Athlete running with healthy, pain free knees

The consensus of opinion is that jogging or running after a full knee replacement is not recommended, but is the advice correct?

“General advice after a total knee replacement is to avoid high-impact exercise such as running and jumping. These activities will increase wear of the artificial joint surfaces.” So says Arthritis UK.

“Running is an aerobic activity like walking, but it’s much more high-impact. For this reason, the AAOS (American Academy of Orthopaedic Surgeons) doesn’t recommend jogging or running after a total knee replacement,” says Healthline.

The NHS isn’t quite so specific, but it does suggest “Even after you have recovered, it’s best to avoid extreme movements or sports where there’s a risk of falling.”

That sounds like bad news for joggers and runners at every level, who need to find another form of stimulation once they’ve had a total knee replacement. Yet opinion is not unanimous. Speaking to Runner’s World, sports medicine specialist Dr J Hill of the University of Colorado in Denver said: “It’s certainly a controversial topic, but basically this is just a legend that’s been passed down from year to year that you shouldn’t run on them. The actual evidence [that high impact activity increases wear on artificial joints] really isn’t there.”

>  Discover more about total knee replacement

 

Partial performance

Modern knee replacement surgery (a process known as resurfacing) has achieved phenomenal success in terms of restoring patients’ quality of life.

Partial knee resurfacing tends to offer better functional results than total knee replacement, and the majority of patients who receive a partial knee resurfacing operation (known as ‘uni-compartment knee replacement’) experience far higher function in the knee. Many return to activities including golf, tennis, running and even skiing. This is because the ‘normal’ part of the knee is retained. Important ligaments in the centre of the knee are not removed and patients often report that the knee feels normal, have a better range of movement which enables them to, for example, kneel.

>  Discover more about partial knee replacement

 

Total agreement?

IF your knee is not suitable for a partial knee, modern total knee replacements still give a very positive outcome. There are many stories of individuals of all ages who continue a surprising degree of high impact activities. This story of a 71 year old’s return to competitive running is certainly inspirational!

Yet every condition has its exceptions and whilst Dr Hill is correct that the evidence isn’t really there to support a claim that people with replacement knees shouldn’t run, this may be more a reflection of the limited levels of research to date than a carte blanche instruction to patients to pull their running shoes back on.

Take a study in Japan that found no effect on joggers who resumed activities after total hip arthroplasty – yet only 3.8% of those studied actually resumed jogging activities after hip replacement.

In contrast, a French study (which again considered hip replacement – data for knee resurfacing is even more elusive) found that high impact activity made patients three times more likely to require revision surgery than those who kept to low impact activities.

 

Proceed with caution

Yorkshire Knee Clinic’s orthopaedic surgeons would certainly welcome more research into this area – but there does appear sufficient evidence to urge caution – for now. After all, even common sense suggests that a moving artificial joint will eventually wear when placed under stress, whether it’s in your knee, your hip or your washing machine.

So until we are satisfied that the evidence really does support a claim that running or jogging with a total knee replacement is safe, our position remains with the majority: it will increase the risk of wear. It will increase the risk of requiring revision surgery or a further replacement. And repeat replacements tend to be slightly less effective than the one before.

 

Want to know how a partial or total knee replacement could benefit you? Talk to Yorkshire Knee Clinic now.

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