Background:

Current recommendations on safe return to sports (RTS) after total hip arthroplasty (THA) are subjective and based on studies of varying quality.

Purpose:

The aim of this study was to synthesize systematic reviews and meta-analyses on post-THA RTS to propose practice guidelines identifying which sports can be resumed, when they can be resumed, and what risks are present.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

This umbrella review followed the Joanna Briggs Institute (JBI) protocol and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Embase, Medline, and Cochrane databases were searched. Included studies were either systematic reviews or meta-analyses addressing primary or secondary outcomes. Outcomes of interest included safe sports after THA, time to RTS, prognostic indicators of RTS, reasons patients do not RTS, percentage of patients who RTS, implant complications, and objective classification of sports by impact level. Included reviews had data extracted and were assessed for methodological quality using the JBI protocol. The authors defined RTS as “returning to a sport the patient participated in at any point preoperatively.”

Results:

Patients demonstrated a trend toward lower-impact sports postoperatively. Sports were classified as low (eg, walking), moderate (eg, downhill skiing), or high impact (eg, soccer). A total of 82% (range, 55%-104%) of patients were able to RTS at a mean time of 6 months (range, 4-7 months). The best prognostic indicator for RTS was previous experience in that sport. The main reason patients did not RTS was surgeon recommendation. Aseptic loosening was the most cited complication after RTS.

Conclusion:

Most patients are able to return to preoperative levels of low- (eg, walking) and moderate-impact (eg, hiking) sports between 7 and 12 months after THA. Patients planning a return to high-impact (eg, singles tennis) sports should be counseled on the possible risks of traumatic injuries and aseptic loosening and monitored closely.

中文翻译：

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全髋关节置换术后重返运动：对共识指南的综合审查

背景：

目前关于全髋关节置换术 (THA) 后安全重返运动 (RTS) 的建议是主观的，并且基于不同质量的研究。

目的：

本研究的目的是综合对 THA 后 RTS 的系统评价和荟萃分析，以提出实践指南，以确定哪些运动可以恢复、何时可以恢复以及存在哪些风险。

学习规划：

系统审查；证据等级，4。

方法：

该综合审查遵循 Joanna Briggs Institute (JBI) 协议和 PRISMA（系统审查和元分析的首选报告项目）指南。搜索了 Embase、Medline 和 Cochrane 数据库。纳入的研究是针对主要或次要结果的系统评价或荟萃分析。感兴趣的结果包括 THA 后的安全运动、到达 RTS 的时间、RTS 的预后指标、患者不进行 RTS 的原因、进行 RTS 的患者百分比、植入物并发症以及按影响水平对运动进行的客观分类。纳入的评论提取了数据，并使用 JBI 协议评估了方法学质量。作者将 RTS 定义为“恢复患者在术前任何时候参与的运动”。

结果：

患者在术后表现出进行低冲击运动的趋势。运动分为低强度（如步行）、中强度（如高山滑雪）或高强度（如足球）。共有 82%（范围，55%-104%）的患者能够在平均 6 个月（范围，4-7 个月）时进行 RTS。RTS 的最佳预后指标是以前在该运动中的经验。患者没有接受 RTS 的主要原因是外科医生的推荐。无菌性松动是 RTS 后引用最多的并发症。

结论：

大多数患者能够在 THA 后 7 到 12 个月之间恢复到术前水平的低强度（例如，步行）和中等强度（例如，远足）运动。计划恢复高强度运动（如单打网球）的患者应就外伤和无菌性松动的可能风险进行咨询，并密切监测。