Alpine and cross-country skiing after total hip replacement: 2 cohorts of 50 patients each, one active, the other inactive in skiing, followed for 5-10 years

Gschwend, N; Frei, Thomas; Morscher, E; Nigg, Benno M.; Lœhr, J. F.

doi:10.1080/000164700317411825

Cited by 76 publications

(43 citation statements)

References 4 publications

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“…Unfortunately, there is a paucity of prospective studies [14,30] regarding risk factors associated with loosening thereby decreasing the strength of our conclusions. However, because our study evaluated prognostic factors, we believe that the use of retrospective studies is acceptable in performing our analysis and formulating our conclusions.…”

Section: Discussionmentioning

confidence: 94%

“…Of the studies that met our modified MINORS criteria, 21 contained the raw data that allowed us to calculate a weighted OR of aseptic loosening after total joint arthroplasty. For THA, the OR of four separate host factors, which included male sex (three studies on 40,615 hips) [4,16,37], high activity level (University of California Los Angeles [UCLA] activity score C 8 points) (three studies on 178 hips) [14,30,42], tobacco use (three studies in 2040 hips) [20,21,35], and obesity (seven studies in 2946 hips) [2,15,28,31,34,37,51] were calculated (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

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What Host Factors Affect Aseptic Loosening After THA and TKA?

Cherian

Jauregui

Banerjee

et al. 2015

Clinical Orthopaedics &Amp; Related Research

155

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Background Aseptic loosening is the most common cause for revisions after lower-extremity total joint arthroplasties, however studies differ regarding the degree to which host factors influence loosening. Questions/purpose We performed a systematic review to determine which host factors play a role in the development of clinical and/or radiographic failure from aseptic loosening after (1) THA and (2) TKA. Methods Two searches on THA and TKA, respectively, using four electronic databases (EMBASE, CINAHL Plus, PubMed, and Scopus) were conducted. We identified a total of 209 reports that encompassed nine potential host factors affecting aseptic loosening. Inclusion criteria for consideration of scientific clinical reports were that 20 or more patients were involved, with more than 1-year followup, with at least three studies pertaining to each factor, and at least six of the Methodological Index for Non-randomized Studies criteria met, and with raw data for odds ratio (OR) calculations. Twenty-one studies (16 THA studies with 45,779 hips and five TKA studies with 288 knees, respectively) were used to calculate weighted OR and CIs (using the random effects theory) and study heterogeneity for four different host factors in THAs (male sex, high activity level, obesity defined as BMI C 30 kg/m 2 , and current or former tobacco use) and one factor in TKA (BMI C 30 kg/m 2 ), which were placed in a forest plot. Results For THA, male sex (OR, 1.39; 95% CI, 1.22-1.58; p = 0.001) and high activity level (University of California Los Angeles [UCLA] activity score C 8 points; OR, 4.24; 95% CI, 2.46-7.31; p = 0.001) were associated with aseptic loosening. However, obesity (OR, 1.01; 95% CI, 0.73-1.40; p = 0.96), and tobacco use (OR, 1.96; 95% CI, 0.43-8.97; p = 0.39) were not associated with an increased risk of aseptic loosening after THA with the numbers available. For TKA, we found no host factors associated with loosening. In particular, obesity (BMI C 30 kg/m 2

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Section: Discussionmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

What Host Factors Affect Aseptic Loosening After THA and TKA?

Cherian

Jauregui

Banerjee

et al. 2015

Clinical Orthopaedics &Amp; Related Research

155

View full text Add to dashboard Cite

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“…Dubs et al reported higher failure rate in inactive patients in comparison to active patients after total hip arthroplasty (THA) [8]. At five years of follow-up Gschwend et al found that winter sports (alpine and cross country skiing) did not increase the risk of loosening after THA compared to the inactive group of patients [15]. Kilgus et al observed higher loosening rates after THA in patients who regularly participated in sports activities compared to more inactive patients [20].…”

Section: Discussionmentioning

confidence: 96%

“…On the other hand, the possible influence of sport on the rate of implant loosening and failure after first MTP arthroplasty should be evaluated in long-term follow-up studies. Previous research has been controversial concerning the effect of sports activities on the survival rate in more or less active patients after joint arthroplasty [8,15,20,31]. Dubs et al reported higher failure rate in inactive patients in comparison to active patients after total hip arthroplasty (THA) [8].…”

Section: Discussionmentioning

confidence: 99%

Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study

Daniilidis

Martinelli

Marinozzi

et al. 2010

International Orthopaedics (SICOT)

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First metatarsophalangeal joint replacement is an alternative surgical procedure to arthrodesis in the treatment of moderate-to-severe hallux rigidus. However, few studies have been published about functional outcome after joint reconstructive procedures for hallux rigidus. The purpose of this study was to assess clinical, radiological and functional outcome, with special regard to recreational and sports activity, after first metatarsophalangeal joint replacement in patients affected by hallux rigidus grade III. Twenty-three patients who had undergone total joint replacement of the first metatarsophalangeal joint were examined preoperatively and three, six, 12 and 18 months postoperatively. All patients (mean age of 57.0±3.7 years) received a non-cemented TOEFIT-PLUS™ implant by one surgeon. Clinical scores (AOFAS score and VAS), radiological examination, patient satisfaction and sport participation were used to evaluate treatment outcome and radiolucent lines. The mean AOFAS score showed a significant improvement from 44.6±7.2 points preoperatively to an average of 82.5±14.4 points at last follow-up (p<0.001). The mean total ROM of the first MTP joint increased from 28.1±4.9 degrees preoperatively to 52.7±15.7 degrees postoperatively (p<0.001). After surgery, 91.3% of the patients were able to resume at least one recreational activity. Total arthroplasty for the treatment of hallux rigidus in an active patient population revealed good clinical and functional results. However, postoperative recreational sport activity showed a decrease in comparison to the pre-arthritic state. Further follow-up is necessary to quantify loosening risk in active patients after total hallux arthroplasty.

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“…The resumption timeframe in the series studied by Banerjee et al [3] was less than three months for 90 % of patients. As noted in other recent series [18,26], we have not determined whether age has a negative influence on number of activities and time spent participating in them. It seems, however, that with age, patients stabilise the amount of time devoted to physical activities by selecting and reducing the number of sports they participate in.…”

Section: Discussionmentioning

confidence: 99%

Can patients return to high-impact physical activities after hip resurfacing? A prospective study

Girard

Miletic

Deny

et al. 2013

International Orthopaedics (SICOT)

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Purpose Although the resumption of low-impact sports activities is compatible with total hip arthroplasty (THA), participation in high-impact sports seems problematic, and there is no consensus as to whether it is advisable. The purpose of this article is to evaluate the quality and possibility of resuming high-impact physical activities after hip resurfacing. Materials The study was performed in an on-going, singlesurgeon, prospective series of 215 resurfacing arthroplasties (RSA). Mean follow-up was 44.1 months (range, 39.1-54.5). Clinical evaluation included the Postel-Merle d'Aubigné (PMA) score, the Oxford hip score, the Harris hip score (HHS), Devane score, and UCLA activity score. A specific questionnaire analysing sports activities was administered to each patient to assess the number and level of physical activities performed (both before the operation and at final follow-up). Results In the series of 202 consecutive patients (215 RSA), 50 patients (55 RSA) engaged regularly in at least one highimpact activity before their operation and the onset of pain, 102 patients practised at least one intermediate-impact activity, and the 50 remaining patients undertook only low-impact activities. Harris hip score increased from 44.8 (range, 23-68) before the operation to 97.8 (range, 85-100) at the last followup. Mean time to sports resumption after surgery was 14.6 weeks (range, 7-29). The resumption rate was 98 % for sports of any impact level and 82 % for high-impact activities. No osteolysis or implant loosening was observed at follow-up. No revision was performed. Conclusion In 2012, no consensus recommendations yet exist for the resumption of sports activities after RSA. Existing recommendations concern only conventional THA. We believe that RSA allows younger and more active patients to resume physical and sports activities without restriction. The rate of return to sports after RSA appears to be excellent and unequalled by conventional hip prostheses. High-impact sports seem to be compatible with hip resurfacing, although no longterm studies have analysed the impact of these activities on wear and/or aseptic loosening.

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Alpine and cross-country skiing after total hip replacement: 2 cohorts of 50 patients each, one active, the other inactive in skiing, followed for 5-10 years

Cited by 76 publications

References 4 publications

What Host Factors Affect Aseptic Loosening After THA and TKA?

What Host Factors Affect Aseptic Loosening After THA and TKA?

Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study

Can patients return to high-impact physical activities after hip resurfacing? A prospective study

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