Does impact sport activity influence total hip arthroplasty durability?

Clin Orthop Relat Res. 2012 Nov;470(11):3060-6. doi: 10.1007/s11999-012-2362-z.


Background: Return to sport is a key patient demand after hip arthroplasty and some patients are even involved in high-impact sports. Although polyethylene wear is related to the number of cycles and the importance of the load, it is unclear whether high-impact sport per se influences THA durability.

Questions/purposes: Therefore, we compared (1) function between the patients involved in high-impact sports and the patients with lower activities as measured by the Harris hip score (HHS) and the Hip Osteoarthritis Outcome Score (HOOS); (2) linear wear rates; and (3) survivorships considering revision for mechanical failure with radiographic signs of aseptic loosening as the end point.

Methods: We retrospectively identified 70 patients who engaged in high-impact sports and 140 with low activity levels from among 843 THAs from a prospectively collected database performed between September 1, 1995, and December 31, 2000. Patients were evaluated at a minimum followup of 10 years (mean, 11 years; range, 10-15 years) by two independent observers. We obtained a HHS and HOOS at each followup.

Results: The mean HOOS was higher in the high-impact group for three of the five subscales of the HOOS. Mean linear wear was higher in the high-impact group than in the low-activities group. We also found a higher number of revisions in the high-activity group.

Conclusions: Our observations confirm concern about the risk of THA mechanical failures related to high-impact sport, and patient and surgeons alike should be aware of these risks of mechanical failures.

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

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Osteoarthritis, Hip / surgery*
  • Prosthesis Failure*
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Sports*