Introduction and Aims: There is very little scientific evidence of which activities to avoid or which are safe following total hip arthroplasty (THA). Our aims were to conduct a survey of Canadian orthopaedic surgeons’ exercise recommendations after THA and to examine the relation between physical activities and hip pain in THA patients.

Method: Patients who had a primary THA five to seven years previously because of osteoarthritis were administered the well-validated Minnesota Leisure-Time Physical Activity Questionnaire, which assesses the frequency, intensity and duration of physical activities. Patients reported on current physical activities and sports and recalled activity two years after their surgery. They also reported whether they had pain in the affected hip during specific activities and if they reduced their activity because of pain. A survey was mailed to 466 Ontario orthopaedic surgeons to determine the types of physical activities recommended to patients following THA.

Results: Results of the surgeon survey indicate that all surgeons allowed walking, stair climbing and swimming. Nearly all did not allow jogging, squash or racquetball. There was considerable disagreement among the surgeons regarding other activities, e.g., downhill skiing and heavy household activities. Seventy-one male (mean age ± SD; 61 ± 8) and 97 female (61 ± 7) THA patients were interviewed. Over 80% of respondents reported bending and lifting activities. About half the respondents reported non-weightbearing activities such as swimming. A higher proportion of men than women reported golf, racquet sports and shovelling snow, whereas a higher proportion of women than men reported doing housework. Hip pain was most frequently reported during lifting and bending activities. Patients were least likely to report pain during non-weightbearing activities. Nearly all patients who reported pain, reduced their activity level. Thus our preliminary data suggest that bending and lifting impact activities appear to cause the most pain and result in reduced activity levels. Our results also show that some patients participate and experience pain in non-recommended activities. Some allowed activities, such as stair climbing, cause pain.

Conclusion: Bending and lifting activities cause the most pain and result in reduced activity. Patients participate and experience pain in activities that surgeons do not recommend. Some recommended activities cause pain. This is one of the first studies to quantify activity and show a relation between activities and pain in THA patients.