February 12, 2020

Sports Activity After Total Joint Replacement

Total joint replacement surgery relieves pain and improves function for many patients suffering from painful arthritis, enabling them to lead a more active life. So what sports activities are safe and appropriate for patients who are looking to become active again after total joint replacement? What are the risks of returning to athletic activities? Are any activities discouraged or even dangerous?

Sports activities are very important to our patients’ health and lifestyle. Regular exercise has beneficial effects for many medical conditions including obesity, heart and lung diseases, diabetes, hypertension, etc. This is why we encourage our patients to resume athletic activities that are important to them. However, our patients must understand that there are risks with sports activity after joint replacement surgery. Such risks would include increase in joint bearing surface wear, dislocation, periprosthetic fracture, implant loosening, and very rarely implant breakage. Increase in joint bearing surface wear will shorten the survivorship of a total joint, which may lead to earlier than expected revision surgery. Awkward or forceful movement may also dislocate total hip and knee replacements. Patients with osteoporosis may sustain fracture of a bone around the implant, which is more challenging to treat than a bone fracture without implants. Repeat micro-traumas or strain from sports may loosen or even cause breakage of an implant.

Despite these risks, complications are usually rare, and active life is still encouraged. There are many safe sports activities that are appropriate for patients with total joint replacement. Most surgeons will encourage low-impact exercises that involve constant motion against resistance rather than sudden jerky movements. Low-impact activity does not always mean low demand. For example, cycling and swimming can be very high demand exercises that are considered non- impact loading in nature. Other recommended athletic activities include golfing, dancing, walking, low-impact aerobics, bowling, cross-country skiing, social tennis, etc. High-impact loading sports are discouraged. High impact activities include jogging, soccer, down-hill skiing, baseball, basketball, football, volleyball, gymnastics, and martial arts. The majority of discouraged activities are fairly obvious to most elderly, but not so obvious to some of our younger patients. Most importantly, athletic activity restrictions are also commonly individualized depending on the patient’s age, previous level of activity, stability of the joint, and implant type as well as fixation method. Please ask your surgeon for specific restrictions before returning to or starting an activity after your surgery.