High- impact physical activity participation and 12-month risk of joint replacement: a longitudinal mediation analysis of 17 661 patients with knee or hip osteoarthritis

Key Points

1. Participation in high impact physical activity was associated with lower odds of hip replacement.

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BACKGROUND & OBJECTIVE

Clinical guidelines promote regular participation in physical activity in individuals with knee and hip osteoarthritis (OA) (1). Although, most recommendations advocate that individuals with OA participate in low-impact physical activity, evidence on the association between high-impact physical activity in those with hip/knee OA and risk of joint replacement is unclear.

This study’s primary aim was to understand whether high-impact physical activity increased the risk of total hip replacement (THR) and knee hip replacement (TKR) at 12 months in those with OA. Secondarily, the study aimed to understand if mediators such as pain intensity, functional capacity, and fear of joint damage by physical activity at three months would explain the relation between high-impact physical activity and joint replacement risk.

Clinical guidelines promote regular participation in physical activity in individuals with knee and hip osteoarthritis.

Higher-impact activity may be encouraged in appropriately selected patients with hip osteoarthritis.

METHODS

This longitudinal, registry- based cohort study used baseline, three, and 12-months data from the Good Life with osteoArthritis in Denmark (GLA:D) registry. GLA:D is a structured, group- based treatment programme for people with knee and hip OA that is aligned

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