Total Hip Arthroplasty in Athletic Patients Under 55 Years Old: Functional Outcomes and Return to Sport at a 2-year Average Follow-up

Abstract Introduction: Total hip arthroplasty (THA) has become a viable option in younger patients due to advances in surgical techniques, tribology, and prosthetic materials. Improved implant durability has made it possible to offer this procedure to active patients, including athletes, with expectations of favorable outcomes and long-term survival. However, fear of not being able to return to sports often delays surgery. This study retrospectively analyzes functional outcomes and return to sport in patients under 55 years old who underwent THA following our rehabilitation protocol. Materials and Methods We evaluated 136 THAs in 117 athletic patients (mean age: 49 years; range: 23–55), with an average follow-up of 24 months. Preoperative diagnoses included 119 cases of hip osteoarthritis, 11 cases of avascular necrosis, 3 cases of necroarthrosis, and 3 sequelae of septic arthritis. Functional outcomes were assessed using the Harris Hip Score (HHS) and the High Activity Arthroplasty Score (HAAS). Results Average improvement was from 52.35 to 93.25 in HHS and from 7.43 to 15.18 in HAAS. Return to sport occurred at a mean of 4 months postoperatively (range: 1.5–6 months). Two patients experienced aseptic loosening of the acetabular component, which was resolved with revision surgery, and both returned to physical activity before 6 months. Conclusion THA in athletic patients under 55 years demonstrated favorable short-term functional outcomes, early return to sport, and satisfactory implant survival. These findings may influence future recommendations regarding postoperative physical activity. Level of evidence: III