Patients who have undergone total knee arthroplasty and have recovered, have the possibility to continue, under certain conditions, their sports activities.

The scientists point out, however, that six months is indicative, as there is no predetermined time of return to sports activities, but it depends on the personal recovery progress of each patient. In the vast majority of cases, the return to exercise and sports is recommended 6 months after the operation, after the doctor has examined the patient and judged that the postoperative course is smooth.

In which cases is the operation considered necessary?

Total knee arthroplasty is the only definitive treatment for end-stage osteoarthritis. In recent years and in relation to patients we were called to operate on in the past, patients who undergo knee replacement are now younger, or if they are elderly, they are quite active. There are many factors that contribute to the fact that younger ages decide to proceed with knee replacement. First, the high rates of obesity, one of the causes of cartilage destruction. Also, the inclusion of systematic exercise in the life of the population, which does promote good health, but at the same time increases the risk of post-traumatic arthritis. Finally, the good results of the surgery, which encourage more and more patients to seek an early solution for the discomforts they face in the knee. In this way, they have the possibility to return to their activities as early as possible, no longer face difficulty and pain, be able to participate in sports, continue to grow without functional problems and conquer the goals they set every day, maintaining and boosting their confidence.

When can a patient return to activities?

To date, many studies have been conducted on the time to return to sports activities in patients who have undergone knee arthroplasty. Most, however, have relied on the recommendations of doctors, based on their personal activity and love for sports, and not so much on scientific evidence. Most studies did not focus on a wide range of sports, but only on individual sports activities, such as skiing.

The factor influencing surgeons’ decision to return their patients to sports activities is their concern about possible complications for the patient after knee replacement.

Therefore, in order to collect the necessary data and prepare instructions to be given by the members of the European Knee Associates, a specialized Pan-European Knee Arthroplasty Society – Section of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), an online survey was carried out which was attended by 120 surgeons, members from 31 countries. The majority of participants (60.2%) said they exercised more than twice a week. Regarding frequency of surgery, 67.2% performed more than 50 total knee arthroplasties per year, while the largest group (31.9%) of surgeons reported performing between 51 and 100 total knee arthroplasties per year, demonstrating the extensive their experience. At the same time, 47 sports were examined, including those performed in America and Europe. Most members agreed to allow 5 different sports in the first 6 weeks after knee replacement, 7 sports from 6 to 12 weeks after surgery, 14 sports 3-6 months after, and 21 of 47 sports 6 months later.

These sports are:

• 6 weeks later: walking, climbing stairs, swimming, aqua aerobics and stationary cycling.
• 6 – 12 weeks after: cycling on flat ground and yoga.
• 12 weeks after: doubles tennis, golf, gymnastics/weight lifting, aerobics, walking, Nordic walking and sailing.
• 6 months after: mountain biking/hill biking, table tennis, rowing, canoeing, kayaking, skiing.

While those who love squash, they will have to take up another sport post-operatively, as this particular one did not receive the approval of the members of the European Knee Associates, even when more than six months have passed since the operation.

In addition, participating orthopedic surgeons in the study discouraged patients from engaging in:

• The first 6 weeks: jogging, running, tennis (singles), cross training, climbing, cross-country skiing. However, there was no consensus to recommend dealing with them after 1.5 months.
• The first 12 weeks: with road running, treadmill running, handball, football, basketball, full contact sports, martial arts. Beyond this time period, the surgeons did not reach a consensus conclusion.
• In the first 6 months: badminton, volleyball, canyoning, surfing, windsurfing, snowboarding, sledding. After 6 months, there was no consensus among participants.

Engaging in sports is therefore allowed, but not from day one. Nor does the same return-to-sport rule apply to everyone. The return to sports activities depends on the general condition of the patient, and on the rate of recovery, which is individualized and indeed the most determining factor for the time of return.

Intervention with the minimally invasive MIK technique

The surgical method chosen to repair the knee injury has an important role in the speed of recovery and the degree of return to sports activities. The performance of knee arthroplasty with minimally invasive technique MIK (Minimally Invasive Knee), where the surgical trauma and therefore the damage to the extensor mechanism of the knee, is much smaller compared to the classic technique, in combination with modern anesthesia protocols and recovery (Fast track), give a very important advantage. At the same time, it speeds up recovery for another reason, as it minimizes the chances of complications and the need for a blood transfusion, which entails risks of allergic reactions and infections. In addition, when the operation is performed using a robotic arm (computer assisted surgery), the surgeon is given the opportunity to pre-plan the operation and check during the operation the optimal placement of the implants, based on the pre-operative planning.

The way knee arthroplasty is performed, which is one of the most effective surgeries in terms of the expected result, plays a very important role in the quick return to normal everyday life, but also to favorite sports activities.

At the 6th Orthopedic Clinic of HYGEIA, we provide specialized services in the field of orthopedic surgery, with particular emphasis on minimally invasive techniques, such as AMIS techniques for the hip (hip arthroplasty) and MIK for the knee (knee arthroplasty), as well as arthroscopic techniques shoulder, ankle, hip, knee, fast track recovery protocols. Our goal is the immediate recovery of the problem, as well as the quick recovery and full return of the patient to his daily activities and his previous functionality.