Hip Replacements-For the Young and Very Active

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Interesting MedPage blog post this morning discussing the “carpet bombing” type advertising being used by manufacturers of hip replacement devices. Of note, the commentator brings up that recent TV ads for hip replacements have young patients who are climbing mountains, running, and participating in high level physical activity. Others have commented on this issue. Do these commercials accurately represent common post hip replacement activity levels? To find out, I performed a quick review of the medical literature this morning. One recent study published in the Journal physical therapy on post-op activity levels of patients with hip replacements concluded, “As among the general population, a considerable number of patients were found to be insufficiently physically active.” How about this research article from another medical journal on hip replacement patient activity levels which states, “At 2 years, 30.3% of participants reported moderate to severe activity limitation; at 5 years, 35% of participants reported moderate to severe activity limitation.” In this study patients with activity restriction were female, heavier, older, and were more likely to be depressed. Hip resurfacing has received much attention because it’s usually performed in younger and active patients who want to return to higher level physical activities. However, how about this study that looked at sports activity after hip resurfacing? The authors concluded, “Physical activity level increased with a shift toward low-impact sports. Duration of sports participation increased. High-impact sports activities decreased.” How about this study from outside the US, who’s authors concluded, “The most preferred activity in both groups was exercise walking and biking.” How about this study looking at range of motion and hip muscle strength after hip resurfacing? The study authors concluded that while post-op pain was less in most patients, “However, the surgical procedure, particularly the division of the external hip rotator muscles led to specific external rotation strength and ROM deficits. Because typical spontaneous physical activity could not restore hip function, there is a need for specific postoperative rehabilitative programs.” Conclusions? While there may be very active patients after hip replacement, the makers of hip replacements devices are painting a picture of hip replacements for young very active people that doesn’t represent the activity level of the majority of patients after hip replacement.

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