Risk of revision arthroplasty surgery after exposure to physically demanding occupational or leisure activities: a systematic review
Risk of revision arthroplasty surgery after exposure to physically demanding occupational or leisure activities: a systematic review
Introduction: lower limb arthroplasty is successful at relieving symptoms associated with joint failure. However, physically-demanding activities can cause primary osteoarthritis and accordingly such exposure post-operatively might increase the risk of prosthetic failure. Therefore, we systematically reviewed the literature to investigate whether there was any evidence of increased risk of revision arthroplasty after exposure to intensive, physically-demanding activities at work or during leisure-time.
Methods: we searched Medline, Embase and Scopus databases (1985—July 2021) for original studies including primary lower limb arthroplasty recipients that gathered information on physically-demanding occupational and/or leisure activities and rates of revision arthroplasty. Methodological assessment was performed independently by two assessors using SIGN, AQUILA and STROBE. The protocol was registered in PROSPERO [CRD42017067728].
Results: thirteen eligible studies were identified: 9 (4,432 participants) after hip arthroplasty and 4 (7,137participants) after knee arthroplasty. Narrative synthesis was performed due to considerable heterogeneity in quantifying exposures. We found limited evidence that post-operative activities (work or leisure) did not increase the risk of knee revision and could even be protective. We found insufficient high-quality evidence to indicate that exposure to physically-demanding occupations increased the risk of hip revision although “heavy work”, agricultural work and, in women, health services work, may be implicated. We found conflicting evidence about risk of revision hip arthroplasty associated with either leisure-time or total physical activities (occupational or leisure-time).
Conclusion: there is currently a limited evidence base to address this important question. There is weak evidence that the risk of revision hip arthroplasty may be increased by exposure to physically-demanding occupational activities but insufficient evidence about the impact on knee revision and about exposure to leisure-time activities after both procedures. More evidence is urgently needed to advise lower limb arthroplasty recipients, particularly people expecting to return to jobs in some sectors (e.g., construction, agriculture, military).
Zaballa Lasala, Elena
f18e08de-4986-4a7c-b925-849f83d33ddb
Harris, E. Clare
3e4bd946-3f09-45a1-8725-d35e80dd7971
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Linaker, Catherine
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
28 February 2022
Zaballa Lasala, Elena
f18e08de-4986-4a7c-b925-849f83d33ddb
Harris, E. Clare
3e4bd946-3f09-45a1-8725-d35e80dd7971
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Linaker, Catherine
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Zaballa Lasala, Elena, Harris, E. Clare, Cooper, Cyrus, Linaker, Catherine and Walker-Bone, Karen
(2022)
Risk of revision arthroplasty surgery after exposure to physically demanding occupational or leisure activities: a systematic review.
PLoS ONE, 17 (2 February), [e0264487].
(doi:10.1371/journal.pone.0264487).
Abstract
Introduction: lower limb arthroplasty is successful at relieving symptoms associated with joint failure. However, physically-demanding activities can cause primary osteoarthritis and accordingly such exposure post-operatively might increase the risk of prosthetic failure. Therefore, we systematically reviewed the literature to investigate whether there was any evidence of increased risk of revision arthroplasty after exposure to intensive, physically-demanding activities at work or during leisure-time.
Methods: we searched Medline, Embase and Scopus databases (1985—July 2021) for original studies including primary lower limb arthroplasty recipients that gathered information on physically-demanding occupational and/or leisure activities and rates of revision arthroplasty. Methodological assessment was performed independently by two assessors using SIGN, AQUILA and STROBE. The protocol was registered in PROSPERO [CRD42017067728].
Results: thirteen eligible studies were identified: 9 (4,432 participants) after hip arthroplasty and 4 (7,137participants) after knee arthroplasty. Narrative synthesis was performed due to considerable heterogeneity in quantifying exposures. We found limited evidence that post-operative activities (work or leisure) did not increase the risk of knee revision and could even be protective. We found insufficient high-quality evidence to indicate that exposure to physically-demanding occupations increased the risk of hip revision although “heavy work”, agricultural work and, in women, health services work, may be implicated. We found conflicting evidence about risk of revision hip arthroplasty associated with either leisure-time or total physical activities (occupational or leisure-time).
Conclusion: there is currently a limited evidence base to address this important question. There is weak evidence that the risk of revision hip arthroplasty may be increased by exposure to physically-demanding occupational activities but insufficient evidence about the impact on knee revision and about exposure to leisure-time activities after both procedures. More evidence is urgently needed to advise lower limb arthroplasty recipients, particularly people expecting to return to jobs in some sectors (e.g., construction, agriculture, military).
Text
Manuscript
- Accepted Manuscript
Text
journal.pone.0264487
- Version of Record
More information
Accepted/In Press date: 12 February 2022
e-pub ahead of print date: 28 February 2022
Published date: 28 February 2022
Additional Information:
Funding Information:
KWB and CC were co-applicants on the MRC Versus Arthritis (formerly Arthritis Research UK) Centre for Musculoskeletal Health and Work award (ref 22090) (https://www.versusarthritis. org/). This award provided support for the PhD studentship of EZ and support for the salaries of CHL and ECH. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2022 et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Identifiers
Local EPrints ID: 455688
URI: http://eprints.soton.ac.uk/id/eprint/455688
ISSN: 1932-6203
PURE UUID: 3f134012-4a80-45bc-86cb-97a76a304f7d
Catalogue record
Date deposited: 30 Mar 2022 16:54
Last modified: 18 Mar 2024 02:51
Export record
Altmetrics
Contributors
Author:
Elena Zaballa Lasala
Author:
E. Clare Harris
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics