Twenty-one sports activities are recommended by the European Knee Associates (EKA) six months after total knee arthroplasty

Abstract

PurposeTo elaborate recommendations for sports participation following TKA among the members of the European Knee Associates (EKA). MethodsA prospective online survey was conducted among the members of the European Knee Associates (EKA). The European Knee Associates (EKA) are a section of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA). The survey investigated recommendations for 47 sports disciplines. Possible answers were: allowed, allowed if experienced, not allowed, no opinion. The survey was conducted separately for 4 specific time frames: within 6 weeks after TKA; 6–12 weeks after TKA; 3–6 months after TKA; and more than 6 months after TKA. Consensus among the respondents was then analyzed. ResultsEKA members (N = 120) participated in the survey. A high level of consensus was reached for a recommendation to allow 5 different sports in the first 6 weeks after TKA, 7 sports 6–12 weeks after surgery, 14 sports 3–6 months after TKA, and 21 out of 47 activities 6 months after surgery. In the first 6 weeks after TKA walking, stair climbing, swimming, aqua fitness, and static cycling were recommended. Six to twelve weeks after TKA, cycling on level ground and yoga were recommended in addition to the aforementioned activities. Further sports activities recommended beyond 12 weeks after TKA were: tennis doubles, golf, fitness/weight lifting, aerobics, hiking, Nordic walking and sailing. The sport for which the recommendation was “not allowed” following TKA was squash. ConclusionThe number of sports recommended by EKA surgeons increases stepwise over the postoperative time frames. The findings are regarded as clinically relevant as they may serve as a basis for answering patient questions on timing and giving recommendations for the resumption of sports activities following standard primary TKA and should be individualized by surgeons for their patients’ expectations and goals. Level of evidenceV.

Being active with a total hip or knee prosthesis: a systematic review into physical activity and sports recommendations and interventions to improve physical activity behavior

“…The studies were conducted in Western countries (Western Europe and the United States), except for one study from Japan [36]. Most studies concerned the hip [19-30, 33, 35-37, 39], with fewer studies on the knee [21][22][23][24][25][26][29][30][31][32][33][34][35][36][37][38].…”

“…Of the 21 articles included, none scored "yes" on all five questions of the MMAT, while 4 positive answers were given in five articles [23,24,27,28,35], 3 in thirteen articles [19, 20, 25, 26, 29-34, 36, 38, 39], 2 in one article [22], 1 in none of the articles, and none in two of the articles [21,37]. There wasn't a "no" score in ten articles [20,23,24,27,28,30,31,[34][35][36], while nine articles [19,22,26,29,32,33,[37][38][39] received a "no" on one out of five questions. Further, one article [25] scored a "no" on two questions and 1 [21] on four questions.…”

Large variability in recommendations for return to daily life activities after knee arthroplasty among Dutch hospitals and clinics: a cross-sectional study

“…However, patient expectations regarding performance of activities after KA can vary greatly, depending on age, type of surgery (i.e., UKA and TKA), lifestyle and other patient characteristics such as body mass index (25)(26)(27). Therefore, although there is a need for uniformity in guidelines across healthcare providers, recommendations should be tailored to the specific needs of patients (22). In our study, age-specific recommendations were not mentioned and only 4 out of the 43 hospitals and clinics provided separate recommendations for a UKA.…”

“…A large number of patients do not return to sports after KA, varying between 0% and 64% (9). There are various studies that examined the time to return to sports after KA (22,28,33). For instance, in a study by Thaler et al (22), recommendations regarding resumption of sporting activities after TKA were provided by members of the European Knee Association.…”

“…There are various studies that examined the time to return to sports after KA (22,28,33). For instance, in a study by Thaler et al (22), recommendations regarding resumption of sporting activities after TKA were provided by members of the European Knee Association. For example, the authors stated that "cycling on level ground" was recommended to be allowed within 6-12 weeks.…”