Are Activity Restrictions Necessary After Total Hip Arthroplasty: A Systematic Review

Sagar Telang, BS; Amir Human Hoveidaei, MD, MSc; Cory K. Mayfield, MD; Jay R. Lieberman, MD; Michael A. Mont, MD; Nathanael D. Heckmann, MD

Arthroplasty Today (Dec 2024)

Are Activity Restrictions Necessary After Total Hip Arthroplasty: A Systematic Review

Sagar Telang, BS,
Amir Human Hoveidaei, MD, MSc,
Cory K. Mayfield, MD,
Jay R. Lieberman, MD,
Michael A. Mont, MD,
Nathanael D. Heckmann, MD

Affiliations

Sagar Telang, BS: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Amir Human Hoveidaei, MD, MSc: International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA
Cory K. Mayfield, MD: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Jay R. Lieberman, MD: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Michael A. Mont, MD: The Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, USA
Nathanael D. Heckmann, MD: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; Corresponding author. Department of Orthopaedic Surgery, Keck Medical Center of USC, 1520 San Pablo Street, Ste 2000, Los Angeles, CA 90333, USA. Tel.: +1 323 704 6363.

Journal volume & issue: Vol. 30
p. 101576

Abstract

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Background: There remains a lack of universal guidelines regarding the appropriate level of postoperative activity restrictions following total hip arthroplasty (THA). This systematic review aims to assess whether the liberalization of postoperative activity restrictions following THA impacts implant survivorship, return to sport, patient satisfaction, and functional health outcomes. Methods: A comprehensive search strategy was completed across PubMed, Scopus, and Web of Science databases using targeted keywords from January 1, 2010, to November 22, 2023. Inclusion criteria included randomized clinical trials, case-control, and cohort studies written in English. Data extraction focused on activity levels, rehabilitation protocols, implant survivorship, and physical and psychological outcomes. The primary search yielded 7420 articles, with 28 studies included after screening. Results: Return to sports outcomes demonstrated notable variability (20%-98.5%). Most studies reported improved survivorship in high-activity patients. High-activity participants had all-cause revision rates of 0.9%-8.57% and aseptic revision rates of 0.4%-5.7%. Low-activity participants had all-cause revision rates of 0.7%-3.4% and aseptic revision rates of 0.0%-2.1%. There was no clear association between activity level and dislocation rates. Positive associations between post-THA activities and improved mental health and patient satisfaction were observed. Conclusions: The current arthroplasty literature demonstrates that patients engaging in high-activity levels after THA exhibit similar or improved implant survivorship rates compared to patients participating in low-activity levels. However, high-quality prospective studies are needed to provide evidence-based guidelines. Patients should be encouraged to partake in activities at their own comfort levels with an understanding of their own limitations and risks.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

About the journal

Abstract

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