After Joint Surgery, Little Increase in Activity Seen
Written by Editor   
Wednesday, October 25, 2017 07:13 AM

Physical activity among patients was not increased in the six months following total knee or hip arthroplasty a systematic review found.  This despite improvements in pain and quality of life.

In a meta-analysis of seven studies, there was no significant increase in physical activity at six months post-surgery, yet at that point in time, major improvements were seen in pain.  Moreover, inactivity can worsen function and contribute to obesity, which in turn raises the risk for joint failure and the need for revision procedures.

Improvements in life expectancy and the increased societal importance place on maintaining mobility at older ages have contributed to an increased number of candidates for total knee arthroplasty and total hip arthroplasty.  An estimated 11 million Americans will have had one of these procedures by 2030.

Because of the “dramatic increases” in both primary and secondary joint replacement procedures, a clear picture of patient outcomes is needed -- including the impact of surgery on physical activity, which has been shown to improve functional mobility, aerobic capacity, pain, and depression in patients with osteoarthritis.  Previous studies of post-surgery outcomes have focused primarily on pain and function, and little attention has been paid to changes in physical activity.

According to normative data, healthy older adults can be expected to walk 6,000 to 8,500 steps per day, and older adults living with disabilities 3,500 to 5,500, the authors note. Potential reasons for the lack of change in physical activity include a higher-than-expected activity level pre-surgery, the possibility that patients’ established sedentary lifestyle did not change, and a role for pain-related fear.

It is important to consider strategies to actively promote changes in physical activity. It also may be necessary to establish physical activity goals for all patients undergoing knee or hip replacement.