The Relationship of Sporting Activity and Implant Survivorship After Hip Resurfacing
ABSTRACT The effect of sports on the durability of the prosthesis after hip resurfacing has not been studied, to our knowledge. The purpose of this study was to correlate sporting activity levels calculated as Impact and Cycle Scores with the survivorship of the hip resurfacing implants.
Four hundred and forty-five patients were surveyed from one to five years after surgery. The mean age of the patients was 48.7 years, and 74% were men. The Impact and Cycle Score included two scores: an Impact Score and a Hip Cycle Score. All patients were also evaluated with the University of California at Los Angeles activity score. Twenty-three patients (twenty-seven hips) underwent revision surgery after they had completed the survey.
The mean duration of follow-up at the time of survey data collection was 1.9 years (range, 1.0 to 4.9 years), and the mean follow-up period was 10.2 years (range, 6.1 to 13.7 years). The mean Impact Score was 28.1 (range, 0 to 128), and the mean Hip Cycle Score was 33 (range, 0 to 144). Positive correlations were found between the University of California Los Angeles activity score and the Impact Score (r = 0.535) or Hip Cycle Score (r = 0.497). After adjustment for femoral component size, body mass index, and femoral defect size, a 10-point increment in Impact Score corresponded to a 37% increase (hazard ratio, 1.37; 95% confidence interval, 1.18 to 1.59) in the risk of revision arthroplasty, while a 10-point increment in the Hip Cycle Score increased the risk of revision by 22% (hazard ratio, 1.22; 95% confidence interval, 1.06 to 1.41).Patients with an Impact Score of < 50 had a risk of revision 3.8 times lower (hazard ratio, 3.8; 95% confidence interval, 1.6 to 8.9) than that of the patients with an Impact Score of ≥ 50, with a survivorship rate at eight years of 96.4% (95% confidence interval, 93.6% to 98.0%) compared with 88.8% (95% confidence interval, 74.7% to 95.3%). We found no association between the University of California at Los Angeles activity score and the survivorship of the implants.
High levels of sporting activities can be detrimental to the long-term success of hip resurfacing devices, independently from other risk factors. Patients seeking hip resurfacing are usually young and should limit their involvement in sports to levels that the implant construct will be able to tolerate.
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ABSTRACT: In this systematic review, our aim was to explore whether or not patients are able to return to athletic activity following lower limb joint replacement. We also investigated any evidence as to whether participation in athletic activity post-joint replacement increases complications and reduces implant survival. A PubMed, Embase and Sports Discus search was performed using the MeSH terms 'Sport', 'Athletic', 'Athlete', 'Physical', 'Activity', 'Arthroplasty', 'Total Hip Replacement', 'Hip Resurfacing', 'Total Knee Replacement', 'Unicompartmental Knee Replacement' and 'Unicondylar Knee Replacement'. From this search, duplications were excluded, the remaining abstracts were reviewed and any unrelated to the search terms were excluded. The remaining abstracts had their full papers reviewed. Following joint replacement, participation in sporting activity is common principally determined by pre-operative patient activity levels, BMI and patient age. The type of joint replaced is of less significance. Total time spent performing activity does not change but tends to be at a lower intensity. There is little evidence in the literature of an association between high activity levels and early implant failure. Cite this article: Bone Joint J 2014;96-B:923-7.07/2014; 96-B(7):923-7. DOI:10.1302/0301-620X.96B7.31585
Article: Arthroplastie de hanche et sport[Show abstract] [Hide abstract]
ABSTRACT: Si la reprise des activités sportives douces est compatible avec une arthroplastie totale de hanche, la pratique de sports avec impacts nombreux semble plus problématique et n’est pas autorisée de façon consensuelle. En 2012, il existe deux types d’arthroplastie de hanche pouvant être proposés aux patients souffrant de coxarthrose : une prothèse conventionnelle avec une tige fémorale ou un resurfaçage de hanche sans effraction du canal fémoral. Ce dernier est destiné aux patients jeunes et/ou sportifs afin de leur permettre une reprise d’activités sans restriction. À la lecture de la littérature, il apparaît que les prothèses conventionnelles ne permettent pas une reprise de tous les sports et semblent s’adresser uniquement aux sports à impact faible. En revanche, les taux de reprise sportive à impact élevé observés après implantation d’un resurfaçage de hanche apparaissent excellents et inégalés par des prothèses conventionnelles. La pratique des sports à impact élevé (et/ou à intensité élevée) semble donc compatible avec un resurfaçage de hanche sans qu’aucune étude à long terme n’ait analysé les conséquences de cette activité sur l’usure et/ou le descellement aseptique.Journal de Traumatologie du Sport 12/2012; 29(4):231-235. DOI:10.1016/j.jts.2012.10.001
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ABSTRACT: Background: Hip-resurfacing arthroplasty (HRA) is a common procedure in the treatment of hip arthritis for younger individuals. Despite initial selection criteria, HRA has become an emerging procedure for older individuals. Objectives: To review the latest research regarding HRA for younger and older individuals. Methods: The literature was reviewed from 1970 to 2012 using PubMed, CINAHL, and Proquest. Results: HRA is an emerging alternative for active younger and older individuals. Research is sparse regarding the different surgical approaches and rehabilitation strategies. Despite initial indications for younger individuals, this procedure has become an emerging procedure for older individuals. Conclusion: Further studies are needed to update the criteria for patient selection, surgical procedures, and rehabilitation.Topics in Geriatric Rehabilitation 10/2013; 29(4):246-252. DOI:10.1097/TGR.0b013e318292e6c9 · 0.14 Impact Factor