MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Acta Orthop. 2024 Aug 15;95:446-453. doi: 10.2340/17453674.2024.41192.
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.
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.
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.
The overall risk of revision was small but intensive and moderate PA may be associated with an increased risk of revision.
全髋关节置换术（THA）的年轻接受者高度重视恢复术前的身体活动（PA）水平。外科医生倾向于对高冲击运动的参与给予谨慎的建议，但很少有长期研究。我们研究的目的是调查术后 PA 水平与翻修关节置换术风险的关系。
研究了在年龄<65 岁时接受选择性 THA 的日内瓦关节置换登记处（GAR）中登记的患者。术后 PA 使用 UCLA 活动量表每 5 年进行前瞻性收集。使用 Cox 比例风险模型估计 PA 与翻修 THA 风险之间的关联。
在 1370 名合格受试者中，THA 的中位年龄为 58 岁（四分位距 51-61），973 名（71%）可获得 UCLA 评分。在 15 年的随访期间，有 79 例翻修，累积风险为 7.4%（95%置信区间[CI]5.8-9.4）。在校正了协变量后，我们发现术后 PA 每增加一个单位，翻修的风险就会增加（HR 1.2，CI 1.1-1.4），与不活动的人相比，进行最剧烈 PA 的人的风险增加（HR 2.7，CI 1.3-5.6）。
总的来说，翻修的风险很小，但剧烈和中度的 PA 可能与翻修风险增加有关。
