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SKIING AND MOUNTAINEERING AFTER HIP OR KNEE ARTHROPLASTY (REVIEW LECTURE)

MIKE RODGER ROYAL CORNWALL HOSPITAL, CORNWALL, ENGLAND
Skiers and mountaineers may consider undergoing Hip or Knee arthroplasty for life-changing disease. They should understand that skiing and mountaineering are high demand activities. Arthroplasty surgery may alter the biomechanics of the joint, making the muscles and stabilising soft tissues around the joint less efficient. Proprioceptive control is often reduced following surgery. Observational studies report after hip arthroplasty only half of the skiers return to skiing and after Uni-compartmental Knee Arthroplasty only one third of skiers return to skiing. Patients undergoing Total Knee Arthroplasty tend to have worse function compared to the Uni-Compartment Knee Arthroplasty patients. There does not appear to be a marked difference in the function following Hip Resurfacing Arthroplasty compared to a Total Hip Arthroplasty.When patients return to skiing and mountaineering after arthroplasty they are likely to increase the wear in the prosthetic joint and risk wearing the joint out. Prosthetic joints are at a higher risk of dislocation compared to native joints and although the risk of fracture is not much increased it is more difficult to manage. Revision surgery does not usually give results as good as primary surgery. However, surgeons encourage return to activity and most surgeons do not discourage patients from resuming easy skiing and climbing. Outcome relates to the surgical decision-making, surgical technique, use of a proven implant and the most consistent results come from well run units. Skiers and mountaineers are advised to choose a surgeon who does a lot of arthroplasty work.
Keywords: 
KEYWORDS: hip, knee, arthroplasty, joint, skiing, mountaineering, resurfacing, uni-compartmental, function.