Hip

The World Sports Trauma Congress will bring together the finest Faculty in Sports Orthopaedic Surgery and allied specialisms.  A comprehensive programme will cover a variety of areas of interest for Hip Surgeons. There will be sessions on groin pain, on femoroacetabular impingement, on hip pathology in the young and on sport after joint replacement.

There are many areas of great interest and debate in hip surgery at the moment and these include our quest to optimise activity levels and sport after hip arthroplasty. The Congress will include a session on sport after joint replacement. Expert will deliver their protocols and the current literature. Hip Surgeons are encouraged to attend in order to debate the management of end stage hip arthritis in the young and active.

Epidemiological studies have clearly demonstrated that athletes face a greater likelihood of developing hip and knee osteoarthritis in their lifetime. Consequently, as the demand for hip and knee arthroplasty surgery increases, surgeons will be faced with ever-younger patients who have higher expectations of their prosthetic joints. Whilst pain-relief and improved mobility will continue to be the primary aim, a secondary consideration is the ability to participate in sports post-operatively.

On the one hand, it has been demonstrated that repetitive forceful loading of prosthetic implants may predispose to osteolysis and aseptic loosening. However, consensus amongst orthopaedic surgeons lacks consistency when allowing patients to resume sporting activities following hip arthroplasty, and over which sports are considered safe. It is widely agreed that low-impact sports such as swimming, cycling and golf are deemed acceptable, whilst impact and higher load-bearing activities such as jogging, weight-lifting and contact sports should be discouraged.

There is evidence that patients increase their level of sporting activity after hip replacement. However, those engaging in high levels of activity are almost five times more likely to require revision surgery. There is a clear correlation between pre-operative function and post-operative athletic participation. It has been shown that those who lead sedentary lifestyles prior to hip arthroplasty seldom take up sports post-operatively, whilst keen sportsmen and women are more likely to persist with their hobbies following surgery. Pre-operative exercise levels, male sex, and lower BMI are all good prognostic indicators for athletic participation after hip arthroplasty. Careful consideration of these factors, combined with appropriate prosthetic choice and good surgical technique are critical for these patients.
               
Knowledge of current evidence regarding sport after joint arthroplasty will enable lower limb surgeons to provide accurate information to their patients and thereby achieve more realistic expectations from their surgery.

We plan that the World Sports Trauma Congress will lead a meeting of minds of Hip Surgeons and their Sports Medicine and Sports Orthopaedic colleagues in order to move key questions and debates in Sports Hip Surgery forward in an appropriate way.

Prof. Fares S Haddad, BSc MCh (Orth) FRCS (Orth) FFSEM