Intensive physical activity following total hip arthroplasty increased the revision risk after 15 years: a cohort study of 973 patients from the Geneva Arthroplasty Register

Authors

  • Elena Zaballa MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
  • Stefania D’angelo MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
  • Christophe Barea Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland https://orcid.org/0000-0003-1781-9453
  • Georgia Ntani MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
  • Didier Hannouche Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
  • Cyrus Cooper MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
  • Anne Lübbeke MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK https://orcid.org/0000-0002-6905-6120
  • Karen Walker-Bone MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK; Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Australia

DOI:

https://doi.org/10.2340/17453674.2024.41192

Keywords:

Arthroplasty, Hip, Physical activity, Total hip arthroplasty under 65 years, Revision arthroplasty

Abstract

Background and purpose: Younger recipients of total hip arthroplasty (THA) highly prioritize returning to preoperative levels of physical activity (PA). Surgeons have tended to give cautious advice concerning high-impact sports participation, but there have been few long-term studies. The purpose of our study was to investigate the risk of revision arthroplasty in relation to postoperative PA levels.
Methods: Patients registered in the Geneva Arthroplasty Register (GAR) who had elective THA when they were aged < 65 years were studied. Postoperative PA was collected prospectively 5-yearly using the UCLA activity scale. Cox proportional hazards models were used to estimate associations between PA and risk of revision THA.
Results: Amongst 1,370 eligible subjects, median age at THA 58 years (interquartile range 51–61), UCLA scores were available for 973 (71%). During follow-up over 15 years, there were 79 revisions, giving a cumulative risk of 7.4% (95% confidence interval [CI] 5.8–9.4). After adjusting for covariates, we found an increased risk of revision for each unit increase in postoperative PA (HR 1.2, CI 1.1–1.4), and among people performing the most intensive PA (HR 2.7, CI 1.3–5.6) compared with those who were inactive.
Conclusion: The overall risk of revision was small but intensive and moderate PA may be associated with an increased risk of revision.

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Published

2024-08-15

How to Cite

Zaballa, E., D’angelo, S., Barea, C., Ntani, G., Hannouche, D., Cooper, C., … Walker-Bone, K. (2024). Intensive physical activity following total hip arthroplasty increased the revision risk after 15 years: a cohort study of 973 patients from the Geneva Arthroplasty Register. Acta Orthopaedica, 95, 446–453. https://doi.org/10.2340/17453674.2024.41192

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Vol. 95 (2024): Acta Orthopaedica

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Copyright (c) 2024 Elena Zaballa, Stefania D’angelo, Christophe Barea, Georgia Ntani, Didier Hannouche, Cyrus Cooper, Anne Lübbeke, Karen Walker-Bone

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Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.
 
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