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Downhill Skiing After Total Knee Arthroplasty: A Systematic Review
Matthew Arnold1, Patrick Nicholas2, Conor Rankin2
1Dept. of Trauma and Orthopaedic Surgery, Forth Valley Royal Hospital, Larbert, United Kingdom; College of Medicine, Veterinary and Life Sciences, University of Glasgow, United Kingdom.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|November 29, 2025
Summary
Patients who underwent total knee arthroplasty (TKA) can safely return to skiing. Experienced skiers with good rehabilitation outcomes showed no increased risk of complications, with favorable functional and patient-reported outcomes.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Rehabilitation Science
Background:
- Downhill skiing is a popular sport with increasing patient interest post-total knee arthroplasty (TKA).
- Skiing poses biomechanical risks (torsional stress, high impact) potentially compromising knee implants.
- Current consensus on skiing safety and outcomes after TKA is lacking.
Purpose of the Study:
- To systematically review the literature on outcomes, risks, and expert opinions regarding skiing after TKA.
- To evaluate the safety and functional benefits of returning to skiing for TKA patients.
Main Methods:
- Systematic review following PRISMA guidelines, registered with PROSPERO.
- Searched Medline, Embase, Cochrane, PubMed, Scopus up to October 2025.
- Included studies reporting skiing-specific outcomes post-TKA; data extracted on study type, sample size, follow-up, outcomes, and findings.
Main Results:
- 21 studies included from 572 identified; many from a single research group.
- Return-to-skiing rates ranged from 47-51% post-TKA.
- No increased radiographic loosening or pain; improved tendon stiffness, gait symmetry, muscle strength; favorable patient-reported outcomes (Oxford Knee Scores >45, Tegner activity levels moderate-high).
Conclusions:
- Evidence suggests skiing after TKA is safe and beneficial for selected patients.
- Experienced skiers with good rehabilitation may return without increased implant complication risk.
- Larger, long-term, multicenter prospective studies are needed for definitive guidelines.
