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Study: No Correlation Between Physical Activity and Knee Revision Surgery


Sports Knee pain concept. | Image by CLIPAREA l Custom media, Shutterstock

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A recent meta-analysis of five different studies found no correlation between high physical activity and revision surgery up to 12 years following knee replacement surgery. Revision surgery refers to the replacement of prosthetic implants in a person who previously had a total knee replacement.

In total, the meta-analysis reviewed data from 4263 patients with a follow-up 4-12 years post-op.

Following knee surgery, the researchers suggest that current guidelines recommend low-impact sports such as “swimming, golf and normal walking” and discourage people from jogging after total knee arthroplasty (TKA).

Healthline, a medical website, corroborates the common sentiment discouraging people from engaging in “contact sports” such as soccer, football, skiing, etc.

The Netherlands-based researchers claim that such recommendations stem from expert opinion rather than peer-reviewed data.

“During the first 12 postoperative years after TKA, there seems to be no increased risk for revision surgery for patients with a [high physical activity] level compared with patients with a [low physical activity] level.”

The study, led by researchers at the Sports & Orthopedics Research Centre of Anna Hospital in the Netherlands, comes as a surprise to some Orthopedists who associate high levels of activity with aseptic loosening.

Aseptic loosening is when a space forms between the mechanical knee and the bone for any reason apart from infection. Aseptic loosening is a serious complication and is often very painful. If the aseptic loosening is severe enough, the knee replacement may require revision surgery which carries lower levels of success.

Similar studies also found that patients are able to return to athletic activity with little risk of aseptic loosening.

“There is little evidence in the literature of an association between high activity levels and early implant failure,” wrote Jassim et. al in a 2014 study.

Another 2004 study also found little correlation between high physical activity and risk of revision. Instead, it found individuals with a high BMI were more likely to need revision surgery. As a result, the researchers concluded that “individuals undergoing primary TKA should be encouraged to remain active after surgery.”

For former runners recovering from a knee replacement, the Netherlands study suggests hope for those itching to reestablish a jogging routine. Knee replacement patients should consult a doctor before resuming high-impact sports.      

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