Resuming Sports After Hip Replacement

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Total hip arthroplasty is a very successful procedure for patients with hip arthritis who have failed conservative management. Hip replacement aims to relieve pain and restore function and motion of the joint. If you are considering total hip arthroplasty, you should speak with your surgeon regarding what types of physical activities and sports are safe and realistic after surgery.

While traditionally, hip replacement surgery was performed in an older and less active patient population, in part because of improvements in surgical technique and implant materials used in today’s surgery, total hip arthroplasty is being performed in a younger and more active patient population with greater expectations for a more active lifestyle.

Unfortunately, when patients are involved in high-impact activities, the hip joint, and therefore the implants, experience much greater forces than they would with normal activity. These increased forces may cause accelerated wear of the implants which can potentially lead to implant loosening and the need for revision surgery. You should discuss your desired physical activity goals with your surgeon BEFORE SURGERY to ensure that they are safe.

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The American Association of Hip and Knee Surgeons (AAHKS) has the following recommendations:

Stay active after surgery

Physical activity is great for your overall health. It has been shown to have a positive impact on your cardiovascular system, overall strength and endurance, and stress and anxiety levels. It is recommended that you try to return to your previous physical activity level and maintain a healthy lifestyle.

Know your body and have realistic expectations

After a hip replacement, you should be able to continue the activities that you were involved in prior to surgery with less pain and stiffness. It does not mean that you should expect to participate in more strenuous activities that you did not perform prior to surgery.

AAHKS recommends patients begin to return to sport within the first three months after surgery. Multiple studies have shown that the majority fully returned to pre-surgical sports within 4-6 months after hip replacement surgery.

Which sports are okay?

Low-impact sports are recommended, medium-impact sports should be approached with caution, and high-impact sports should be avoided. These recommendations are based on our knowledge that the wear rates of the hip replacement materials are a function of patient activity level and joint loading. Running, for example, places a large amount of stress on the implants and may lead to implants loosening over time. If there is any question, we recommend being cautious and protective of your hip replacement Implants | Hip and Knee Care (aahks.org)

Talk to your doctor

Talk to your surgeon about your goals and expectations after surgery to gain a better understanding if these are in line with their recommendations.

References

Hoorntje A, Janssen KY, Bolder SBT, et al. The Effect of Total Hip Arthroplasty on Sports and Work Participation: A Systematic Review and Meta-Analysis. Sports Med. 2018;48(7):1695-1726. doi:10.1007/s40279-018-0924-2
Cowie JG, Turnbull GS, Ker AM, Breusch SJ. Return to work and sports after total hip replacement. Arch Orthop Trauma Surg. 2013 May;133(5):695-700. doi: 10.1007/s00402-013-1700-2. Epub 2013 Feb 27. Erratum in: Arch Orthop Trauma Surg. 2014 Apr;134(4):595. Turnball, GS [corrected to Turnbull, GS]. PMID: 23443526.
Fawaz WS, Masri BA. Allowed Activities After Primary Total Knee Arthroplasty and Total Hip Arthroplasty. Orthop Clin North Am. 2020 Oct;51(4):441-452. doi: 10.1016/j.ocl.2020.06.002. Epub 2020 Aug 13. PMID: 32950213.
Schmalzried TP, Shepherd EF, Dorey FJ, Jackson WO, dela Rosa M, Fa’vae F, McKellop HA, McClung CD, Martell J, Moreland JR, Amstutz HC. The John Charnley Award. Wear is a function of use, not time. Clin Orthop Relat Res. 2000 Dec;(381):36-46. doi: 10.1097/00003086-200012000-00005.
Swanson EA, Schmalzried TP, Dorey FJ. Activity recommendations after total hip and knee arthroplasty: a survey of the American Association for Hip and Knee Surgeons. J Arthroplasty. 2009 Sep;24(6 Suppl):120-6. doi: 10.1016/j.arth.2009.05.014.
Klein GR, Levine BR, Hozack WJ, Strauss EJ, D’Antonio JA, Macaulay W, Di Cesare PE. Return to athletic activity after total hip arthroplasty. Consensus guidelines based on a survey of the Hip Society and American Association of Hip and Knee Surgeons. J Arthroplasty. 2007 Feb;22(2):171-5. doi: 10.1016/j.arth.2006.09.001.

This article has been written by Alexandra Stavrakis, MD in collaboration with and the AAHKS Patient and Public Relations Committee and the AAHKS Evidence Based Medicine Committee. Links to these pages or content used from the articles must be given proper citation to the American Association of Hip and Knee Surgeons.