Arthroplasty and Tennis: A Narrative Review

BACKGROUND: An active sporting lifestyle is associated with numerous health benefits. In this regard, tennis as a sport that can be practiced by young and old can be a component throughout life. The extent to which play is possible and medically advisable after arthroplasty of the hip, knee, ankle, and shoulder joint is the subject of this narrative review.

PURPOSE: To summarize the current literature and evidence regarding prosthetic treatment of the hip, knee, ankle, and shoulder joints in relation to tennis, both in singles and in doubles, so the clinician can use evidence-based medicine to advise and treat patients who want to return to tennis.

STUDY DESIGN: Narrative review.

METHODS: An electronic databases search, including PubMed, Google Scholar, ScienceDirect, UpToDate, and Springer, was conducted on articles including tennis and arthroplasty.

RESULTS: The return-to-play rate ranged from 7% to 62.5% for total hip arthroplasty, 0% to 62.5% for total knee arthroplasty, 0% to 37.5% for unicondylar knee arthroplasty, 0% to 30% for total ankle arthroplasty, 75% to 100% for anatomic total shoulder arthroplasty, 0% to 50% for reverse total shoulder arthroplasty, and 50% to 100% for shoulder hemiarthroplasty. Tennis play clearance given by surgeons (for singles/doubles) was 80%/89% for total hip, 70%/87% for total knee, 40%/85% for total ankle, 75%/86% for anatomic total shoulder, 30%/43% for reverse total shoulder, and 85/88% for shoulder hemiarthroplasty. The mean period for a return to play was 5-7 months (range, 1-36 months). Existing evidence cannot prove a higher complication rate caused by playing tennis.

CONCLUSION: The current evidence indicated that tennis can be continued even after arthroplasty. The return-to-play rate was higher for total hip arthroplasty, total knee arthroplasty, anatomic shoulder arthroplasty, and shoulder hemiarthroplasty compared with ankle and reverse shoulder arthroplasty. The time frame for a return to sports depended on a variety of intrinsic and extrinsic factors. For players with sufficient experience, tennis doubles and singles could be played after 3 to 6 months. Each patient should therefore be assessed and advised individually and also informed that the practice of high-impact sports (such as tennis) could potentially lead to complications like premature polyethylene wear, implant loosening, dislocations, or periprosthetic fractures, even though no fully conclusive data are available. This article provides information about the outcomes and return-to-play rates for tennis after shoulder, hip, knee, and ankle replacement and will help physicians better advise patients who wish to return to tennis after endoprosthesis surgery.