The guidelines regarding resuming exercise and return to athletic endeavors after a joint replacement are evolving. Improved materials and design have led to increased flexibility in replaced knees. Material that allows decreased wear rates and improved technique has led to more stable and durable hip replacements. Current guidelines are based on consensus of surgeons’ opinion. The Mayo Clinic published a survey that has become such a guideline. Walking, cycling, and swimming are typically advised cardiovascular exercises, before and after hip and knee replacement. However, firm rules regarding athletic participation should be individualized. You can imagine someone who has participated in a sport since they were young, and has remained strong, may be able to resume playing, or may be able to modify the intensity, without endangering the successful joint replacement. Often patients can easily return to low impact sports such as golf, doubles tennis, yoga, hiking, weight lifting, dancing even ice skating or cross country skiing. Safe return to a specific sport and activities should be discussed with your surgeon before a joint replacement surgery so your expectations align.
Activity and sports participation after a joint replacement should be approached with consideration of that activities’ characteristics. The need for flexibility, the repetitive load, and potential for high impact will effect a total joint replacement. For instance, running for cardio fitness would be discouraged but short infrequent running such as in tennis or softball is often tolerated well. High impact sports with possible uncontrolled falls like football, soccer, rugby should be avoided. While playing hockey is discouraged, simple ice skating may be acceptable. The main risks include hip dislocation, loosening, wearing out of the surfaces, and fractures around the replaced joint. Another consideration in return to sports is your physical strength, coordination and skill level before the joint replacement.
In the early stages after a hip replacement or knee replacement, controlled specific exercise allows time for bone and wound healing, and the return of flexibility and muscle mass. After coordination and reflexes improve, a gradual return to activity and sport is advised. A study published in Journal of Bone and Joint Surgery showed that there are more than 7 million Americans are living with artificial knees and hips. This study indicates that the personal and societal benefits of knee and hip replacement are measurable and significant. Returning to an active, rewarding lifestyle is one of those benefits. Discuss your expectations of return to activity with your surgeon, and remember the stronger you are going into an operation the stronger you will be coming out of it.
