Study finds nerve blocks after TKA, THA associated with falls

CHICAGO — Educating patients preoperatively about how to walk after total knee or hip arthroplasty can help reduce the number of falls that occur in patients who receive a nerve block postoperatively, according to a presenter here.

Brian A. Klatt, MD, and colleagues conducted a retrospective case-control study at a single institution during nearly 4 years and found that 131 falls occurred among more than 7,000 consecutive patients (1.85%). Nerve blocks were given to about 5,000 of the patients studied who underwent either total knee or hip arthroplasty. Based on the findings, nerve blocks proved to be an independent predictor of falls following total joint arthroplasty.

Brian A. Klatt

“Sixty-two percent of these [falls], as has been reported before, occurred while toileting” and more of them were in the patients who had total knee arthroplasty, Klatt said.

From the demographic analysis findings, “Age was a significant predictor for falls,” he added.

Patients who were older than 65 years had a greater likelihood of a fall, based on the study results.

About 87% percent of the falls led to no or minor injury, Klatt explained, but more than a dozen were serious, with some that resulted in a return to the operating room for the patient.

Klatt said this is an important area of patient safety that surgeons should focus on, he said. “Hospitals are all looking at this and it has become a national safety goal.”

Reference:

Klatt BA. Paper #98. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 19-23, 2013; Chicago.

Disclosure: Klatt has no relevant financial disclosures.