Running After Joint Replacement Surgery: Yes or No…or Maybe?

    What should surgeons recommend to patients who are runners about when they can resume running after hip or knee replacement surgery? Is running even safe for these patients, or should it be avoided?

    This would be a good place to insert the shrug emoji because the answer is that no one really knows. There are no evidence-based recommendations for whether runners can return to running after undergoing joint replacement surgery.

    A team of researchers from Brigham & Women’s Hospital, The Rothman Institute, and Force Therapeutics sought to provide some insight on running after joint replacement surgery in a prospective, cross-sectional study presented at the recent annual meeting of the American Association of Joint Replacement Surgeons.

    Using a multi-institutional patient database, they identified 4492 patients who had undergone primary total hip arthroplasty (THA, 44.4%), total knee arthroplasty (TKA, 51.4%) or unicompartmental knee arthroplasty (UKA, 4.2%) between June 2015 and June 2020. These patients were asked to complete an online survey that included questions on:

    • Demographics
    • Preoperative running experience
    • Expectations and satisfaction
    • Surgeon recommendations about returning to running
    • Postoperative running
    • Cross-training practices
    • Reoperation

    There were 549 preoperative runners in the study cohort, 98.3% of whom had been running for more than 2 years before surgery and 46.5% of whom had been running for more than 20 years. In the responses to the survey, the researchers found that:

    • 30.5% of preoperative runners expected to return to running after surgery; 69.5% did not
    • 11.8% actually returned to running after surgery: 64.6% 2 to 6 months after surgery and 86.2% within 12 months; THA patients were significantly more likely to run postoperatively than TKA patients
    • 67.2% of runners were satisfied with their postoperative running, 32.8% were not; 30.8% reported pain
    • Preoperative runners who resumed running had a higher revision rate (6.2%) than preoperative runners who did not run after surgery (4.8%)
    • 1% of patients who were not runners prior to surgery started running after the procedure; 69.3% were satisfied with their postoperative running

    Patient-reported surgeon recommendations for running after surgery were not standardized:

    • 29.5% told preoperative runners that they could not return to running
    • 35.2% recommended low-impact activities only
    • 5.1% said patients could return to their preoperative running level
    • 30.1% made no recommendations on running postoperatively

    The study authors said that, “while almost 12% of runners…were able to return to running within 1 year [of surgery], further larger-scale studies are needed to guide surgeons to provide realistic recommendations for patients that wish to return to running after [joint replacement surgery].”  


    Antonelli BJ, Teng T, Breslow RG, Ponzio DY, Ulcoq S, Chen AF. Do Runners Return to Running After Total Joint Arthroplasty? Abstract 34. Presented at the annual meeting of the American Association of Hip & Knee Surgeons, November 5-8, Dallas, Texas.