Hip and knee replacement and physical activity
What is hip and knee replacement?
The rate of hip and knee replacement surgeries is growing worldwide. In the Grand-Duchy of Luxembourg, 222 hip and 160 knee replacement surgeries per 100 000 persons were performed in 2011 . Hip and knee joint replacements are surgical interventions designed to replace all or part of the hip or knee joint with a prosthesis. The surgery aims to relieve the pain and dysfunction from the joint that limits the patient’s daily activities. Three profiles of patients are described: younger patients with joint disease as a result of traumatic injury or malformation, older patients with degenerative disease and rheumatoid patients with systemic disease . Joint replacement is recommended, if and when medications and other treatments such as physiotherapy or injections are no longer effective .
What are the effects of physical activity on hip and knee replacement?
Even if participation in sport remains difficult for a quarter of patients who have undergone a joint replacement , participation in leisure activities is important and lead to an improvement in overall health. Exercise can reverse the impairment related to physical inactivity secondary to joint disease, and result in improved cardiovascular fitness  and muscle strength . In addition, active patients exhibit reductions in both pain scores and body mass index, as well as an improvement in quality of life . In addition, physical activity may enhance the quality of the interface between bone and prosthesis by increasing bone quality and thereby improving fixation .
What are the risks?
Participation in vigorous and/or high-impact physical activity can lead to earlier and increased implant wear and failure. The large forces induced by some exercises may serve to loosen cemented components. In addition, it appears that parts made of conventional polyethylene are more at risk of failure in more active patients particularly. High-impact exercises like jogging, running, tennis, squash, snowboarding, martial arts, football, handball and basketball should be avoided [2, 4, 7].
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- Skoffer B, Dalgas U, Mechlenburg I. Progressive resistance training before and after total hip and knee arthroplasty: a systematic review. Clin Rehabil 2014. Available at: http://dx.doi.org/10.1177/0269215514537093.
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Authors & experts
Experts: Christian Nührenbörger3.
1 Luxembourg Institute of Health, Sports Medicine Research Laboratory, L-1460 Luxembourg, Luxembourg
2 Centre Hospitalier Universitaire Vaudois, Policlinique Médicale Universitaire, CH-1011 Lausanne, Switzerland
3 Centre Hospitalier de Luxembourg - Clinique d'Eich, Clinique du Sport, L-1460 Luxembourg, Luxembourg