The Effect of Total Hip Arthroplasty on Sports and Work Participation: A Systematic Review and Meta-Analysis

Abstract

BackgroundTotal hip arthroplasty (THA) is a successful procedure to treat end-stage hip osteoarthritis. The procedure is increasingly performed in adults of working age, who often wish to return to sports (RTS) and return to work (RTW). However, a systematic overview of the evidence on RTS and RTW after THA is lacking.ObjectivesOur aim was to systematically review (1) the extent to which patients RTS and RTW after THA, including (2) the time to RTS and RTW.MethodsWe searched MEDLINE and Embase from inception until October 2017. Two authors screened and extracted the data, including study information, patient demographics, rehabilitation protocols and pre- and postoperative sports and work participation. Methodological quality was assessed using the Newcastle–Ottawa scale. Data on pre- and postoperative sports and work participation were pooled using descriptive statistics.ResultsA total of 37 studies were included, of which seven were prospective studies and 30 were retrospective studies. Methodological quality was high in 11 studies, moderate in 16 studies, and low in ten studies. RTS was reported in 14 studies. Mean RTS was 104% to the pre-surgery level and 82% to the pre-symptomatic sports level. Time to RTS varied from 16 to 28 weeks. RTW was reported in 23 studies; the mean was 69%. Time to RTW varied from 1 to 17 weeks.ConclusionA great majority of patients RTS and RTW after THA within a timeframe of 28 and 17 weeks, respectively. For the increasingly younger THA population, this is valuable information that can be used in the preoperative shared decision-making process.Electronic supplementary materialThe online version of this article (10.1007/s40279-018-0924-2) contains supplementary material, which is available to authorized users.

Integrated care programmes for sport and work participation, performance of physical activities and quality of life among orthopaedic surgery patients: a systematic review with meta-analysis

“…This is remarkable given the importance of participation in sports and work for patients after orthopaedic surgery,5 6 especially for patients who are of working age for whom resumption of societal participation is an important treatment goal. Moreover, return to sports and work is typically delayed and/or not successful for many of these patients 7–11. For instance, patients undergoing joint replacement surgery considered advice regarding participation to be inconsistent and not tailored to their individual circumstances, which often left them with the feeling that they would have been able to recover sooner than what they had actually accomplished 5…”

Hip Arthroplasty with Increased Expectancy

“…In 2018, Hoorntje et al published a current meta-analysis of 37 studies to evaluate ability to work and return to sports after hip arthroplasty [41]. They calculated that the "Return to sports" was 104 % in comparison to the preoperative level or 82 % in comparison to the presymptomatic level.…”

“…The mean time to return was 16-28 weeks. The rate of return to work was 69 % and took a mean of 1-17 weeks [41].…”

“…In their meta-analysis, Hoorntje et al also evaluated factors that influence return to sport [41]. Only 3 of 8 studies found a negative correlation between age and return to sport.…”

“…Finally, one study investigated the degree of physical stress during the sport ("low" vs. "high impact" sport) and how it influences the return to sport. The authors demonstrated that return to "low impact" sport was more probable than for "intermediate" and "high impact" sports [41]. The "high impact" sports include highly stressful sports such as jogging, aerobic exercises, singles tennis and climbing.…”