Symposium: Own the Fall: The Role of the Orthopaedic Surgeon in Falls and Fall Prevention
Paul A. Anderson, MD, FAOA
Jay S. Magaziner, PhD, MSHyg; Daniel A. Mendelson, MS, MD; Julie A. Switzer, MD, FAOA
Participants will learn the morbidity and mortality associated with falls in orthopaedics (including elective surgery) patients
Attendees will Introduce falls assessment into orthopaedic practice
Participants will be able to provide evidence-based care for patients at risk of falling
The goals of this critical issue symposium are to raise awareness among orthopaedic surgeons of the role they play in assessing the causes of falls. This is important not only at the time of injury but also as a component of preoperative optimization in elective surgery to improve outcomes and prevent complications. Falls and subsequent fractures are well known causes of morbidity and mortality.
An initial fall is a major predictor of a subsequent fall and additional fractures, but is rarely evaluated in orthopaedic practices. Secondary fracture prevention services focus on diagnostic and pharmaceutical interventions while rehabilitation is mainly directed at recovery from injury. Fall prevention, although a key quality parameter for the AOA’s Own the Bone program, is subject to significant variation and is delayed until after fracture healing has occurred.
Despite the relevance of falls to our patients’ health, orthopaedic educational curricula do not generally include information on this subject to train surgeons in assessing fall risk nor multidisciplinary options to prevent falls. The fact that falls occur commonly after elective orthopaedic surgery, such as joint replacement, is even less well-known, yet can be associated with complications such as loosening, periprosthetic fracture, and in the spine junctional segment fracture. Similar to the concept of preoperative medical optimization, assessment of fall risk could lead to preoperative and postoperative rehabilitation strategies to improve outcomes and avoid complications.