Athletics following a Total Joint Replacement is a controversial topic within the orthopedic community and varies by region and comfort level of the orthopedic surgeon. The scientific literature on the subject is quite limited. Returning to exercise after a joint replacement does not necessarily imply a return to sports. The predictors of whether a patient will return to sports after a joint replacement were the subject of an article appearing in Clinical Orthopedics and Related Research by Williams et al., in 2012:Prior high level participation in a given sport 2) Male gender, 3) Low BMI, 4) Under 50 years of age. Be informed that return to sports after a TJR may not be feasible.
Stem Cells and Joint Replacement in Sports Medicine
In a recent study, of a population that underwent a Total Joint Replacement, only 32% were active after five years. Recipients of hip prostheses were twice as active as those who had undergone a knee replacement. The limits of our knowledge in part are based on the absence of a joint replacement registry in the United States. As a result, we are dependent on New Zealand, Australia, the United Kingdom and Scandinavia for our data. Basically, your participation in sports after a total joint replacement is at your own risk. What is that risk? A revision surgery in less than five years; one out of every 75 total knee replacements undergoes revision in 3 years.
Turning our attention to sports after Bone Marrow Aspiration Concentrate for an arthritic joint, there is no available scientific data to allow for generalizations. It is just too soon. The other problem is that I am one of the few orthopedic surgeons involved in Regenerative Medicine and the Anesthesiologists and Physiatrists who pioneered this modern approach to the non-operative care of arthritis do not use the same outcome criteria as that used in orthopedic surgery. Theirs is of a subjective measurement while ours is both subjective and objective. The net result is that, while I am gathering data on the patients I treat, at this time the best I can do is anecdote. In each and every Blog, I strive to feature the outcomes of my patients. You may read about those outcomes in my Blog Archives; but let me leave you with several observations drawn from my database to date as well as the findings of a scientific study in which I was the senior author:
1) The best outcomes for BMAC (Stem Cells) in arthritis have been seen in patients with class two to three arthritis and those with a low BMI
2) Studies including Knee Joint Biomechanics During Cycling in Patients with Total Knee Arthroplasty indicate the best sport and fitness routine for hip and knee osteoarthritis whether pretreatment, treatment with BMAC or a TJR is cycling
3) Swimming works as well (personal observation)