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RETURN TO SPORT FOLLOWING TOTAL HIP ARTHROPLASTY(THA): DO WE ALL AGREE?
  1. Y Kaplan
  1. Lerner Sports Center, Hebrew University, Jerusalem, Israel

Abstract

Background As younger,healthier patients are having THA, a greater emphasis is being placed on postoperative function, activity, and exercise. With recent advances in implant technology and surgical technique, the survival rates for modern prosthetic designs and patients with these high demands are promising. There is no current consensus on the safety of resuming to sport. The main concerns nevertheless are remaining instability, wear, loosening, and fracture.

Objective To provide a narrative literature review relating to returning to sporting activity following a THA.

Design An electronic search was conducted up to October 2013, using medical subject headings and free-text words. Subject-specific search was based on the terms “total hip arthroplasty”, “return to sport” and “exercise”.

Results 10 articles were found to be suitable. Only one was a prospective randomized study, comparing the type, intensity and frequency of sports activities performed after resurfacing hip arthroplasty vs. THA using a metal-on-metal bearing. All the rest were narrative reviews and expert opinion. One guideline consensus paper was published. Substantial limitations were observed in most of the publications, including small sample size, patient selection, trial quality, heterogeneity of outcome assessments, and potential sources of confounding variables not investigated.

Conclusion Each sport should be evaluated on its potential risk to a joint replacement, whether from the force of repetitive injury or the possibility of catastrophic failure. Likewise, a surgeon can use techniques, biomaterials, and implants that will maximize an athlete's chance of success over time. There is a need for a long-term, high-quality, prospective randomized control trial that will compare low vs. high impact sports and their effect on the prostheses. Until then, definitive recommendations should be made based on each patient's expectations, goals and the surgeon's past experience.

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