Summary

Goal-based RTS criteria have reduced time to sport compared to time-based criteria. Patients continue to improve for a considerable period after returning to sport.

Abstract

Introduction

There is no consensus over time to return to sport (RTS) following arthroplasty; patients are usually given a period of three to six months. The objectives of this study were to determine criteria that would allow earlier return to sport than the time-based method.

Patients & Methods
This prospective study included 50 patients that participated in amateur sports before the onset of their knee arthritis. The study included 28 males and 22 females with a mean age was 62 ± 4.5 years. All study patients underwent Total Knee Arthroplasty (TKA) by a single surgeon, and received a milestone-based rehabilitation programme with the goal of getting back to golf or tennis at the earliest opportunity. Functional outcomes were recorded after surgery at 3,6,9 and 12 weeks, and gait analysis was performed using a force plate treadmill after 3 months, and 24 months. Mean follow-up was 27.8 months (range, 24 to 35 months).

Results

96% (48) returned to their goal level of sporting activity. Mean time for full RTS activity was 10 ± 3.5 weeks, although some patients were able to start as early as 4 weeks after surgery. At two years follow-up, study patients had improved mean Oxford knee scores (40 ± 3.1 vs 16 ± 3.5 respectively, p<0.001), Forgotten Joint scores (46 ± 8.5 vs 8 ± 3.5 respectively, p<0.001) and improved lower extremity functional scores (68 ± 3.2 vs 29 ± 2.2 respectively, p<0.001) compared to preoperative values. Gait analysis revealed significantly better cadence, walking speed, stride length and stance time, for all sporting activities at 24 months compared to 3 months.

Conclusion

Goal-based RTS criteria have reduced time to sport compared to time-based criteria. Patients continue to improve for a considerable period after returning to sport.