Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania.
J Arthroplasty. 2023 May;38(5):806-814.e5. doi: 10.1016/j.arth.2022.11.008. Epub 2022 Dec 5.
Quality data on physical activity participation following total joint arthroplasty (TJA) are limited. The purpose of this study was to explore patient participation, outcomes, and limitations in sports/physical activities following TJA.
Patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) at a single institution from 2015 to 2020 were surveyed on sports/physical activity participation before and after TJA. Data were correlated with perioperative demographic and outcome scores. In total, 2,366 patients were surveyed: 788 (33.3%) underwent THA, 1,175 (49.7%) underwent TKA, and 403 (17.0%) underwent both THA/TKA.
Participation rates were 69.2, 61.5, and 61.3% at one year prior and 86.8, 81.5, and 81.6% at five years prior to THA, TKA, and THA/TKA, respectively. Participation rates were 73.1, 72.0, and 60.8% at mean 4.0 years postoperatively. Weekly time spent (P < .05) and exertion levels (P < .001) increased postoperatively for all three cohorts. For all three cohorts, the most common sports/activities were recreational walking, cycling, swimming, and golf, while intermediate- and high-impact activity participation decreased postoperatively. Independent predictors of postoperative sports/physical activity participation were younger age [THA (P < .001); TKA (P = .010)], lower body mass index [THA (P < .001); TKA (P < .001)], fewer comorbidities [THA (P < .001)], and higher postoperative Hip Injury and Osteoarthritis Outcome Score Junior[THA (P = .012)], Knee Injury and Osteoarthritis Outcome Score Junior[TKA (P = .004)], 12-Item Short Form Physical Component Score[THA (P < .001); TKA (P < .001); THA/TKA (P = .004)], and 12-Item Short Form Mental Component Score[TKA (P = .004)] scores. Activity restrictions were reported among 17.5, 20.9, and 25.1% of THA, TKA, and THA/TKA patients, respectively, and were more commonly self-imposed than surgeon-directed for all cohorts.
Though sports/physical activity participation may improve following TJA compared to one year preoperatively, participation is decreased compared to five years preoperatively, transitions to low-impact activities, and varies among subsets of patients.
关于全关节置换术后（TJA）体力活动参与情况的质量数据有限。本研究的目的是探讨 TJA 后患者参与体育/体力活动的情况、结果和限制。
对 2015 年至 2020 年在一家机构接受全髋关节置换术（THA）和全膝关节置换术（TKA）的患者进行了 TJA 前后体育/体力活动参与情况的调查。数据与围手术期人口统计学和结果评分相关。共有 2366 名患者接受了调查：788 名（33.3%）接受了 THA，1175 名（49.7%）接受了 TKA，403 名（17.0%）接受了 THA/TKA。
THA、TKA 和 THA/TKA 术前一年的参与率分别为 69.2%、61.5%和 61.3%，术前五年的参与率分别为 86.8%、81.5%和 81.6%。术后平均 4.0 年的参与率分别为 73.1%、72.0%和 60.8%。三组患者术后的每周时间投入（P<.05）和运动量（P<.001）均增加。三组中最常见的运动/活动是休闲散步、骑自行车、游泳和打高尔夫球，而中高强度活动的参与度则降低。THA（P<.001）和 TKA（P=0.010）术后体育/体力活动参与的独立预测因素为年龄较小、身体质量指数较低（THA（P<.001）；TKA（P<.001））、合并症较少（THA（P<.001））和术后髋关节损伤和骨关节炎结果评分青年组较高（THA（P=0.012））、膝关节损伤和骨关节炎结果评分青年组较高（TKA（P=0.004））、12 项简短表格身体成分评分较高（THA（P<.001）；TKA（P<.001）；THA/TKA（P=0.004））和 12 项简短表格心理成分评分较高（TKA（P=0.004））。THA、TKA 和 THA/TKA 患者的活动受限率分别为 17.5%、20.9%和 25.1%，所有患者的活动受限更常见于自我限制而非医生指导。
与术前一年相比，TJA 后体力活动参与可能会有所改善，但与术前五年相比，参与度仍有所下降，向低强度活动转变，且在不同患者亚组中存在差异。
