Physical activity after total hip arthroplasty

Regular physical activity plays an important role in the primary and secondary prevention of several chronic conditions, and is linked to a reduction in all-cause mortality. It also enhances musculoskeletal fitness. Through these effects, regular physical activity can make an important contribution to maintaining the health and health-related quality of life of people of all ages. Additionally, it can help counter the functional declines associated with aging, thereby contributing to the maintenance of the functional autonomy of an aging population in Western society.The recognition of these beneficial effects in society has resulted in the issued of guidelines for health-enhancing physical activity as well as numerous public campaigns to promote physical activity, as large proportions of the general population are insufficiently physically active. Despite these developments, little is still known about the physical activity behavior of a large and growing subset of the population: patients after total hip arthroplasty (THA). Studies addressing physical activity in these patients have mainly pertained to sports and walking activity, or have only used scoring tools like the UCLA activity score to categorize level of physical activity, but have failed to provide detailed insight into the physical activity behavior of patients after THA. Furthermore, these studies have focused mainly on the determination of realistic loading conditions for hip prostheses and the implication of certain activities on implant survival, as well as on the return to specific activities after THA, but not on the beneficial effect of regular physical activity. In order to provide more detailed insight into the physical activity behavior of patients after THA, this thesis addressed physical activity after THA, with a focus on the assessment of physical activity from the perspective of its beneficial effects on health and musculoskeletal fitness. In the end, more insight into this behavior will also follow for a better and fairer comparison of the results of surgical procedures performed with different surgical approaches (e.g. minimally invasive versus traditional), different prostheses and/or different bearing couples.