Hockey Doc

The Hockey Doc: Hockey after hip replacements

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Last Updated on Sunday, 27 May 2012 23:31

By Dr. Rob LaPrade
http://drrobertlaprademd.com

Question: I am a 65 year old University professor with hip arthritis who still enjoys playing hockey. Is there any evidence concerning the impact on hip replacements of participation in “old guy” recreational ice hockey?

Answer: This is a very good question in which specific hard research has not been done to date. It is well recognized that hockey players have a high risk of developing hip arthritis so this is a great question. What it all boils down to is to use common sense in deciding whether to resume on-ice activities after a total hip replacement.

Hip arthritis is a very common ailment which appears to be primarily due to the effects of aging. Hip arthritis is caused by a loss of the articular cartilage on the end of the two bones which form the ball and socket of the hip joint. Over time, patients usually lose hip flexion, internal rotation, and abduction which can interfere with skating. Patients can also be limited by pain which classically occurs in the groin area and not the outside of the hip. As increasing numbers of baby boomers reach the age where they are having joint replacements, their higher level of activities has resulted in many continuing to play various types of sporting events after joint replacements which previous generations did not do.

In your case, the two biggest risks to you of returning back to skating activities would be a dislocation of the hip prosthesis or a fracture around it. While these risks are felt to be low, they are present and would vary depending upon the type of prosthesis implanted and the overall quality of the bone around your hip. Talking to your orthopaedic surgeon to consider an increased femoral head size to increase the femoral head-neck ratio may help to minimize a total hip replacement from levering out and dislocating may potentially be useful for patients who anticipate playing hockey after a joint replacement. In addition, using appropriately sized breezers with padding would help to minimize the risk of a fracture around the prosthesis if you had any on-ice collisions or contact against the boards.

Overall, it is recommended that patients who skate after a total hip replacement participate in a hip and lower extremity strengthening program to make sure that the muscles are strong enough to hold the total hip prosthesis in place. There should be no specific limitations to backwards skating, crossovers, or leg extensions in abduction if one follows these recommendations.

To summarize, it is possible to continue your on-ice hockey activities after a total hip replacement. However, there is a slightly increased risk of injury and it’s important that you take that in consideration for whether you will resume your hockey career after a total hip replacement. Participating in a good lower extremity strengthening program and wearing appropriately padded breezers will help to minimize the main risks to you after a total hip arthroplasty.

Robert F. LaPrade, M.D., Ph.D. is a complex knee surgeon at The Steadman Clinic in Vail, Colorado.  Dr. LaPrade is also the Chief Medical Research Officer at the Steadman Philippon Research Institute. If you have a question for the Hockey Doc, e-mail it to This email address is being protected from spambots. You need JavaScript enabled to view it. .