Introduction. Previous systematic reviews have shown that patients experience low physical activity levels following total hip replacement (THR). However no previous systematic reviews have examined the changes between pre- and post-operative physical activity levels. Methods. AMED, MEDLINE, EMBASE, CENTRAL, CINHAL, openSIGLE, . ClinicalTrials.gov. and UK Clinical Trials Gateway databases were searched to 19. th. May 2015. All study designs presenting data on physical activity at pre- and up to one-year post-operatively were included. Eligible studies were critically appraised using the Cochrane risk of bias tool (for randomised controlled trials (RCTs)) and the CASP tool (non-RCTs). Where possible, mean differences (MD) and 95% confidence intervals (CI) were calculated through meta-analyses. Results. From 3850 citations, 16 met the eligibility criteria; nine included in the meta-analysis. The quality of the evidence was graded low to moderate. There was no statistically significant difference in physical activity pre- to one year post-THR when assessed using: movement-related activity (MD: −0.08; 95% CI:- 1.60 to 1.44; I. 2. =0%; n=77), percentage of 24 hours spent walking (MD: −0.21; 95% CI: −1.36 to 0.93; I. 2. =12%; n=65), six minute walk test (MD: −60.85; 95% CI: −122.41 to 0.72; I. 2. =84%; n=113) or the cardiopulmonary exercise test (MD: −0.24; 95% CI: −1.36 to 0.87; I. 2. =0%; n=76). Discussion. There is no evidence to suggest that physical activity changes pre- compared to post-THR. The low methodological quality of the included papers means this finding should be viewed with caution. Further research is warranted to better understand the relationship between physical activity pre- and post-THR, as greater consideration may be needed to increase physical activity in this population post-operatively. Conclusion. Surprisingly, there is no significant change in physical activity following THR. Surgeons, physiotherapists and patients should consider how to increase and maintain physical activity levels to maximise the potential for wider-health benefits following THR

The Kent hip is a distally-locked femoral stem which was developed to address severe proximal bone loss, severe bony deformity and peri-prosthetic fracture.

We reviewed the results of 145 consecutive Kent hips implanted into 141 patients between 1987 and 2000. The indications for implantation were aseptic loosening (75 hips), septic loosening (two), peri-prosthetic and prosthetic fracture (37), severe bony deformity (24), and fracture through a proximal femoral metastasis (seven).

The median time to full weight-bearing after surgery was two days and the mean length of follow-up was 5.1 years (2 to 15). Further revisions were required for 13 femoral stems. With removal of the stem for any reason as an end-point, the cumulative survival at five, ten and 15 years was 93%, 89% and 77%, respectively. In patients aged ≥ 70 years, the cumulative survival at 15 years was 92%, compared with 68% in those aged < 70 years. Because of these findings, we recommend the use of interlocking stems in patients aged ≥ 70 years, particularly in those with a peri-prosthetic fracture, for whom alternative methods are limited. Outcome scores and survival data, compared with other systems, indicate that the Kent hip should be used with caution in younger patients.