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Most return to the same sport at the same level of intensity
Athletes needing knee replacement have new reason to be optimistic about returning to the sports they love. Recent research from Cleveland Clinic shows that many athletes are able to resume activity, even on a competitive level, after having unicompartmental knee arthroplasty to eliminate pain and restore movement.
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“Traditionally, there has been a lot of caution around allowing patients to return to sports after joint replacement due to concerns about how it could affect survivorship of the implant,” says Nicolas S. Piuzzi, MD, Enterprise Vice Chair of Research for Orthopaedics and Rehabilitation at Cleveland Clinic. “I think that now, our data and others show that patients do well and that they’re able to return safely to higher levels of activity.”
Dr. Piuzzi and the Cleveland Clinic Adult Reconstruction Research team will present their data at the 2025 American Academy of Orthopaedic Surgeons meeting.
Their study included 224 athletes who had medial unicompartmental knee arthroplasty (mUKA) at Cleveland Clinic between 2016 and 2022 and completed a one-year follow-up. A total of 131 (58.5%) were able to return to sports, while 93 (41.5%) were not.
Of those who did return to sports, 60.3% returned to the same sport at the same level of intensity and performance, while 34.3% returned at a lower level. Another 5.4% subsequently took up a different sport.
The median time to return was 10 weeks.
“This was a bit surprising,” Dr. Piuzzi says. “I thought it was going to be a little longer, actually, if you think of the time that it takes to heal.”
By 25 weeks, 90% of those returning to sports had resumed their athletic activity.
Females were less likely than males to return (OR: 0.40, 95% CI: 0.19-0.82). People who had been competitive athletes had a greater chance of returning than did those who had been recreational athletes (OR: 0.02, 95% CI: 0.00-0.09).
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Dr. Piuzzi’s team continues to follow these patients, with no evidence so far of any adverse long-term outcomes of resuming athletics.
“These findings can guide patient expectations and inform shared decision-making about returning to sports after mUKA,” Dr. Piuzzi says. “Surgeons should consider these factors when counseling patients on their postoperative goals and potential barriers to resuming athletic activities.”
There is more work to be done, including investigating the likelihood of returning to specific types of sports and using activity monitors to gather quantitative data about an individual’s movement after surgery.
“If we have wearable sensors, we can determine the exact pathways of recovery and identify which ones are ideal,” Dr. Piuzzi says. “We’re trying to create truly personalized care pathways.”
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