Tennis After Joint Surgery?

After my total hip replacement surgery, I was amazed to find myself being able to use the ball machine in just four weeks.  And now, I feel just about “totally whole.”  But what do the experts say about playing tennis after total hip or knee replacements?  You may be surprised …

National Institute of Health says …

 “Lower extremity total joint arthroplasties are among the most successful operations in orthopaedics. Presently, it appears that some patients wish to not only have general functions restored, but also desire the opportunity to return or continue on a high level of activity.”

“Orthopaedic surgeons frequently recommend participation in low-impact sports such as swimming, walking, bicycling, bowling and golf. The patient’s return to these recreational activities appears to be without problems. In contrast, there has been a general consensus from surgeons to avoid high-impact sports such as tennis and jogging after total joint arthroplasty, but there have been numerous studies that reported functional results being compatible with these activity levels.

“Conflicts emerge with some studies that describe lower survival rates for hip and knee arthroplasty in patients participating in high-impact sports. Most of these studies report that participation in sporting activities following total joint arthroplasty refers to increased polyethylene wear and debris, which could eventually result in implant failure. With recent advances in implant technology and surgical technique, the survival rates for modern prosthetic designs and patients with these high demands are promising. Various studies assessing the association between clinical outcome and participation in tennis did not demonstrate a harmful effect on implant survival rates.

“Although the majority of these studies do not reflect a true representation of the average patient undergoing total joint arthroplasty, more surgeons are confronted with the patients’ desire to continue with sports activity. To optimise results, patients who demand higher levels of activity must be carefully selected, and must have the motivation and drive to optimise their results. In general, all patients should be encouraged to remain physically active to improve general health, maintain good bone quality, and improve implant fixation. There is still a need for prospective, randomised controlled studies concerning high activity and its impact on total joint arthroplasty.”

And from the Arthritis Foundation…

Doctors have long recommended that knee replacement patients avoid sports like football, soccer, aerobics, jogging, baseball and basketball because it was thought that high-impact activities might contribute to the early failure of artificial joints, leading to the need for a second surgery. 

But a study suggests that those long-held assumptions could be wrong.

The study compared two groups of people with knee implants  – those who ignored advice to take it easy on their new joints (called the sport group) and model patients who followed doctors’ orders to avoid high-impact activities (the control group). 

Researchers found that after more than seven years there were no significant differences in wear or mechanical failure between the two groups.

The research was presented at the 2010 annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans, La.

“We were a little bit surprised because we were not thinking that there would be absolutely no difference,” says lead author Sebastian Parratte, MD, PhD, an orthopaedic surgeon from the Mayo Clinic in Rochester, Minn., and the Aix-Marseille University, Center for Arthritis Surgery, Hospital Sainte-Marguerite in Marseille, France.

“Before, everybody was thinking if you go running or something like that it will kill the prosthetic and don’t do that. It’s forbidden,” Dr. Parratte says

Perhaps even more surprising is that researchers found that those who took part in the non-recommended sports actually showed higher knee and function scores than the control group.

 “The big news is that everybody before was thinking that doing high-activity sports would be terrible for the prosthetic of the patient and what we discovered was it was not terrible and indeed the patients that did high-level activity sports were doing better than others,” Dr. Parratte says.  

 “There may be an increased risk, but it’s minimal,” he continues. “So patients have to decide if that’s worth it for them to lead a more active lifestyle.”

I am now coming up on two years with my new hip; and I feel like I am moving well, with no complications. What is YOUR experience?

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17 thoughts on “Tennis After Joint Surgery?

  1. George, does your positive result include singles ambition now or in the future (80’s gold ball)? As I recall you were competing enthusiastically in singles until hip issues. How do you see singles for you now?

    Winder, coincidentally, i played my first post-tournament singles match on Friday. The challenge nowadays, is not whether i can play tournament singles; but if i can play singles AND dubs on the same day! My public goal is still to be “top ten in the nation in the 90s”! thanks, george

  2. Hi George!
    I had total knee robotic replacement about 3 weeks ago and doing really well, riding a stationery bike and 111 degree bend. Go back to Michigan mid May and plan to start off slow on the ball machine a few weeks in Florida. Will rehab the knee in the summer and play social tennis, nothing real competitive. Plan to come back in October to Florida and be ready to play hopefully without any pain. Know lot of players who are playing tennis successfully with both knees replaced. Is this plan too aggressive or not?

    Ron, i am a “hip guy,” which i understand is easier than the knee, so i will defer to others on that. george

  3. Had a total knee replacement (TKR) in 2010. had to go back in to the OR for a procedure called MUA, or Manipulation Under Anesthesia. It was hell restoring my range of motion even with the help of PT. Fast forward to today. I have zero pain or discomfort. No problem on the court with this knee. I only wish they could come up with a total spine replacement that works as well since I’ve already had to have the nerve blocker injection to relieve the horrible sciatic pain!

    Jim, “if it ain’t one thing, it’s another!” Be well. George

  4. I think that for most of us who have had multiple replacements (sometimes from different surgeons) have heard the caution about playing tennis (at least singles tennis)

    First, I believe we are fortunate here in S. W. Florida…that at least for me 100% of my tennis is on Har-tru. Have NO desire to play on hard courts.

    When we start our return to hitting …8 weeks…and playing 10–12 weeks, are brain and knees are telling us go easy….not allowing us to go hard for wide or short balls as there is some discomfort/pain. As the days turn to weeks you suddenly find yourself going a little harder with little pain….that turns into NO discomfort or pain.

    Finally, as it relates to the unproven longevity argument….in my mind for those of us that started replacement surgery in our mid 60’s…if given the choice at the time of surgery of “possibly” loosing a few years in your late 80’s early 90’s…or playing active (relative quality) tennis into your mid 80’s and for some beyond. For me that is an easy choice…I will take the tennis!

    Dave, great advice. thanks, george

  5. I had bilateral (both at once) knee replacements in January of 2009 at age 62. I had stopped playing tennis at age 51 after 4 other knee surgeries. I was playing on hard courts and it just wasn’t worth playing, having both of my knees swell up, being in pain for a few days and doing it over again. So, once I retired to FL I decided to have my knees replaced and try to get back to playing tennis. My Doctor was Ed Humbert of “Joint Implant Surgeons of SW FL”. One of the reasons that I really like Dr Humbert is that he is a guy who really encourages his patients to get back out there and do the things that you like to do. Six weeks after the surgeries I was hitting golf balls, playing 18 holes at eight weeks, Hitting tennis balls at 3 months (just hitting, not playing matches) and playing doubles at 6 months. I have now been playing golf and/or tennis (Soft surfaces only) almost every day for over 11 years with little problem. I run around pretty well, for a 73 year old, and don’t even think about my knees for the most part. Recently one of my knees was getting a little swollen after tennis and sometimes even golf from the rotation. I went back and saw Dr Humbert, thinking that maybe I had worn down the implant and that I might have to cut back on my activities, particularly tennis. After examination and consultation he told me that the implants were fine and had many years left on them. He drained the knee and gave me two injections. So I asked him if I should consider giving up tennis so that my knees would last longer. He asked me “do you want to keep playing”? I said yes and then he said, “then you should keep on playing”. Loved that answer. He also told me that if the plastic part of the implant did wear out in many years they can replace it without doing the whole knee over with a much shorter recovery time. Loved that answer to. So my experience is; if you need a replacement to do what you want to do, get it done and keep on playing til you drop. What are we saving ourselves for? Keep on trucking.

    Jim, once again, my favorite quote: George Bernard Shaw: “You don’t stop playing because you grow old. You grow old because you stop playing.” Thanks, george

  6. I had osteoarthritis in my left hip resulting from a bad auto accident in my early twenties. The dislocation resulted in a bone on bone situation which I had to address in my late fifties. After doing extensive research online I discovered a website focusing on the Birmingham Hip Replacement procedure. I found an Orthopedic surgeon in Rhode Island who was well trained having performed 1000 surgeries of this type.
    That was in 2012. Since then, after he released me back to regular activities, I went from hobbling to running around faster and easier and more confidently than ever! It’s amazing! Orientation of hip joint is better for active men, but you be the judge.

    Philip, thanks for the new info. george

  7. I was a ranked senior in Colorado and Wyoming in the 60’s and 65’s playing entirely on hard courts until bone on bone inevitably occurred. Had left knee replacement surgery in June 2017 which required a manipulation surgery in late July. Today the left knee has a 112 degree range of motion good enough to play tennis. The right knee was replaced in late July at the time of the manipulation of the left knee. Same reputable doctor and hospital in Denver. I have not been able to play a tennis match since that day. Flexion of the right knee has plateaued at 85 degrees even after manipulation, physical therapy twice a week for 30 months, and a second knee replacement surgery in May 2018. Two bouts with infection did not help. Built up scar tissue remains the chief culprit. I can use the ball machine and hit cross court and down the line patterns but cannot run and reach a ball fifteen feet away from me. At 71 the choice is hobble along and just practice hitting the ball or submit to another surgery to remove the scar tissue to see if flexion will then improve or just start all over again with a third knee replacement. I am now with Andre Agassi’s surgeons at the Vail Steadman Clinic who also have operated on skier Lindsay Vonn, tight end Rob Gronkowski, and a host of baseball and soccer players. Am undergoing bone scans, blood tests and infectious disease studies this month and next. Recommendation and decision to be made in May. Would love to travel to Florida after I retire from my law practice next year and be able to play with my old doubles partner George Wachtel. But on soft courts!!!

    Tom, let us hope your remain the rare exception! I look forward to teaming up with you again. george

  8. Love the GB Shaw comment above, and everyone should move to the Naples area when they retire….or BEFORE! Thankful every day that we are healthy enough to play the game. Keep on Trucking, indeed!

  9. Hello George:
    As you know I had left hip replaced 4 weeks ago. Doing well, walking couple of miles a day, expect to be hitting on ball machine in next month. I have had both knees replaced in last three and a half years. So I am close to being a Cyborg! My orthopaedic surgeon, who has done all my parts, says go forth and play. Prefers me to back off on singles some but play all the doubles I want. Plus I am 1/2 inch taller, that will help with overheads, and I am faster, so I can get to those wide balls you hit.

    Gary, great stuff. You are taller; so more difficult to lob over you. You are faster; tougher to hit by you. What to do now?! thanks and be well. george

  10. 1996…..24 years ago….I had my left hip replaced when I was 55…….surgeon said I should play only doubles……his assistant said “ridiculous, play singles too”…..I followed the assistant’s advice.
    My right hip was replaced in 2013.
    Both hips feel great…..still playing singles……..running easily and well.

    John, great stuff! thanks, george

  11. I had a total left knee replacement January 8th of this year and was able to play some doubles by week 6 although it required yelling, “Yours!” often. By week 8 I was able to begin singles being limited primarily by my non surgical knee.
    My surgeon and PT were somewhat skeptical of my desire to get back as soon as the knee permitted and urged caution which was constantly in the back of my mind. Having read the research you cited and paired with my experience of very little discomfort (or swelling) I am ready to return to a full schedule. In fact, to my surprise and delight the knee both felt and functioned better following vigorous tennis.
    What a blessing to be back on court.

    Jack, i cannot imagine how different life would be without being able to whack that fuzzy yellow ball back and forth! thanks, george

  12. George, From the volume of responses you have definitely “hit a nerve” with this topic.
    I had a total knee replacement 5 or 6 years ago. I had my knee replaced in June and was comfortably playing competitive tennis in October. I told my surgeon “all I want to do is be able to play Old Man’s Doubles Tennis.” He said no problem and it wasn’t. I did have a much tougher time initially than what I had anticipated but after that with religious PT things went really well. The one caveat is that everybody’s recovery is different. I’ve seen guys in great shape have a great deal of difficulty in recovery; while other guys, who I thought were in terrible shape, had no problem at all recovering. The scar tissue issue happened to one of my doubles partners up North and it was brutal. Fortunately the % of that complication happening is very low.

    Ted, i think commitment to rehab is a critical factor; and i picture you being an excellent candidate! thanks, george

  13. George,
    Two years ago at age 83 I was playing tennis regularly with younger players at our club and on USTA teams when I started having problems with my left hip. I did some research and consulted with a top orthopedic group in Georgia working with SEC college football and pro football injuries and ended up selecting the top owner/doctor (who has done over 15,000 hip and knee replacements and helped pioneer and uses front entry procedures) and traveled to the hospital he uses where only orthopedic surgery is done (avoided sick patients) had surgery replacement at 1PM stayed overnight – told me to get out of bed next morning without help and walk to nurse counter with walker and back to room. Then told me I could check out before lunch and have wife drive me 100 miles home. Then had 4 weeks of super physical therapy help at home with never any pain from surgery or PT and was back on tennis court in 5 weeks. Now at 85 still playing regularly several times each week on rubico courts. Here is a recent quote of a text message from a young lawyer player friend: “ I don’t think you missed a single short shot I gave you this last Tuesday. I want you to know I’m proud to tell people I play tennis with a fellow in his 80s that gets to everything I can send him.” All to say YES, carefully get the joint replacements you need and keep getting the exercise you need by playing the game you love!

    Floyd, great story! And, almost identical to mine: from front entry surgery, to no pain, to back on the court in weeks! Let’s hope others can have the same happy results. thanks, george

  14. George,
    As others have said, it’s not only the game we love, but the game we need for good health and is a good reason to have these surgeries. It’s great to be on the court with a successful implantee!

    Noble… i assume that would be me! thanks, george

  15. In late August of 2017 I had TKR of my right knee at the age of 77. 3 weeks later had TKR of my left knee. Was on a piano stool hitting volleys 3 weeks later. Started playing doubles in December on Har Tru and was playing singles in January. I play singles and doubles 2-3.5 hours a day. Very grateful to my surgeon. No problems.
    This next comment is not exactly related, but I would seriously caution against partial knee replacement. The reason being that re entry to the knee is not easy and statistically less successful than if the TKR was done initially.

    Michael, fantastic recovery!! george

  16. George, you may recall our dialogue regarding hip replacement prior to your surgery. I had a total replacement (anterior) back in 2017. A great surgeon, Dr David Whiddon, technology, and my dedication to rehab/training got me back on the court soon. I was instructing/feeding balls within a month, drilling (in controlled ways) soon thereafter, and playing singles after just 3 months. The majority of my tennis, over almost 50 years, has been on hardcourt. I still teach and drill on hardcourt and I play singles (criss-cross half-court) similar to one-on-one doubles, sans the rule of the server being required to serve and volley. Everyone and every case is different. And yes the knee is more difficult to repair than a hip. I am blessed and fortunate to enjoy tennis without much difference than prior to my surgery.

    Alan, yes, i remember your words of encouragement when i had mine done! Thanks! george

  17. I had my first hip procedure (hip resurfacing) 14 years ago; went through the backside; cut the muscle; on crutches 6 weeks; could not play tennis for 6 months: never felt normal.
    Two years ago had double hip replacement; went through the front this time; up and walking 5 hours after surgery; back to work in 9 days; played 3 sets of tennis 3 months later. Today they feel like normal hips. Please don’t be afraid that joint replacement will keep you off the courts and not allow you to keep playing good (maybe great?) tennis 🙂

    Roy, i am also a believer in going in the front side for hips! thanks, george

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