Physical activity and sports participation preceding and one year following total knee arthroplasty: results of the prospective FInGK study

Abstract Aim Data on physical activity (PA) and sports participation in individuals with total knee arthroplasty (TKA) are limited. This study aimed to assess PA and sports participation before and one year after TKA and to identify associated factors. Subject and methods In this cohort study, patients undergoing primary or revision TKA at a German university hospital (Dec 2019–May 2021) were surveyed one day before and 12 months after surgery. Questionnaires assessed PA, sports participation, sociodemographics, and lifestyle factors; data were linked to medical records. Multivariable logistic regression identified factors associated with sports participation one year postoperatively. Results Of 283 eligible patients, 241 (85%) participated, and 95% provided follow-up data. The 229 patients analysed had a mean age of 69.3 years, with 59% being female. PA was reported by 55% pre- and 53% postoperatively, with a shift of people who were active or not. Sports participation remained stable (65% vs. 67%), with cycling, hiking, swimming, and aquatic exercise most common. Higher education (OR middle vs. low: 2.50; high vs. low: 7.68) and non-smoking status (OR: 4.10) were significantly associated with post-TKA sports participation. Conclusion PA and sports participation remained largely stable across the TKA trajectory, though with a shift in individuals who were and were not physically active. Furthermore, the prevailing hypothesis that predominantly knee-related disease burden is the main driver of activity levels does not appear to be sufficient to explain this finding. Rather, it appears that affected individuals’ educational level and current smoking status have a substantial influence.