Total Hip and Knee Replacement in the Mature Athlete

CONTEXT: Total hip replacement and total knee replacement are among the most successful and common surgical procedures in orthopaedics. These operations were traditionally reserved for older, sedentary patients. However, these are now being increasingly performed in patients expecting to return to athletic activities. EVIDENCE ACQUISITION: The peer-reviewed medical literature was searched via PubMed from the years 2000 to 2013. Those studies pertinent to modern hip and knee replacement in an athletic population were selected for inclusion. STUDY DESIGN: Literature review. LEVEL OF EVIDENCE: Level 4. RESULTS: There is a lack of high-quality evidence in the peer-reviewed literature relating to the replacement of hips and knees in younger athletic patients. Although many patients undergoing joint replacement are active in recreational activities, a minority engage in high-impact sports. Following surgery, overall activities tend to increase, but high-demand athletic activities may be limited by pain, functional outcome, or activity restrictions imposed by health care providers. CONCLUSION: Patients receiving hip and knee replacements should be counseled in that returning to high-impact and repetitive-loading athletic activities after surgery may shorten the life span of their implant. STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT): C.