A high physical activity level after total knee arthroplasty does not increase the risk of revision surgery during the first twelve years: a systematic review with meta-analysis and GRADE

Key Points

1. This systematic review and meta-analysis demonstrated no association between high physical activity level and an increased risk of all-cause revision surgery (level of certainty: very low) or revision surgery due to aseptic loosening (level of certainty: moderate) during the first 12 years following total knee arthroplasty (TKA).

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BACKGROUND & OBJECTIVE

High physical activity levels are thought to be an important patient-related factor influencing implant survival following total knee arthroplasty (TKA). However, current guidelines on activity recommendations following TKA are mainly based on expert consensus (1).

Therefore, the objective of this systematic review was to examine the association between activity levels and the risk of revision surgery at medium (3–10 years) and long term (>10 years) follow up in patients with primary TKA.

High physical activity levels are thought to be an important patient-related factor influencing implant survival following total knee arthroplasty.

Activities involving loading at greater angles of knee flexion may place undue stress on the implant bearing surface and accelerate wear of the polyethylene insert.

METHODS

• The authors conducted a systematic review with meta-analysis. Cohort and case-control studies with a minimum follow-up of 3 years following TKA were included.

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