Tennis After Total Hip Arthroplasty

abstract & commentary

Synopsis: Return to playing tennis is an attainable goal after total hip arthroplasty. However, it does present a risk for early implant failure.

Source: Mont MA, et al. Tennis after total hip arthroplasty. Am J Sports Med 1999;27:60-64.

Mont and colleagues characterized the functional results related to the return to playing tennis after total hip arthroplasty. They studied hip arthroplasty patients who returned to playing tennis after their operation, recording functional outcome measures and patient satisfaction. They found that all of their patients were extremely satisfied with their functional results, and they were all happy to resume playing tennis. These patients were playing both singles and doubles tennis approximately three times per week. There were, however, three patients (3/58) who did require revision surgery eight years later. Therefore, Mont et al offer caution and close follow-up of patients who do resume such high-impact activities.

Comment by Stephen B. Gunther, MD

Impact-loading activities present a theoretical risk for loosening and wear-related osteolysis in total joint arthroplasties. This study specifically addresses functional outcome measures related to total hip arthroplasty. Tennis is an impact activity that does pose a risk of wear-related complications, including osteolysis and implant failure.1 However, all patients in this study were satisfied with their surgical result, including the patients who eventually required revision surgery. Therefore, the functional results were excellent, even in patients who could be classified as clinical failures.

Ultimately, it is the patient who must weigh the risks and benefits of resuming potentially harmful activities. Impact-loading sports increase the risk of implant failure, but this may be a worthwhile risk for many patients. The role of the orthopedic surgeon, therefore, is to properly advise these patients. Further outcome studies recording clinical as well as functional results in longer-term follow-up of larger numbers of patients will assist both patients and surgeons in this role.

Reference

1. Kilgus DJ, et al. Patient activity, sports participation, and impact loading on the durability of cemented total hip replacements. Clin Orthop 1991;269:25-31.