Return to Sports After Total Hip Arthroplasty: Keep your (Femoral) Head in the Game – A Narrative Review

Summary Background Demand for Total Hip Arthroplasty (THA) continues to rise worldwide with the largest absolute increase of procedures in patients younger than 65 years. Return to Sports (RTS) is now the third greatest expectation for patients awaiting THA. This review highlights the benefits and complications of RTS, an approach to safe RTS after THA and current guidelines. Findings Functional outcomes after THA are better for patients that RTS and when experienced surgeons naturally adopt more lenient activity limitations. Systematic reviews have found the most common reason patients do not RTS is attributed to advice given by healthcare professionals and not due to any functional limitations. The hesitancy to recommend RTS is not unfounded with reports demonstrating increased risks of implant wear rates and periprosthetic fractures, particularly associated with high-impact activities. There is no international consensus on safe RTS and pre-operative participation may supersede generalized restrictions for all patients after THA. Conclusions Recommendations should be carefully considered on individualized assessment. Multidisciplinary team rehabilitation should be implemented to ensure patient satisfaction.