Return to Sports and Recreational Activity After Single-Stage Bilateral Short-Stem Total Hip Arthroplasty: 5-Year Results of a Prospective Observational Study

Abstract

Background: Single-stage bilateral total hip arthroplasty (THA) is an alternative to staged unilateral THA in patients suffering from bilateral hip arthritis; however, there is still broad concern regarding the safety and reliability of this procedure. Short-stem THA has emerged in recent years. To date, no data are available on sports and recreational activity levels after single-stage bilateral short-stem THA in the general patient population. Hypothesis: Patients who have undergone single-stage bilateral short-stem THA return to a satisfying level of sports and recreational activity at midterm follow-up. Study Design: Case series; Level of evidence, 4. Methods: A total of 54 consecutive patients (108 hips) were prospectively included. Midterm follow-up was performed in 51 patients (94.4%). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and the Harris Hip Score (HHS) were assessed clinically after a mean of 5.2 years. After a mean of 4.9 years, activity levels were assessed using the University of California, Los Angeles (UCLA) activity scale via a questionnaire. Additionally, a detailed evaluation of sports behavior was conducted using an additional questionnaire. Pain and satisfaction with sporting ability were assessed using a visual analog scale (VAS). Complications and revisions were documented. Results: Patients had a mean WOMAC score of 98.0 (range, 60.0-100.0) and HHS score of 97.8 (range, 65.0-100.0) at final follow-up. The mean UCLA activity score was 4.7 (range, 2.0-10.0). An increasing number of patients were active in sports at follow-up compared with before surgery (76.5% vs 60.8%, respectively); 2 patients (3.9%) stopped participating in sports on a regular basis, and 10 (19.6%) commenced with sports after surgery. The most popular activities before surgery were cycling (31.4%), hiking (29.4%), swimming (21.6%), and fitness/weight training (15.7%). At follow-up, most patients were engaged in cycling (35.3%) and fitness/weight training (33.3%), followed by swimming (25.5%) and hiking (19.6%). The duration (hours per week) and frequency (times per week) of sporting activities remained stable. The mean VAS pain level during sports was 1.3 (range, 0.0-7.0). No revision surgery had to be performed. Conclusion: After single-stage bilateral short-stem THA, the study patients returned to satisfying levels of activity at midterm follow-up. Postoperatively, few patients were engaged in high-impact sports; however, more patients commenced with lower impact activities. Satisfaction with sporting abilities was high, and the complication rate in total was low.