术后患者深静脉血栓认知水平及健康行为的影响. 海军医学杂志, 2020, 41(3): 343-345.
32. 符美玲, 苏飞月, 赵庆华, 等. 患者安全文化建设实践研究. 中国卫生质量管理, 2021, 28(5): 75-78.
33. 赵瑞萍, 李澍, 张鹏, 等. 基于 HFMEA 的医院公共区域公用设施患者安全流程再造. 中国医院管理, 2021, 41(11): 57-59.
34. 郭丽敏, 杨思源, 贾媛, 等. 术后跌倒恐惧对髋关节置换患者结局指标的影响. 长春中医药大学学报, 2020, 36(6): 1272-1274, 1278.
35. 徐程, 徐姝娟, 陈思仙, 等. 皖南地区三级甲等医院护士对患者安全态度现状及影响因素分析. 职业与健康, 2022, 38(4): 488-491, 496.

West China Medical Journal

Summary of best evidence for fall prevention after total hip arthroplasty in elderly patients

Abstract Full text Figures/Tables Video References Cited by

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