Exercise is important for our physical and mental health. For many people who develop an arthritic hip, the lack of the ability to participate in a particular form of exercise is a major loss. Some of the commonest questions we are asked by our patients relate to return to sport after hip replacement. In this blog, Consultant Hip Surgeon Mr Simon Newman discusses what level of function you might expect to return to following surgery.
In the not too distant past, hip replacement was the preserve of those who had “earned the right for surgery” by being made to wait until they were struggling to walk. By this stage, patients were relieved enough being able to walk, let alone do anything more strenuous.
In recent years, studies have shown that waiting too long for a hip replacement is a bad idea and we have developed better implants and techniques to make the implants last longer. Consequently, people are having a hip replacement when they are younger and more active.
Surgeons have traditionally been reluctant to recommend strenuous exercise following a hip replacement for three reasons: firstly the risk of dislocation – the ball coming out of the socket of the hip, secondly the risk of loosening of the implants and finally the risk of fracturing the bone around the implants.
Hip replacement technology has advanced to allow the use of more stable implants and tissue sparing techniques that have significantly reduced the risk of dislocation.
The fixation of modern hip replacements also seems to be durable in those who return to sporting activity in the short to medium term, though longer term (over 10 years) data is yet to be collected. At the moment there is minimal research on the risk of fracture around hip replacements with different types of sporting activity.
Low impact sporting activity like hiking, golf and swimming is absolutely fine after a hip replacement and is encouraged.
If you are keen to return to higher impact activities like running or tennis, the available evidence covering the short to medium term is reassuring.
However at the moment we do not know if undertaking these activities will shave a few months or years off the lifespan of the replacement in the long term.
Falling onto a hip replacement can run the risk of dislocation or fracture, so contact sports like rugby and football are inadvisable.
Skiing is controversial, however there are many examples of people returning to the activity after a hip replacement.
Despite this, real care needs to be taken to avoid falls. If you are an experienced skier that absolutely must return to the slopes despite the risk: make sure you are fully fit, go at quieter times of the year and steer clear of difficult runs, ice and moguls.