Many of my patients enjoy playing a variety of sports. Often symptoms of hip and knee arthritis are exacerbated by these activities, and the pain and joint dysfunction experienced during sports are common reasons for patients to come see me for an evaluation of their hips and knees. When there is significant arthritis in a knee, partial knee replacement and total knee replacement are potential treatment options. For severe hip arthritis, total hip replacement and hip resurfacing are excellent options to get patients back to the activities and sports they most enjoy.

Patients who participate in regular athletic activities prior to joint replacement have an expectation to return to sports after their joint replacement. However, there is little evidence in the published literature to guide patient expectations in terms of returning to regular athletic activity after total joint replacement, but I’ve summarized what we do know here along with my experience.

What is the likelihood that I will return to sports after total joint replacement?

This number varies in the literature from 54% to 98%. Positive predictors for return to athletics are: male gender, low body mass index (i.e., non-obese), young age, participation in sports prior to joint replacement, and absence of pain in other joints.

Total hip replacement and hip resurfacing are both reliable options for returning patients to their pre-surgical level of sport. Hip patients are probably more likely to return to higher-level athletics than knee patients. For knee surgery patients, partial knee patients are probably more likely to return to sports than total knee patients. For total knee replacement patients, satisfaction with activities requiring kneeling, cutting, twisting and pivoting is lower than for partial knee patients.

Ultimately, confidence in your joint replacement and successful physical rehabilitation after joint replacement will improve your odds of returning to sports.

Will sports participation compromise my joint replacement outcome and survival?

No studies have examined this particular question explicitly. Theoretically, implant bearing surface wear is increased with increasing cycles (i.e., steps or revolutions) and increasing load. However, in controlled studies, no differences in complications or implant survivorship were observed in active patients versus less-active patients.

In general, I don’t encourage high-impact activities, such as running, after joint replacement, but patients frequently set their own limitations after joint replacement. Certainly, any higher-impact activities should be delayed until 6 months after surgery. Contact sports and sports that increase your risk of falling may increase the risk for sustaining a fracture around your hip or knee replacement, which may require a revision or “redo” surgery.

What activities do you recommend after joint replacement?

A primary goal for joint replacement is to allow you to enjoy your life and forget that you had a joint replacement surgery. Following recovery from surgery you will be able to return to an active lifestyle. I generally recommended these sports following joint replacement surgeries:

• Swimming
• Golf
• Cycling
• Rowing
• Doubles Tennis

These sports are low impact on your new joint replacement, and also present little risk of falling, an important consideration following joint replacement.

Yoga, pilates, elliptical trainers, and weight-training are all acceptable forms of exercise after joint replacement.