Publié le 15 August 2023
HIP PROSTHESIS WHEN PRACTICING A FIGHTING SPORT
Martial arts and fighting sports practiced at a high level are demanding sports in terms of athleticism, technique and mental strength. They are part of the “contact pivot sports”: the approach, the standing fight, hand-to-hand or on the ground generate a wide variety of constraints. As pivotal joint between the trunk and the lower limbs, the hip is particularly exposed, subjected to shocks and indirect torsion, compression, in extreme amplitudes.
For the sportsman, a painless, mobile hip, stabilized by a powerful musculature is the prerequisite of a confident and successful practice.
THE IMPORTANCE OF THE PREOPERATIVE SPORTS LEVEL
The evaluation of the level in sport and the impact of the coxopathy on the physical capacities is fundamental in the elaboration of the therapeutic project. Post-operative sports aspirations and objectives will condition the management of rehabilitation and reathletisation.
The athlete’s previous level of fitness determines his or her subsequent sporting activity. The therapeutic strategy focuses on preserving the periarticular musculature, using the anterior hip approach. Enabling the athlete to reach the set objectives requires a great mastery of the surgical procedure, but also of the rehabilitation and reathletisation. This last phase must be supervised by a sports trainer, with the approval of the hip surgeon and the sports physician.
WHEN CAN YOU RESUME SPORTS ACTIVITIES AFTER A HIP PROSTHESIS?
After a hip replacement operation, the first phase is dedicated to the healing and solid osseointegration of the prosthetic parts.
Therefore, only non-impact physical activities are allowed during the first two months after surgery. The practice of fighting sports is therefore prohibited during this period. Walking, with the help of canes, swimming and gentle pedaling are gradually introduced. Muscle contractions without movement allow the preservation of muscle capital.
Once this healing phase is over, global muscular re-education, lumbar and abdominal sheathing, and toning up of the muscles around the hip (glutes, psoas, rotators…) are encouraged, under the direction of the physiotherapist.
After 2 to 3 months, weight-bearing and counter-resistance work is introduced, followed by reathletization guided by the physical trainer.
ARE THERE ANY SPORTS LIMITATIONS RELATED TO THE PRESENCE OF THE HIP PROSTHESIS?
In young, athletic patients, whatever their level, the objective is to restore satisfactory and efficient sports practice.
To restore a mobile, stable, powerful and painless joint, it is essential to respect the musculature and geometric parameters of the hip: this is achieved through the anterior approach and ideally through the implantation of a personalized prosthesis.
Under these conditions, and in the absence of complications, there is no specific limitation linked to the prosthesis when practicing martial arts. On the other hand, if the practice of martial arts is accompanied by mechanical difficulties related to the hip prosthesis, the cause must be identified and treated.
ADVICE FROM EXPERT HIP SURGEONS
The choice of an expert surgical team, accustomed to the treatment of young and athletic patients is particularly relevant for combat athletes. The surgical project must:
- Precisely identify the geometric parameters of the hip joint in 3D using a specific scanner, and define the reconstruction objectives.
- Use a surgical technique that preserves the musculature (anterior approach)
- Favour personalized implants (custom-made prosthesis).
- Support the sport recovery through rehabilitation and specific reathletisation