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What Do the Experts Say About Athletic Activity After Joint Replacement?
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Posted on: 11/30/1999
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Twenty-five per cent of the American population are Baby Boomers. This means they were born between 1946 and 1964. They are active. They are unwilling to experience pain or disability. They are involved consumers interested in making their own choices. And they want total joint replacements sooner than later.
Many older adults expect to remain engaged in their favorite activities and sports -- even after getting a hip or knee replacement. They want little or no pain or discomfort with the surgery and recovery process. They want the new joint to last a long time no matter what kind of abuse they dish out. And they don't want to be told they can't do what they want to, when they want to do it.
How realistic are all these expectations? Can seniors getting new joints throw caution to the wind and continue running marathons, engaging in daily activities, or participating in regular sports of their choosing?
In this review of athletic activity after joint replacement, the authors try to give patients and surgeons an idea what the experts are saying about safe and appropriate athletic activity after total joint replacement. They base their comments on information taken from several studies published on athletic activity after hip and knee replacements. They also used surveys of surgeons collected by the Hip and Knee Society.
In general, it looks like there is agreement that patients with total joint replacements CAN participate in demanding sports. Some of the high-demand sports patients were involved in included tennis, jogging, downhill skiing, racquetball or squash, and basketball. But it's not clear whether or not it is wise to do so. Most surgeons advise avoiding these activities because of the high-impact loading and twisting motions required.
In some cases, patients' preoperative expectations exceed their actual postoperative actions. Fear of damaging the implant, pain in other parts of the body, and pain at the site of surgery are mentioned as reasons why people don't pursue their athletic goals. One study from UCLA showed that only about 11 per cent of the patients were engaged in strenuous work or sports after knee replacements.
The rate of return to sports activity is much higher with hip joint resurfacing. Hip resurfacing is a type of hip replacement that replaces the arthritic surface of the joint but removes far less bone than the traditional total hip replacement. The design features of the hip resurfacing may make it possible to be more active. At the present time, there aren't enough studies to support safe return to high-demand sports activity after hip resurfacing.
Results of the Hip and Knee Society survey break down activities according to whether they are allowed by surgeons, allowed with experience, or not recommended. A separate category exists for activities for which there is no consensus (general agreement). Although this information is considered expert opinion, the authors point out it is not necessarily backed by evidence from published studies.
Experts advise surgeons to educate their patients about the risks of sports activities. Specific risks associated with particular sports should be discussed at length. Patients are encouraged to have fun but keep in mind the need to prevent injury and protect their new joints. Training is especially important. A rehab program under the direction of a physical therapist should include: back, hip, and knee rehab; core strength training; stretching and flexibility; and muscle strengthening.
The trend toward increased activity in the golden years (age 65 and older) may result in changes in joint implants and surgical techniques to meet all the Baby Boomers' expectations. For now, there is concern about how long the available implants will last -- especially when exposed to increased load and bearing surface wear from high levels of activity.
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References:
William L. Healy, MD, et al. Current Concepts Review. Athletic Activity After Total Joint Arthroplasty. In The Journal of Bone & Joint Surgery. October 2008. Vol. 90-A. No. 10. Pp. 2245-2252.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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