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THA leads to increased physical activity levels regardless of age or gender
The percentage of patients with a sedentary lifestyle decreased from 61% to 45% at 5 years after total hip arthroplasty.
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CHICAGO — Total hip arthroplasty was associated with increased physical activity in patients and that activity persisted at 5 years and 10 years postoperatively, according to Swiss researchers.
“Primary total hip arthroplasty substantially and durably improves physical activity in men and women and in all age categories,” Anne Lübbeke, MD, DSc, the study’s lead investigator, said at the American Academy of Orthopaedic Surgeons Annual Meeting, here. “In patients less than 55 years, postoperative activity levels remained lower than just before [osteoarthritis] OA symptom onset,” said Lübbeke, who is at Geneva University Hospitals, in Geneva.
She and colleagues performed cross-sectional analyses to determine the course of osteoarthritis (OA) in four time periods, which were prior to the disease, preoperative to total hip arthroplasty (THA), at 5 years postoperatively and 10 years postoperatively.
Results of prospective study
The researchers used the Geneva Hip Arthroplasty Registry in their investigation, which allowed them to study a prospective cohort of patients treated at their institution starting back in 1996. From that group they analyzed all primary THAs performed from January 2000 to April 2012.
When they focused on the period prior to the onset of OA symptoms, Lübbeke and colleagues found mean UCLA scores of 6.9 points, which significantly decreased to 3.5 points in the preoperative period.
After surgery, results showed that mean UCLA scores were significantly higher with 5.7 points at 5 years and 5.5 points at 10 years postoperatively.
Lübbeke said post-THA physical activity should be of concern to the surgeon and his or her patients. In patients who were obese, activity levels tended to be lower overall over time compared to patients who were not obese.
Impact of lifestyle, age
Sixty-one percent of patients studied had sedentary lifestyles before surgery, based on the results. At 5 years after THA, the percent of patients with that kind of lifestyle decreased to 45%.
Preoperative mean UCLA scores were similar across all age groups. They ranged from 3.7 points in the youngest patients to 3.2 points in the oldest ones; however investigators reported UCLA scores decreased at 5 years postoperatively, as patient age increased.
Lübbeke noted in the past decade the number of individuals with a “perceived” active lifestyle who underwent THA increased by 10%. When she and colleagues followed the prevalence of active lifestyles in patients who underwent 2,995 THAs, in all, and studied the group both before and after surgery, 33% were active from 2000 to 2003. However, from 2008 to 2012, 47% of patients set to undergo THA were active.
Lübbeke received the Jacques Duparc Award at the EFORT Congress held June 5-8 for this study. – by Jeff Craven
- Reference:
- Lübbeke A. Paper #44. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 19-23, 2013; Chicago.
- For more iformation:
- Anne Lübbeke, MD, DSc, can be reached at Department of Surgery, HUG, 1211 Geneva 14, Switzerland; email: Anne.Lubbekewolff@hcuge.ch.
Disclosure: Lübbeke has no relevant financial disclosures.
Perspective
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Roberto Binazzi, MD PhD
This interesting research gives some scientific evidence to a concept that has become clear in the last 10 years to 15 years: Physical activity is extremely popular and has increased dramatically in both women and men.
This observation is particularly evident after a total joint replacement (TJR) and the surgeon has to accept the fact that the patient often returns to sometimes strenuous or risky sport activities, like jogging, tennis or even skiing. Luckily, the improvement in TJR materials, especially new bearings, has helped limit the amount of complications and failures that can result when patients return to sports postoperatively.
Nevertheless, this study suggests that the bar has been raised for the surgeon in these cases.
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