Objectives: (1) to evaluate the change in time of pain, stair climbing ability and fear of falling (FOF), (2) to determine the association between pain, stair climbing ability and FOF for patients with knee osteoarthritis (OA) following the knee replacement over the course of six months, (3) and to compare the results with healthy controls in terms of stair climbing ability and FOF.
Methods: Fifteen female healthy controls and 21 female consecutive subjects who were scheduled to undergo primary bilateral knee replacement for the treatment of knee OA were involved. Pain, stair climbing ability and FOF were assessed with a numerical pain rating scale, Going up and Down Scale (GUDS) and Tampa Scale for Kinesiophobia (TSK) at pre-surgery and discharge. After discharge, patients were asked to answer the outcome measures at 2, 4, 8, 12 and 26 week by phone.
Results: Patients had significantly improvement in the postoperative 26-week scores of pain (p< 0.001), stair ability (p< 0.001), and FOF (p=0.006) compared with the preoperative scores. There was also decreased pain at 4.week, improved stair ability at 8.week, and delayed improvement at FOF in patients. While patients had significantly worse stair ability than controls preoperatively (p< 0.001), the difference was not significant at postoperative 26-week (p=0.561). A positive significant correlation was found between the stair ability, FOF and pain scores (p< 0.001).
Conclusion: It would be reasonable to consider that FOF control is potentially useful for preventing severe functional limitation in stair climbing for subsequent knee OA before and early after the surgery.
Keywords: Total knee replacement; fear of falling; knee osteoarthritis; pain; stair ability.