Return to athletics after total knee arthroplasty
A May 2024 study in the journal Archives of Orthopaedic and Trauma Surgery (1) from the Department of Orthopedic Surgery, NYU Langone Health examined if and when knee replacement patients were able to return to recreational activity following a total knee replacement, patient population.
- The researchers followed up on 1,063 patients who had elective total knee replacement between June 2011 and January 2022.
- Of the 1,063 patients, 784 indicated being active in sport. These sports were:
- Cycling – 273 patients or 34.8%.
- Swimming – 228 patients or 29.1%.
- Jogging – 68 patients or 8.7%.
- High-impact team sports – 64 patients or 8.2%.
- Tennis – 63 patients or 8.0%.
- Skiing – 55 patients or 7.0%.
- Running – 33 patients or 4.2%.
According to the paper: “The majority of respondents were “satisfied” or “very satisfied” with their return across all sports, though dissatisfaction was highest among runners and joggers.”
In March 2022, a study in the journal Bone and Joint Open (3) made these general recommendations as to what sports patients could or should not be recommended following knee replacement:
Recommended as a low-impact activity
- Walking
- Golf
- Biking
- Stationary cycling
- Ballroom dancing
- Water aerobics
- Bowling
- Table tennis
- Jazz dancing and ballet
- Bicycling
Recommended if the patient had prior experience in this sport or activity:
- Hiking
- Doubles tennis
- Downhill skiing
- Horseback riding
- Ice skating
- Rock climbing
- Low-impact aerobics
- Doubles tennis
- In-line skating
- Downhill skiing
Possible return to activities as
Not recommended, but a collective decision between patient and physician can be made:
- Baseball
- Basketball
- Running
- Soccer
Return to cycling after total joint replacement
Doctors at Colorado Joint Replacement wrote in a May 2024 paper (2) in The Journal of Arthroplasty, about their patient outcomes in being able to return to cycling after a knee and or hip joint replacement or replacements. Patients in this study had: single total hip replacement, single total knee replacement, multiple knees and hip joint replacement, and a revision joint replacement surgery.
- 94% of patients who were cycling before surgery, were able to return to cycling
- There were 41.8% who returned to cycling less than three months after surgery.
- Most cyclists were able to return to their previous level.
Patients who had a revision joint replacement surgery had significantly lower rates of returning to cycling. Patients who never returned to cycling had higher revision rates in comparison to those who were able to get back on a bike.
Undertaking high-impact activities after surgery
A January 2025 (4) study form Australian university researchers compared knee replacement patient expectations for activity before the surgery with patient reported outcomes at three months after the surgery. Data were collected from 861 knee replacement patients, 43% of the patients considered return to sports or activities as an important factor. The doctors found patients have expectations for returning to high-impact activities after surgery. At 3 months after surgery, less impactful activities were more commonly satisfied (67%).
References
1 Lawrence KW, Bloom DA, Rajahraman V, Cardillo C, Schwarzkopf R, Rozell JC, Arshi A. Return to athletics after total knee arthroplasty: a survey study of 784 recreational athletes across 12 sports. Archives of Orthopaedic and Trauma Surgery. 2024 May 22:1-0. [Google Scholar]
2 Driesman A, Johnson RM, Yang CC, Miner TM, Dennis DA, Jennings JM. Return to Cycling After Total Joint Arthroplasty. The Journal of Arthroplasty. 2024 May 18. [Google Scholar]
3 Meena A, Hoser C, Abermann E, Hepperger C, Raj A, Fink C. Total knee arthroplasty improves sports activity and the patient‐reported functional outcome at mid‐term follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy. 2023 Mar;31(3):905-13. [Google Scholar]
4 Ribbons K, Payne K, Ditton E, Johnson S, Wills A, Walker FR, Pollack M, Nilsson M. Determining patient activity goals and their fulfillment following total knee arthroplasty: Findings from the prospective, observational SuPeR Knee study. PloS one. 2025 Jan 24;20(1):e0317205. [Google Scholar]