Total hip arthroplasty is increasingly performed in younger, more active patients. Thirty-five percent of patients are involved in sports preoperatively, and a desire to return to sporting activity is now a major expectation. Sporting activity potentially risks premature failure of the implant, and there is no consensus or guidelines among British or European surgeons performing total hip arthroplasty in sporting patients.
The current practice of British Hip Society members was explored through a Web-based survey. Of the 260 members surveyed, 109 responded.
The majority of respondents (33%) would perform uncemented, 29.1% would perform hybrid, 15.5% would perform fully cemented, and 11.7% would perform a resurfacing hip arthroplasty for sporting patients. The preferred approach is the standard posterior (68.9%) and preferred bearing couples are ceramic-on-ceramic (39.8%) and ceramic-on-polyethylene (36.9%). Half of respondents would opt for a femoral head smaller than 36 mm, whereas 22.3% would use a head 36 mm or larger. A third would allow patients to return to sports between 6 and 12 weeks after surgery, whereas 43.7% advise patients to wait until 3 months postoperatively. All respondents allow patients to return to low-impact activities, but significant caution is exercised with regard to taking part in high-impact activities.
We report the practice of a specialist group of hip surgeons, the majority of which consider themselves young adult hip specialists. We believe that these data may be of use to help inform the practice of our colleagues when performing arthroplasty in sporting patients and may serve to inform future consensus guidelines.