Why Patients Do Not Participate in Sports Activities After Total Knee Arthroplasty

BACKGROUND: It is important to identify the reasons or factors preventing patients from participating in sports activities after total knee arthroplasty (TKA) to improve patient satisfaction and general health that can be gained from regular sports activities. PURPOSE: To determine the reasons for lack of participation in regular sports activities after TKA as perceived by patients and to identify specific factors involved. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 369 patients with a follow-up longer than 1 year after TKA were included in this retrospective study. A postal survey regarding sports activities was conducted using a questionnaire gathering information such as sociodemographic data, activity levels, and sports activities after TKA. The reasons perceived by patients for not participating in sports activities were determined. Patients unable to participate in sports activities were compared with patients able to do so in terms of sociodemographic data and pre- and postoperative outcomes. RESULTS: Of the 369 patients, 88 (24%) replied that they could not participate in a sports activity. Among the perceived reasons, reasons not related to the replaced knee were more frequent than those related to the replaced knee (76% vs 24%). Symptoms related to the spine or other joints composed 25% of the total perceived reasons. The presence of medical comorbidities accounted for 16%, while symptoms in the nonreplaced knee represented 8% of the reasons. In terms of patient factors, multivariate logistic regression revealed that male sex, a floor-based (ie, non-Western) lifestyle with greater demands on knee flexion, and worse postoperative University of California at Los Angeles activity scale were associated with nonregular sports activity levels. CONCLUSION: The perceived reasons and patient factors hindering regular sports activities after TKA were not restricted to problems with the replaced knee. Nonetheless, orthopaedic surgeons may have a substantial role in encouraging patients to participate in sports by resolving joint-related problems. Furthermore, this study supports the notion that a multidisciplinary approach is needed to improve sports participation after surgery.