Does hip or knee joint replacement decrease chances to complete an ultra-trail race? Study in participants at the Ultra-Trail du Mont Blanc®

Rochoy, Michaël; Six, Julien; Favre, Jonathan; Lagrange, Nicolas; Lefebvre, Jean‐Marc; Rollier, Jean-Charles; Girard, Julien

doi:10.1016/j.otsr.2020.07.011

Cited by 10 publications

(4 citation statements)

References 32 publications

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“…Hara et al even found an increased activity level after THA 17 . One study even reported successful participation in ultra trail races by patients with hip replacement 18 .…”

Section: Introductionmentioning

confidence: 99%

In vivo loading on the hip joint in patients with total hip replacement performing gymnastics and aerobics exercises

Haffer

Popovic

Martin

et al. 2021

Sci Rep

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A further increase in the number of total hip arthroplasty (THA) is predicted, in particular the number of young THA patients has raised and with it their demands. There is no standardized evidence-based rehabilitation program and no reliable guidelines for sports activities after THA. Stretching and strengthening gymnastics are routinely performed in rehabilitation and aerobics as a sport after THA. The aim of the investigation was to determine the in vivo force and moments acting on the hip prosthesis during gymnastics and aerobic exercises to provide a source for evidence-based recommendations. Hip joint loads were measured in six patients with instrumented hip implants. The resulting force FRes, bending moment MBend at the neck and torsional moment MTors at the stem were examined during seven strengthening (with two different resistance bands) and four stretching gymnastic exercises and seven aerobic exercises with and without an aerobic step board compared to the loads during the reference activity walking. The stretching and strengthening gymnastics exercises and the aerobic exercises with and without a board demonstrated in their median peak force and moments mostly lower or similar values compared to walking. Significantly increased loads were recorded for the flexor stretching exercise in monopod stand (Fres and MBend), the strengthening abduction exercise on the chair (MTors) and the strengthening flexion exercise with the stronger resistance band (MTors). We also found a significant increase in median peak values in aerobic exercises with a board for the "Basic Step" (ipsilateral started Fres and MTors; contralateral started MTors), "Kickstep ipsilateral started" (Fres and MTors) and "Over the Top contralateral started" (Fres). The in vivo loads in THA patients during frequently performed stretching, strengthening and aerobic exercises were demonstrated for the first time. It was proved that stretching gymnastic exercises are safe in terms of resulting force, bending and torque moments for THA patients, although an external assistance for stabilization may be considered. Strengthening gymnastics exercises are reliable in terms of Fres, MBend and MTors, but, based on our data, we recommend to adhere to the communicated specific postoperative restrictions and select the resistance bands with lower tension. Aerobic exercises without an aerobic board can be considered as reliable activity in terms of force and moments for THA patients. Aerobic exercises with a board are not recommended for the early postoperative period and in our opinion need to be adapted to the individual muscular and coordinative resources.

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“…Hara et al even found an increased activity level after THA 17 . One study even reported successful participation in ultra trail races by patients with hip replacement 18 .…”

Section: Introductionmentioning

confidence: 99%

In vivo loading on the hip joint in patients with total hip replacement performing gymnastics and aerobics exercises

Haffer

Popovic

Martin

et al. 2021

Sci Rep

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“…To date, only observational studies and case series providing very little guidance have been published, mostly after hip joint replacement. 1 , 24 – 26 Although these studies suggest that running might be relatively safe and competing in ultraendurance events might even possible be after a joint replacement, just a single recent study has specifically reported on the knee joint. 26 This low level of evidence is likely related to the uncertainty expressed by HCPs in our survey.…”

Section: Discussionmentioning

confidence: 99%

“…1,[24][25][26] Although these studies suggest that running might be relatively safe and competing in ultraendurance events might even possible be after a joint replacement, just a single recent study has specifically reported on the knee joint. 26 This low level of evidence is likely related to the uncertainty expressed by HCPs in our survey. Taken together, our findings highlight 2 main points.…”

Section: Discussionmentioning

confidence: 99%

Do the General Public and Health Care Professionals Think That Running Is Bad for the Knees? A Cross-sectional International Multilanguage Online Survey

Esculier

Besomi

Silva

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Running is a popular sport with widely recognized health benefits. Given the high rates of knee injury in runners and the growing prevalence of knee osteoarthritis (KOA), it may be useful to assess perceptions about running and knee joint health. Purpose: The objectives of this study were to (1) explore and compare the perceptions of the general public (PUB) and health care professionals (HCPs) on the topic of running and knee health and (2) explore recommendations about running and knee health provided by HCPs. Study Design: Cross-sectional study. Methods: We conducted an online survey between June 18 and October 1, 2020. The questionnaire included questions on running and knee health, and HCPs were asked about their typical recommendations and level of confidence in providing recommendations on the topic. Perceptions (proportions) were compared between the PUB and HCPs using the chi-square test. Results: In total, 4521 responses (PUB, n = 2514; HCPs, n = 2007) were analyzed. A greater proportion of HCPs perceived regular running as healthy for knees (86% vs 68%; P < .001). More of the PUB than HCPs ( P < .001) believed that running frequently (29% vs 13%), long distances (54% vs 45%), and on hard surfaces (60% vs 36%) increased the risk of developing KOA. Running for those with KOA was perceived by the PUB as posing an increased risk of getting more knee pain (48%) and needing joint replacement surgery (38%), more so than by HCPs (26% and 17%, respectively). The majority of HCPs reported being relatively confident in providing evidence-based recommendations about running and knee health and mostly recommended that runners with KOA modify training parameters instead of quit. Conclusion: More HCPs perceived running as healthy for knees when compared with the PUB. Most HCPs felt confident in providing evidence-based recommendations about running and knee health.

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“…The question of return to high-impact sports after total joint replacement has been investigated previously [38][39][40] and studies that have been published on return to highimpact sports after TKA suggest encouraging results regarding short to intermediate outcomes [39,41]. However, whether the performance of high-impact sports reduces TKA implant longevity and survivorship requires longer investigation times of 20-30 years.…”

Section: Sports After Tkamentioning

confidence: 99%

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

Vu-Han

Gwinner

Perka

et al. 2020

JCM

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(1) Background: Improved surgical techniques and implants in total knee arthroplasty (TKA) have led to broader indications for surgical interventions of osteoarthritis of the knee. There is a growing young and active patient subgroup with high return to sports (RTS) expectations after TKA. The current lack of evidence regarding RTS capacity in this patient cohort, requires the consolidation of experts’ opinions and experiences to address the special needs among these patients. The aim of this study was to assess current expert opinions in regard to preoperative patient assessment, surgical technique and decision-making and patient counseling for these patients. (2) Methods: We performed a survey among surgeons specialized in arthroplasty with a questionnaire designed to assess current recommendations, surgical techniques, and implant preferences as well as patient counseling in patients with high expectations for RTS after TKA. (3) Results: The majority of surgeons are in favor of return to low-impact sports after TKA within 3 to 6 months. Some even recommend return to high-impact sports. Despite improvement of surgical techniques and implants, we observed no clear preference for a single surgical technique or implant specification in active patients. (4) Conclusions: Current evidence for sports-associated complications after TKA is scarce. Despite a growing array of surgical techniques and implants, the available literature is still controversial with no single surgical technique or TKA design distinguishing itself clearly from others. Surgeons’ recommendations are mostly based on their experience and training. Nonetheless, we observed growing faith in modern implants with some surgeons even recommending high-impact sports after TKA.

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Does hip or knee joint replacement decrease chances to complete an ultra-trail race? Study in participants at the Ultra-Trail du Mont Blanc®

Cited by 10 publications

References 32 publications

In vivo loading on the hip joint in patients with total hip replacement performing gymnastics and aerobics exercises

In vivo loading on the hip joint in patients with total hip replacement performing gymnastics and aerobics exercises

Do the General Public and Health Care Professionals Think That Running Is Bad for the Knees? A Cross-sectional International Multilanguage Online Survey

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

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