Recommendations for return to sports after total hip arthroplasty are becoming less restrictive as implants improve
- PDF / 894,750 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 27 Downloads / 180 Views
HIP ARTHROPLASTY
Recommendations for return to sports after total hip arthroplasty are becoming less restrictive as implants improve T. Vu‑Han1 · S. Hardt1 · R. Ascherl2 · C. Gwinner1 · C. Perka1 Received: 4 June 2020 / Accepted: 11 November 2020 © The Author(s) 2020
Abstract Introduction Total hip arthroplasty (THA) surgeries are expected to exponentially increase in the upcoming years, likely because of the overall broader indication of THAs. With these developments, an increasing number of younger ( 6 M’: 22 counts, ‘ > 3 M’: 72 counts, ‘not recommended’: 1 count, ‘undecided’: 1 count.
Fig. 8 Specific activity recommendations after THA, y-axis: numbers as absolute counts, x-axis: type of activity/sport (Ballroom was abbreviated for ballroom dancing). Recommendations ‘without limitations’ (dark grey), ‘with adequate training’ (medium grey), ‘not recommended’ (light grey), ‘undecided’ (lightest grey)
13
a
level biking were among the activities that the vast majority of surgeons recommended without limitations or training. Recommendations seemed to vary more for sports such as ballroom dancing, cross country biking, bowling, dancing, e-scooters, fitness/weights, golf, horseback riding, jogging, Pilates, cross country skiing, table tennis, and yoga where the sport was either recommended without limitations or with adequate training.
Discussion Our study results showed that preoperative physical activity of the patient was part of a standard patient interview for the majority of surgeons. Previous studies suggest that the level of preoperative physical activity of the patient correlates with patient expectations for post-operative RTS and return to physical activity (RPA) [26, 32, 35, 37]. Along with
b
Archives of Orthopaedic and Trauma Surgery
current trends toward younger and more active patient clientele receiving THA [43], managing and counseling patient expectations after THA may become an important task for surgeons and physicians, who will need to provide answers despite the lack of evidence in the literature [9]. Among the risks associated with RTS after hip replacement, wear-related implant failure only ranked third after periprosthetic fractures and hip dislocation among expert opinions. The shift away from the previous assumption that high-activity levels seen in younger, active patients would impact long-term wear-related implant survivorship [35] may reflect the improvement in implants. Early implants were accompanied by restrictive recommendations with regard to physical activity [10]. Polyethylene wear and implant abrasion are used to pose a viable risk for patients with hip or knee replacement. The risk of abrasion and implant loosening was especially true for the metal-on-metal (MoM) pairings [5, 20], which were associated with adverse local tissue reactions (ALTR) and aseptic lymphocytic vasculitis-associated lesions (ALVAL) [14]. More recent publications as well as our results suggest a growing trend toward liberal counseling of patients with regard to RTS after THA [7, 40, 44, 60].
Data Loading...
