Study: Hip replacement improves quality of life, but not activity

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This is the result of a new study that shows that a total hip replacement does not lead to more physical activity on its own.

Given the pervasive beliefs we have about hip replacements, this is a remarkable finding – that joint pain is everything that stands between our elders and the dust that builds up on their ellipticals. With a new femoral cap, our feet will no longer lie idle, exercise will follow and the pounds will fall off like empty bottles of soaking salt.

Instead, it turns out that topping up the exercise is the exception rather than the rule when it comes to bringing a new ball and pan into the space behind the front pocket.

The study, conducted by a team of Australian researchers and published in the Journal of Bone and Joint Surgery, examined activity patterns and other functional markers in 51 hip replacement patients, on average 66 years of age, before and after getting a new hip.

The project didn’t just report back in a week. The authors waited patiently and performed activity assessments one year after the surgery was completed, and then another year after, using the truth-finding methods of wrist-worn activity trackers.

The data from these tapes was added to the researchers’ other ratings, measurements, and questionnaires, which told a story of patients who reported less pain, increased quality of life, and improved walking biomechanics, speed, and stride length.

But unfortunately not a minute less was spent in the stationary configuration. On average.

Instead, the authors found that the patients were sedentary nineteen and a half hours a day before and after the operations. Again on average.

That’s a big detail, says Dr. Michael Taunton, orthopedic surgeon at the Mayo Clinic.

“So there are some patients because they get older and they become less active,” he said. “There are also the few very young patients with endoprosthetics who actually increase their activity dramatically. The study isn’t wrong, but it doesn’t tell the full story. “


Dr.  Michael Taunton.  Photo courtesy of Mayo Clinic.

Dr. Michael Taunton. Photo courtesy of Mayo Clinic.

Those new hips won’t push you to the gym

“I think we keep seeing that,” said Taunton, who has nothing to do with the study. “That the patients are generally not more active before and after the endoprosthetics.

“If someone hasn’t been very active for ten years because their hip hurts, then no, they won’t go back to where they were ten years ago.”

If you measure the number of steps a day someone takes before and after the endoprosthetics, Taunton says: “Actually, it doesn’t change much. I think many things play a role.”

For starters, Taunton says, the population undergoing hip replacement is often at a stage in life where they are slowing down, regardless of the limitations caused by joint pain.

“Sometime around the age of 70 you start to lose weight physically,” he says. “It’s inevitable … I hear a lot of patients say, ‘If I could replace my hip, I could be so much more active’. It’s in the same vein as, ‘If I could replace my hip or my knee could decrease. ‘

“We found … that patients by and large do not lose weight after a hip or knee replacement. Some patients do. But what we are talking about is averages. If someone does not lead a very active lifestyle preoperatively.” “They are unlikely to change and become exceptionally active people.”

For the extremely active, however, there is good news, as it turns out that artificial hips can take a lot of beatings.

Taunton offers an anterior tissue sparing procedure that avoids severing muscles, and for those patients who qualify, they exit the procedure with a hip without asterisks.

“I see her again when I am three months old and I say, ‘You have no restrictions at this point,'” he says. “‘I say that’ You should let pain guide you, but the more active and stronger you get, the better you will feel. ‘

“I’m really trying to emphasize to them that they don’t have any restrictions on their joints.

Taunton says he has artificial hip receivers that professional sports do, and everything is down.

“I have people in the older population who play waterskiing, downhill skiing, hiking, tennis, and pickleball,” he says. “The sky is the limit. The limits are much more down to the general physical fitness of the patient than to the joint replacement.”

But you need to get out of your preoperative routine.

“Sometimes people feel like they go out and walk every day to make them strong,” he says, “and that’s not the case.

For their part, the Australian authors advised health systems to offer a more multifaceted model of care after hip surgery, in short a hip surgery that also identifies activity barriers after hip surgery.

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