SUMMARIES FOR PATIENTS
Knee Buckling in Older Adults
16 October 2007 | Volume 147 Issue 8 | Page I-41
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The summary below is from the full report titled "Knee Buckling: Prevalence, Risk Factors, and Associated Limitations in Function." It is in the 16 October 2007 issue of Annals of Internal Medicine (volume 147, pages 534-540). The authors are D.T. Felson, J. Niu, C. McClennan, B. Sack, P. Aliabadi, D.J. Hunter, A. Guermazi, and M. Englund.
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What is the problem and what is known about it so far?
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Knee buckling is a sudden "giving way" of the knee. It may happen when weight-bearing demands are increased, such as when one goes up or down stairs. Buckling commonly occurs in persons with severe knee arthritis and after knee-related surgical procedures. Some experts think that buckling is also common among adults without these problems, but few studies have examined its frequency or consequences in a general community population.
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Why did the researchers do this particular study?
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To assess the frequency of knee buckling among adults, and to identify factors and outcomes associated with buckling.
2351 community-dwelling adults who were middle-age or older. Their median age was 64 years.
The researchers recruited adults 36 to 94 years of age who had participated in 2 other population-based studies conducted in Framingham, Massachusetts. None had rheumatoid arthritis or a history of bilateral knee replacement surgery. Researchers asked the adults questions about knee buckling in the past 3 months; knee pain and stiffness in the past month; and physical function activities related to lower limbs, such as climbing stairs. They measured the strength of thigh muscles (quadriceps). They also took knee x-rays to check for osteoarthritis and sometimes did magnetic resonance imaging (MRI). They then analyzed data to explore factors that might be associated with buckling.
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What did the researchers find?
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The researchers found that 278 (12%) adults reported at least 1 episode of buckling in the past 3 months. Of these, 13% fell during the episode. The frequency of buckling was similar both among men and women and among middle-age and older persons. Most persons were walking or climbing stairs when their knees buckled. Most people (217 people) reported more than 1 episode of buckling. Knee pain, quadriceps weakness, radiographic osteoarthritis, and limitations of physical function were more common among patients with buckling than among those who reported no buckling.
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What were the limitations of the study?
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Patient recall of buckling may not have been accurate. Causes of buckling were not established.
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What are the implications of the study?
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Knee buckling seems to be common among middle-age and older adults. It may cause falls and may be associated with functional limitations, such as limited ability to climb stairs.
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