Predictors of participation in sports after hip and knee arthroplasty

Clin Orthop Relat Res. 2012 Feb;470(2):555-61. doi: 10.1007/s11999-011-2198-y.


Background: While the primary objective of joint arthroplasty is to improve patient quality of life, pain, and function, younger active patients often demand a return to higher function that includes sporting activity. Knowledge of rates and predictors of return to sports will help inform expectations in patients anticipating return to sports after joint arthroplasty.

Questions/purposes: We measured the rate of sports participation at 1 year using the UCLA activity score and explored 11 variables, including choice of procedure/prosthesis, that might predict return to a high level of sporting activity, when controlling for potential confounding variables.

Methods: We retrospectively evaluated 736 patients who underwent primary metal-on-polyethylene THA, metal-on-metal THA, hip resurfacing arthroplasty, revision THA, primary TKA, unicompartmental knee arthroplasty, and revision TKA between May 2005 and June 2007. We obtained UCLA activity scores on all patients; we defined high activity as a UCLA score of 7 or more. We evaluated patient demographics (age, sex, BMI, comorbidity), quality of life (WOMAC score, Oxford Hip Score, SF-12 score), and surgeon- and procedural/implant-specific variables to identify factors associated with postoperative activity score. Minimum followup was 11 months (mean, 12.1 months; range, 11-13 months).

Results: Preoperative UCLA activity score, age, male sex, and BMI predicted high activity scores. The type of operation and implant characteristics did not predict return to high activity sports.

Conclusions: Our data suggest patient-specific factors predict postoperative activity rather than factors specific to type of surgery, implant, or surgeon factors.

Level of evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip*
  • Arthroplasty, Replacement, Knee*
  • Body Mass Index
  • British Columbia
  • Chi-Square Distribution
  • Female
  • Hip Joint / physiopathology
  • Hip Joint / surgery*
  • Humans
  • Knee Joint / physiopathology
  • Knee Joint / surgery*
  • Male
  • Middle Aged
  • Odds Ratio
  • Quality of Life
  • Recovery of Function
  • Regression Analysis
  • Reoperation
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Sports*
  • Time Factors
  • Treatment Outcome