Safe Activity participation Following Elective Total hip replacement: the SAFE-T investigation

Area of Science:

• Orthopaedic Surgery
• Rehabilitation Medicine
• Sports Medicine

Background:

• Total hip replacement (THR) is a common surgery with rising demand among younger patients.
• Evidence-based guidelines for safe post-THR activity levels, especially for high-intensity sports, are limited.
• Understanding the impact of physical activity intensity on outcomes is crucial for patient management.

Purpose of the Study:

• To determine if increased physical activity intensity after THR is associated with greater activity-related hip pain.
• To investigate the relationship between activity intensity and revision rates following THR.
• To assess the impact of activity intensity on patient-reported outcome measures (PROMs) and activity duration.

Main Methods:

• A 5-year prospective study of two groups undergoing THR: pre-operative and 5-7 years post-surgery.
• Self-reported physical activity categorized by intensity (A-F) using validated questionnaires.
• Primary outcome: hip pain during activity; Secondary outcomes: activity duration, revision rates, and PROMs.

Main Results:

• No significant interaction between activity intensity and hip pain was found.
• High-intensity activities (categories E and F) did not correlate with decreased activity duration, worsened PROMs, or increased revision rates.
• Specific activities like snowboarding and tennis showed higher pain correlation, while swimming and aquafit showed lower pain correlation.

Conclusions:

• Higher-intensity physical activities are not associated with adverse outcomes like decreased duration, worsened PROMs, or increased revision rates after THR.
• Certain high-impact activities may be linked to increased hip pain, but do not compromise implant longevity or overall function.
• Findings support patient counseling regarding safe and varied physical activity participation post-THR.