ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Multivariate Analysis of Newly Diagnosed Hip, Knee, and Combined Hip and Knee Osteoarthritis and Recurrent Fall Risk: Data from the Osteoarthritis Initiative
Reza Sorbi 1,2
Ghaith Al Tawil 2
Simone Gantz 2
Baraa Khamees 1
Maciej Simon 1
Babak Moradi 1,2
Hadrian Platzer 1,2
1. Universitatsklinikum Schleswig-Holstein Klinik fur Orthopadie und Unfallchirurgie - Campus Kiel, Kiel, Germany
2. Orthopedic Research Center, Christian-Albrechts-Universitat zu Kiel, Kiel, Germany
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Abstract
Background: Osteoarthritis (OA), the most prevalent joint disease, is associated with impaired mobility and may contribute to fall risk in older adults. Recurrent falls (≥ 2 falls/year) are of particular concern due to their impact on morbidity and independence. This study is the first to examine whether individuals with early hip and/or knee OA are at increased risk of recurrent falls within 12 months of diagnosis and to identify biopsychosocial factors associated with fall risk. Methods: Data were derived from the Osteoarthritis Initiative (OAI), a retrospective cohort of 4,427 participants stratified into four groups: individuals without OA, with knee OA, with hip OA, and with combined hip and knee OA. Self-reported recurrent falls within 12 months post-diagnosis were analyzed. Correlation and multivariable logistic regression analyses were conducted to identify predictive factors and interactions. Results: The presence of OA alone was not independently associated with recurrent falls in short term. However, multivariable logistic regression identified several factors associated with recurrent falls. There was a trend toward increased odds among participants with hip OA (OR = 2.35, p = 0.062). Individuals under 65 years had lower odds of recurrent falls compared to older adults (OR = 0.752, p = 0.034), and better physical function was protective (SF-12: OR = 0.980, p = 0.005). Depressive symptoms were associated with increased odds (CES-D: OR = 1.024 per point, p = 0.005). Interaction analysis showed that depression particularly increased recurrent falls risk in those with knee OA (OR = 1.036, p = 0.034), while younger age was protective among individuals with hip OA (OR = 0.230, p = 0.036). Conclusions: While Osteoarthritis itself does not directly predict recurrent falls in short term, its risk in individuals with OA is shaped by a multifactorial interplay of age, marital status, ethnicity, physical functioning, and depressive symptoms, with specific interactions involving OA location. Therefore, a differentiated assessment and multidisciplinary approach addressing these factors are essential to reduce recurrent falls in this population.
Summary
Keywords
Aging, Depression, falls, Osteoarthritis, physical function, risk factor
Received
22 September 2025
Accepted
17 February 2026
Copyright
© 2026 Sorbi, Al Tawil, Gantz, Khamees, Simon, Moradi and Platzer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Hadrian Platzer
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