Sports Activity and Hip, Knee, Shoulder and Intervertebral Disc Arthroplasties

Abstract

The success of joint replacement surgery has been responsible for raising patients' expectations regarding the procedure. Many of these procedures are currently designed not only to relive the pain caused by arthrosis, but also to enable patients to achieve functional recovery and to engage in some degree of physical activity and sports. However, as physical exercise causes an increase in forces exercised through the articular prosthesis, it can be an important risk factor for its early failure. Scientific literature on sports after arthroplasty is limited to small-scale retrospective studies with short-term follow-up, which are mostly insufficient to evaluate articular prosthesis durability. This article presents a review of the literature on sports in the context of hip, knee, shoulder and intervertebral disc arthroplasty, and puts forward general recommendations based on the current scientific evidence. Systematic Review, Level of Evidence III.

Recommendations for Sport and Physical Activity after total Hip and Knee Arthroplasty: A Systematic Review

“…This could have been correlated to the higher level of physical activity of the younger patients. (1) During physical activity, the increased force exerted through the prosthesis can represent an important risk factor for early failure, as it determines a high stress and wear between prosthetic components and also at the interface with the bone, inducing early loosening and implant instability. Beside material properties of the prosthetic components, the load force exerted on the implant is very important, as it can increase exponentially the amount of wear.…”

“…The joint replacement surgery has received recognition as a very successful intervention and is indicated in advanced stages of hip and knee osteoarthritis, in order to offer pain relief, to correct deformities, to re-establish the function and finally to improve the quality of life of these patients. (1,2) Usually, these are older sedentary adults, with comorbidities such as overweight or obesity, high blood pressure or diabetes. In these cases, regular physical activity could have a beneficial effect on the general health and therefore total joint arthroplasty (TJA) could contribute to this outcome, as it facilitates not only the relief of pain, but also an increased sport activity.…”

Cervical and Lumbar Disk Replacement in Athletes: Is It Safe to Return to Play? A Systematic Review of the Scientific Literature and Lay Press

“…8 However, studies, to date, are limited to the general population, and literature on return to play (RTP) after TDR in athletes remains sparse. 11,12…”

“…Among the few studies that have investigated outcomes after TDRs in athletes, the overall level of evidence is low. 11-15 Current studies include mostly case reports 13 and reviews, 11 with some studies focusing exclusively on TDRs, 15 whereas others have included a mixed cohort of TDRs and fusions. 14 The heterogeneous nature of these studies calls for an effort to systematically organize RTP data in athletes undergoing TDRs.…”