title: Does impact sport activity influence total hip arthroplasty durability?
abstract: BACKGROUND
  Return to sport is a key patient demand after hip arthroplasty and some patients are even involved in high-impact sports. Although polyethylene wear is related to the number of cycles and the importance of the load, it is unclear whether high-impact sport per se influences THA durability.
  
  
  OBJECTIVE
  Therefore, we compared (1) function between the patients involved in high-impact sports and the patients with lower activities as measured by the Harris hip score (HHS) and the Hip Osteoarthritis Outcome Score (HOOS); (2) linear wear rates; and (3) survivorships considering revision for mechanical failure with radiographic signs of aseptic loosening as the end point.
  
  
  METHODS
  We retrospectively identified 70 patients who engaged in high-impact sports and 140 with low activity levels from among 843 THAs from a prospectively collected database performed between September 1, 1995, and December 31, 2000. Patients were evaluated at a minimum followup of 10 years (mean, 11 years; range, 10-15 years) by two independent observers. We obtained a HHS and HOOS at each followup.
  
  
  RESULTS
  The mean HOOS was higher in the high-impact group for three of the five subscales of the HOOS. Mean linear wear was higher in the high-impact group than in the low-activities group. We also found a higher number of revisions in the high-activity group.
  
  
  CONCLUSIONS
  Our observations confirm concern about the risk of THA mechanical failures related to high-impact sport, and patient and surgeons alike should be aware of these risks of mechanical failures.
  
  
  METHODS
  Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: APHM, Center for Arthritis Surgery, Hospital Sainte-Marguerite, Aix-Marseille University, Marseille, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Ollivier
authors.forename: Solenne
authors.initials: S
authors.lastname: Frey
authors.forename: Sebastien
authors.initials: S
authors.lastname: Parratte
authors.forename: Xavier
authors.initials: X
authors.lastname: Flecher
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Argenson
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013177:Sports