Treatments that stabilise the knee in older adults my reduce the risk of falls

Symptoms of knee instability in older people may indicated an increased risk of falling, according to new research. Knee buckling, is often described by people as a knee “giving way”. It is a symptom on knee instability that frequently effects older people, particular those with knee pain and knee osteoarthritis, and falls can lead to a number of physical and psychological effects in the person who has had the fall.

The study, which is published in Arthritis Care & Research, was carried out by Dr Michael Nevitt and his team at the University of California, San Francisco. He and his colleagues studied 1,842 participants in the Multicenter Osteoarthritis Study (MOST) who had an average age of 67 at the start of the study and who had, or were at high risk for, knee osteoarthritis.

After the end of five years, 16.8% of participants reported knee buckling, and at the end of seven years. 14.1% had had recurrent falls. Those who knees had buckled at five years had a 1.6 – 2.5-times higher likelihood of recurrent falls, fear of falling, and poor balance confidence at seven years.

Those who fell when a knee buckled at the start of the study had a 4.5-times, 2-times, and 3-times higher likelihood 2 years later of recurrent falls, significant fall injuries, and fall injuries that limited activity, respectively, and they were 4-times more likely to have poor balance.

Finding new treatments for knee instability may reduce the risk of falls in older adults and should be an important priority for the clinical care of ageing patients, say researchers.

“Falls, injury from falls and poor balance confidence are extremely common and debilitating problems in older people. 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,” says Dr. Nevitt.

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

He added that pain is 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 concluded.

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