Background Artificial joint replacement surgery is one of the most reliable procedures for the joint that has already seen an irreversible joint destruction as the means for pain relief and functional reconstruction even in the era of biologic agents. Total elbow arthroplasty (TEA) are also increasingly being performed to improve function and quality of life. Some patients who underwent TEA may wish to return to recreational and athletic activity, although there are few evidences about proper strength, duration, and little have been reported about complication rate in recreational and athletic activity after total elbow arthroplasty in contrast with total hip, knee, and shoulder arthroplasty 1,2. Therefore, we reviewed our patients after TEA about their function, activity of daily living, and athletic activity.
Objectives We aimed to investigate the relation between function and activity of daily living and both recreational and athletic activity in patients after TEA.
Methods 83 elbows of 69 patients after TEA were available for this study. There were 68 patients with rheumatoid arthritis and one patient with osteoarthritis. Average age (year-old) was 60.8 +/- 8.6, and follow-up period (month) was 80.3 +/- 43.4. They were examined about whether they had ever participated in recreational and athletic activities after TEA or not. Patients who had participated in recreational and athletic activities (group A) were asked the kind of sports they had. On the other hand, patients who had not participated in recreational and athletic activities (group B) were asked the reason why they had not. Their clinical condition of elbows after operation was assessed according to the scoring system of Japanese Orthopaedic Association (JOA) elbow score. They also examined about health assessment questionnaire - disability index (HAQ-DI), disability of arm, shoulder, and hand (DASH) score, Hand 20 score. Statistical analysis was performed between group A and group B on HAQ-DI, DASH, Hand20, and JOA score by Mann-Whitney U test.
Results 13 of 69 patients participated in recreational and athletic activities on various levels. The kind of sports they participated in were swimming (4 patients), playing catch (4 patients), badminton (3 patients), table tennis (2 patients), and others (2 patients). HAQ-DI, DASH, Hand20, and JOA score were 1.41+/- 0.80 (p=0.274), 35.8 +/- 23.2 (p=0.281), 30.4 +/- 23.8 (p=0.046), and 91.3 +/- 3.2 in group A (p=0.175), and 1.13 +/- 0.78, 43.5 +/- 24.6, 47.3 +/- 28.9, 89.3 +/- 7.6 in group B, respectively.
Conclusions Hand20 score were only related in participation in recreational and athletic activity, although their clinical condition of elbows were similarly excellent in both group A and B. The current study indicate that athletic activity might not deteriorate clinical condition of elbows after TEA, and that remaining function on upper extremity largely might influence patients’ decision to participate in recreational and athletic activity because most TEAs were performed for patients with rheumatoid arthritis.
Healy WL, Iorio R, Lemos MJ. Athletic activity after Joint replacement. Am J Sports Med 2001; 29: 377-88
Clifford PE, Mallon WJ. Sports after total joint replacement. Clin Sports Med 2005; 24: 175-86
Disclosure of Interest None Declared