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Return to sports after knee replacement

The decision to return to sports after a knee replacement is one that should be made in consultation with your surgeon and physiotherapist. Your overall satisfaction with the outcome of the surgery and your pre-operative condition would have some bearing on whether you are able to return to sports or not.

Let us look first at what makes up a successful outcome to knee replacement.

  1. No pain during walking on flat surfaces.
  2. Return of mobility in the knee joint. You should be able to bend your knee to 105 degrees, which is sufficient for most daily activities such as getting in and out of a vehicle, climbing up and down stairs.
  3. A feeling of well being. Constant, nagging pain before the surgery may have resulted in a depressed mood. This changes as the person realises the surgery was successful.
  4. No pain with stair climbing.

If you were an active athlete before the surgery, you would expect to return to sport afterward. However, your doctor and physiotherapist may recommend that you switch from high-impact to low-impact sports such as cycling, swimming, skiing or golf. The reason is that high-impact sports such as running, jumping, soccer or tennis put a lot of stress on the prosthesis. This may lead to premature failure of your knee, loosening of the prosthesis and even fracture of the skeleton around the knee and other trauma.

Some athletes, especially the younger ones, may have had a knee replacement in hopes of increasing their level of participation and may not be satisfied with switching to a less strenuous activity. If that is the case, and they are training to meet that level, the surgeon should explain the risks involved in high-impact sports versus low-impact sports. He should also explain the risk of total knee failure in endurance training, although there are no statistics to support this view.

Patients should also understand that they may have to postpone their activities until the musculature around the knee is sufficiently strong in order to protect the joint and avoid trauma. If they are prepared to take that risk, then they should be allowed to play. Just as long as they keep in close contact with their doctor and physiotherapist.


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