Danish surgeons allow the most athletic activities after total hip and knee replacement

Counselling patients for or against athletic activities after well performed total hip arthroplasty (THA) and total knee arthroplasty (TKA). Level of evidence is low, and the current international guidelines are based on North American expert opinions in 2001 and 2008. Could technical and operative development and social or cultural differences apply for different counselling?

All Danish experts in head of departments performing more than 100 THAs or TKAs per year, were invited to fill in a questionnaire regarding the most popular sport activities in the Danish 60-69 years old population

Response rate was 74 and 89% for the TKA and THA departments, respectively. A pronounced variation between the departments was observed and compared to the latest published US recommendations in 2007, the present Danish recommendations are significantly more liberal. Athletic activities are now allowed by 87% of the Danish arthroplasty departments. Of these 55% allow for high-impact activities after THA compared to 21% in US in 2007 (p < 0.0001). Recommendations for TKA patients are less liberal. Only 38% of the departments allow for high-impact activities after TKA compared to the 55% after THA (p < 0.0001).

Based on the pronounced variation between departments and the fact that a highly significant trend was observed over 5 years on an undocumented basis it was concluded that there is an imminent need for a higher scientific level on this issue—which hopefully can develop in a few years using PROMs in large scale follow-up studies.