[Does Sports Activity Influence Total Knee Arthroplasty Durability? Analysis with a Follow-Up of 12 Years].

Background  Total knee replacement is the only surgical option to treat painful degenerative osteoarthritis, restore knee function, improve quality of life, and enable patients to return to sports activity. With an aging population expecting an active life after retirement, patients' expectations of improvement after surgery are increasing as well. In view of the growing demand for higher performance, exercise and athletic activity, clinicians have been increasingly forced to question how much athletic activity a patient may resume after total knee replacement, and what types of athletic activity seem to be acceptable. However, there is currently no consensus on the appropriate intensity of physical activity after total knee arthroplasty or how activity levels affect the rate of revision surgery. Patients, material and methods  In a retrospective study with a follow-up period of 12 years, 130 patients were asked about their sport activities 22 months before and after total knee replacement. Based on their answers, the patients were divided into one sports group (group A) and one group without any sports activity (group B). Seven years after surgery the same patients were asked about their sports activity again, and 12 years postoperatively they were additionally asked about whether or not they underwent revision surgery. Results  Twenty-two months after total knee replacement 88 (67.7 %) of the 130 patients practiced sports for a minimum of 3 times a week (group A), whereas 42 (32.3 %) patients reported that they practiced no sports (group B). In 2010 - 7 years postoperatively - 60 patients of group A and 27 patients of group B took part in the survey; their levels of sports activity had not changed over the previous 7 years. In 2015, 46 patients out of group A and 21 patients out of group B were questioned. We saw a revision rate of 15.2 % (7 out of 46 patients) in the group with continuous sports activity, whereas we found an increased revision rate of 23.8 % (5 out of 21 patients) in the group without any sports activity 12 years after total knee arthroplasty. Conclusion  Our study showed that sports activity after total knee replacement led to a reduced revision rate in the sports group compared with the non-sports group. Therefore, more liberal recommendations should be given to patients regarding athletic activity after total knee arthroplasty. We conclude that moderate sports activities have no negative influence on total knee arthroplasty and may even lead to improved osteointegration with a decrease in osteolytic changes and less prosthesis loosening.