AB0590 ARTHRITIS OF THE KNEE AND BALANCE DISORDER
Authors: W. Belhaj, S. Miladi, A. Fazaa, M. Sellami, K. Ouenniche, L. Souebni, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2021)

Background: Knee osteoarthritis has been identified as a risk factor for falls and balance disorders. Several clinical scales have been put in place to assess this risk. Objectives: The aim of this work was to assess the risk of falls in patients followed for osteoarthritis of the knee. Methods: A prospective study was conducted over a period of 4 weeks. Sixty-six patients followed for knee osteoarthritis at different stages of the disease were included into this work. Epidemiological data, physical examination data and x-ray data were collected. The impact of knee osteoarthritis was evaluated by the Lequesne and WOMAC indices. The patients were asked about the history of a fall since the onset of knee osteoarthritis and they had the Tinetti test where a score less than 20 reflects a very high risk of falling, from 20 to 23 significant risk, from 24 to 27 moderate risk and 28 means a normal test. Results: In the studied population, the majority of patients were women (87%) with an average age of 55 years and an average body mass index of 29kg /m2. The most common comorbidities were high blood pressure (61%), diabetes (38%) and osteoporosis (36%). Sixty-nine percent of patients took more than two oral treatments. The average duration of development of osteoarthritis of the knee was 9 years. The most common radiological stage was stage 1 (58%) followed by stage 2 (31%). The site was femorotibial in 88% of cases, patellofemoral in 4% of cases and bi or tri compartmental in 8% of cases. The arthritis most often affected both knees: 86% of cases. The average of the Lequesne index was 11. The mean WOMAC index was 12 in pain, 1.5 in stiffness and 48 in dysfunction. Patients who had a normal Tinetti score represented 39% of the studied population, those who had a score from 24 to 27 were 35% of the studied population, those who had a score between 20 and 23 were 14% of the studied population, and those who had a score below 20 were 12% of the studied population. Patients reporting a history of one or multiple falls were 19%. Among these patients 93% were women and 88% were hypertensive under antihypertensive treatment. The average age of these patients was 61 years. The Tinetti test revealed in this group of patients that 40% had a very high risk of falling, 48% had a high risk of falling, 10% had a moderate risk and 2% had a normal Tinetti test. These patients had been followed for knee osteoarthritis for an average of 10 years. The average Lequesne index was 12.5. The average WOMAC index was 12 for pain, 2 for stiffness and 55 for dysfunction. In the following Table 1 we summarized the different stages of risk of falling according to the Tinetti score according to the epidemiological data and the characteristics of knee osteoarthritis: Tinetti score Less than 20 From 20 to 23 From 24 to 27 Equal to 28 Average age (years) 66 65 56 47 Women (%) 78 81 88 89 Men (%) 22 19 12 11 Average BMI (kg/m 2 ) 31,7 30,4 29,3 28,6 High blood pressure (%) 77 60 67 57 Average Lesquene 12,5 11 11 10,5 WOMAC pain 14 12 12 10 WOMAC stiffness 2 1,5 1 1 WOMAC dysfunction 58 49 46 44 Conclusion: The epidemiological characteristics as well as the knee osteoarthritis characteristics are statistically close in the different groups of stages of risk of fall according to Tinetti test. Indeed, according to this study, knee osteoarthritis does not represent a significant risk factor for falls. References: [1]Mat S, Tan MP, Kamaruzzaman SB, Ng CT. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review. Age Ageing. 2015 Jan;44(1):16-24. doi: 10.1093/ageing/afu112. Epub 2014 Aug 22. PMID: 25149678. [2]Köpke S, Meyer G. The Tinetti test: Babylon in geriatric assessment. Z Gerontol Geriatr. 2006 Aug;39(4):288-91. doi: 10.1007/s00391-006-0398-y. PMID: 16900448. Disclosure of Interests: None declared.