Hip Arthroplasty with Increased Expectancy

Abstract

The patientʼs demands and expectations after total hip arthroplasty have increased significantly. In particular, the athletic function is the focus of the patientʼs interest, whereby not the basic sports ability is inquired, but also the achievable sports level. The benefits of increased activity with a reduction in cardiovascular mortality and the minimization of osteoporosis risk are contrasted by amplified wear followed by prosthesis loosening. Activities are categorized in low-, intermediate- and high-impact kind of sport. Patient-based influencing factors such as physical condition and expertise in his sport, as well as the self-reference of the surgeon to the desired sport influence the recommendation and advice of the patient. Innovations in prosthesis design and materials technology allow meeting patientʼs expectations and aiming to improve the return to sport. After total hip arthroplasty, the majority of preoperatively active patients return to athletic activity, although there is a tendency to shift from “high-impact” to “low-impact” sports. The currently recommended sports include swimming, cycling, Nordic walking, sailing, golf, hiking, dancing and cross-country skiing. A limited recommendation exists for tennis (single), alpine skiing, mountain hiking and sportive running. Not recommended are marathon, football, handball, volleyball, basketball, martial arts, high jump, water skiing and rock climbing. The recommendations are based primarily on expert opinions and are in a progressive extension including “high-impact” sports.

Key words

sports after hip arthroplasty - high impact - low impact - wear - joint load

Publication History

Article published online:
19 November 2019

• References/Literatur

• 1 Kuster MS. Exercise recommendations after total joint replacement: a review of the current literature and proposal of scientifically based guidelines. Sports Med 2002; 32: 433-445 doi:10.2165/00007256-200232070-00003
• 2 Schmalzried TP, Shepherd EF, Dorey FJ. et al. The John Charnley Award. Wear is a function of use, not time. Clin Orthop Relat Res 2000; (381) 36-46
• 3 McGrory BJ. Periprosthetic fracture of the femur after total hip arthroplasty occurring in winter activities: report of two cases. J Surg Orthop Adv 2004; 13: 119-123
• 4 [Anonymous] American College of Sports Medicine position stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc 1990; 22: 265-274
• 5 Garber CE, Blissmer B, Deschenes MR. et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359 doi:10.1249/MSS.0b013e318213fefb
• 6 Nocon M, Hiemann T, Müller-Riemenschneider F. et al. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2008; 15: 239-246 doi:10.1097/HJR.0b013e3282f55e09
• 7 Healy WL, Sharma S, Schwartz B. et al. Athletic activity after total joint arthroplasty. J Bone Joint Surg Am 2008; 90: 2245-2252 doi:10.2106/JBJS.H.00274
• 8 Egan E, Reilly T, Giacomoni M. et al. Bone mineral density among female sports participants. Bone 2006; 38: 227-233 doi:10.1016/j.bone.2005.08.024
• 9 Calbet JA, Moysi JS, Dorado C. et al. Bone mineral content and density in professional tennis players. Calcif Tissue Int 1998; 62: 491-496
• 10 Fisher J, Jin Z, Tipper J. et al. Tribology of alternative bearings. Clin Orthop Relat Res 2006; 453: 25-34 doi:10.1097/01.blo.0000238871.07604.49
• 11 Epinette JA, Manley MT. No differences found in bearing related hip survivorship at 10–12 years follow-up between patients with ceramic on highly cross-linked polyethylene bearings compared to patients with ceramic on ceramic bearings. J Arthroplasty 2014; 29: 1369-1372 doi:10.1016/j.arth.2014.02.025
• 12 Kim YH, Park JW, Kulkarni SS. et al. A randomised prospective evaluation of ceramic-on-ceramic and ceramic-on-highly cross-linked polyethylene bearings in the same patients with primary cementless total hip arthroplasty. Int Orthop 2013; 37: 2131-2137 doi:10.1007/s00264-013-2036-9
• 13 Krismer M. Sports activities after total hip arthroplasty. EFORT Open Rev 2017; 2: 189-194 doi:10.1302/2058-5241.2.160059
• 14 Bergmann G, Graichen F, Rohlmann A. Hip joint loading during walking and running, measured in two patients. J Biomech 1993; 26: 969-990
• 15 Andriacchi TP, Andersson GB, Fermier RW. et al. A study of lower-limb mechanics during stair-climbing. J Bone Joint Surg Am 1980; 62: 749-757
• 16 van den Bogert AJ, Read L, Nigg BM. An analysis of hip joint loading during walking, running, and skiing. Med Sci Sports Exerc 1999; 31: 131-142
• 17 Cleather DJ, Goodwin JE, Bull AMJ. Hip and knee joint loading during vertical jumping and push jerking. Clin Biomech (Bristol, Avon) 2013; 28: 98-103 doi:10.1016/j.clinbiomech.2012.10.006
• 18 Klein GR, Levine BR, Hozack WJ. et al. Return to athletic activity after total hip arthroplasty. Consensus guidelines based on a survey of the Hip Society and American Association of Hip and Knee Surgeons. J Arthroplasty 2007; 22: 171-175 doi:10.1016/j.arth.2006.09.001
• 19 Healy WL, Iorio R, Lemos MJ. Athletic activity after joint replacement. Am J Sports Med 2001; 29: 377-388 doi:10.1177/03635465010290032301
• 20 Swanson EA, Schmalzried TP, Dorey FJ. Activity recommendations after total hip and knee arthroplasty: a survey of the American Association for Hip and Knee Surgeons. J Arthroplasty 2009; 24(6 Suppl.): S120-S126 doi:10.1016/j.arth.2009.05.014
• 21 Oljaca A, Vidakovic I, Leithner A. et al. Current knowledge in orthopaedic surgery on recommending sport activities after total hip and knee replacement. Acta Orthop Belg 2018; 84: 415-422
• 22 Laursen MK, Andersen JB, Andersen MM. et al. Danish surgeons allow the most athletic activities after total hip and knee replacement. Eur J Orthop Surg Traumatol 2014; 24: 1571-1577 doi:10.1007/s00590-014-1442-z
• 23 Mont MA, LaPorte DM, Mullick T. et al. Tennis after total hip arthroplasty. Am J Sports Med 1999; 27: 60-64 doi:10.1177/03635465990270011801
• 24 Mont MA, Rajadhyaksha AD, Marxen JL. et al. Tennis after total knee arthroplasty. Am J Sports Med 2002; 30: 163-166 doi:10.1177/03635465020300020301
• 25 Mallon WJ, Callaghan JJ. Total hip arthroplasty in active golfers. J Arthroplasty 1992; 7 (Suppl.) S339-S346
• 26 Mallon WJ, Callaghan JJ. Total knee arthroplasty in active golfers. J Arthroplasty 1993; 8: 299-306
• 27 Papaliodis DN, Photopoulos CD, Mehran N. et al. Return to golfing activity after joint arthroplasty. Am J Sports Med 2017; 45: 243-249 doi:10.1177/0363546516641917
• 28 Porcari J, McCarron R, Kline G. et al. Is fast walking an adequate aerobic training stimulus for 30- to 69-year-old men and women?. Phys Sportsmed 1987; 15: 119-129 doi:10.1080/00913847.1987.11709285
• 29 Abe H, Sakai T, Nishii T. et al. Jogging after total hip arthroplasty. Am J Sports Med 2014; 42: 131-137 doi:10.1177/0363546513506866
• 30 Fouilleron N, Wavreille G, Endjah N. et al. Running activity after hip resurfacing arthroplasty: a prospective study. Am J Sports Med 2012; 40: 889-894 doi:10.1177/0363546511434564
• 31 Girard J, Lons A, Pommepuy T. et al. High-impact sport after hip resurfacing: the Ironman triathlon. Orthop Traumatol Surg Res 2017; 103: 675-678 doi:10.1016/j.otsr.2017.04.004
• 32 Dubs L, Gschwend N, Munzinger U. Sport after total hip arthroplasty. Arch Orthop Trauma Surg 1983; 101: 161-169
• 33 Schwameder H, Roithner R, Müller E. et al. Knee joint forces during downhill walking with hiking poles. J Sports Sci 1999; 17: 969-978 doi:10.1080/026404199365362
• 34 Singh R, Stringer H, Drew T. et al. Swimming breaststroke after total hip replacement; are we sending the correct message. J Arthritis 2015; 4: 147 doi:10.4172/2167-7921.1000147
• 35 Almeida GJ, Khoja SS, Piva SR. Physical activity after total joint arthroplasty: a narrative review. Open Access J Sports Med 2018; 9: 55-68 doi:10.2147/OAJSM.S124439
• 36 Banerjee M, Bouillon B, Banerjee C. et al. Sports activity after total hip resurfacing. Am J Sports Med 2010; 38: 1229-1236 doi:10.1177/0363546509357609
• 37 Ollivier M, Frey S, Parratte S. et al. Pre-operative function, motivation and duration of symptoms predict sporting participation after total hip replacement. Bone Joint J 2014; 96-B: 1041-1046 doi:10.1302/0301-620X.96B8.32813
• 38 Girard J, Miletic B, Deny A. et al. Can patients return to high-impact physical activities after hip resurfacing? A prospective study. Int Orthop 2013; 37: 1019-1024 doi:10.1007/s00264-013-1834-4
• 39 Bonnin MP, Rollier JC, Chatelet JC. et al. Can patients practice strenuous sports after uncemented ceramic-on-ceramic total hip arthroplasty?. Orthop J Sports Med 2018; 6: 2325967118763920 doi:10.1177/2325967118763920
• 40 Delasotta LA, Rangavajjula AV, Porat MD. et al. What are young patients doing after hip reconstruction?. J Arthroplasty 2012; 27: 1518-1525.e2 doi:10.1016/j.arth.2012.02.001
• 41 Hoorntje A, Janssen KY, Bolder SBT. et al. The effect of total hip arthroplasty on sports and work participation: a systematic review and meta-analysis. Sports Med 2018; 48: 1695-1726 doi:10.1007/s40279-018-0924-2