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Are military fitness tests safe for members with a total hip arthroplasty?
Max Talbot1, L Pullman2, M Sokolov2
1Royal Canadian Medical Service, Department of National Defence and the Canadian Armed Forces, Ottawa, Ontario, Canada X@X.com.
Insights
Canadian Armed Forces (CAF) members with total hip arthroplasty (THA) can safely perform annual fitness evaluations. Expert consensus indicates the 10 tasks are safe, with one requiring modified hip flexion.
Area of Science:
- Orthopaedic surgery
- Military medicine
- Sports medicine
Background:
- Canadian Armed Forces (CAF) members undergo annual fitness evaluations.
- Members with total hip arthroplasty (THA) may face injury risks during strenuous fitness tests.
- Current CAF policy requires clarification regarding fitness testing for THA patients.
Purpose of the Study:
- To achieve expert consensus on the safety of fitness evaluations for CAF members with THA.
- To inform CAF policy development concerning fitness standards for personnel with hip replacements.
Main Methods:
- A three-round Delphi study was conducted with hip arthroplasty specialists.
- Experts reviewed video evidence of the 10 individual tasks within the CAF fitness evaluations.
- Consensus was sought on the safety of each task for individuals with THA.
Main Results:
- All 10 fitness evaluation tasks were deemed safe by expert consensus.
- One task, shovel digging, was considered safe with the caveat of avoiding deep hip flexion.
- Nine tasks were deemed safe without modifications.
- Experts recommended allowing THA patients to participate if they meet specific criteria (primary THA, no instability, ≥12 months post-op, medical clearance).
Conclusions:
- Arthroplasty experts concluded that CAF fitness evaluations are generally safe for members with THA.
- Video analysis supported the safety of the fitness tasks for this population.
- The findings provide a basis for updated CAF policies regarding fitness evaluations for THA patients.
Introduction:
Canadian Armed Forces (CAF) members must complete an annual fitness evaluation. Members with a total hip arthroplasty (THA) may be at risk of injury during these strenuous tests. To inform CAF policy, we sought expert consensus on the safety of fitness testing for members with a THA.
Methods:
We conducted a three-round Delphi study with a panel of hip arthroplasty experts to determine the safety of CAF operational fitness evaluations for members with a THA. The experts evaluated videos of the 10 individual tasks included in the evaluations.
Results:
All individual tasks were judged to be safe by consensus. One task, which involves digging with a shovel, was considered safe provided that participants avoid deep hip flexion. The nine other tasks were judged to be safe without modifications or interventions. The experts also supported a policy recommendation that would allow members to perform military fitness evaluations if they (1) have a primary THA, (2) had no episodes of instability, (3) are at least 12 months postoperatively and (4) have been cleared by an orthopaedic surgeon and a physiatrist/physiotherapist.
Conclusion:
A panel of arthroplasty experts concluded, based on video analysis, that CAF fitness evaluations are generally safe for members with a THA.
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