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2026, Vol: 10, Issue: 8
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Review Article
Online Published: 21 Aug 2026
 


Return to sport after total knee arthroplasty: a systematic review

Saad Alghnimei, Sultan Ayed K Alanazi, Meshari Owaid H Alanazi, Abdullah Qasem Alruwaili, Motaz Abdulsalam A Alkhaldi, Abdulelah Ayad A Alruwaili, Ahmed Mohammed A Alkathiri, Khalid Nafel A Alruwaili.


Abstract
Total knee arthroplasty (TKA) is increasingly performed in younger, more active patients who expect to return to recreational and sporting activities. Understanding return to sport (RTS) outcomes is essential for preoperative counseling and shared decision-making. This systematic review was conducted following PRISMA guidelines. A comprehensive literature search of MEDLINE, Embase, CINAHL, Scopus, and SPORTDiscus identified studies published between 2021 and 2026 reporting RTS outcomes after primary TKA. Sixteen studies met inclusion criteria. Quality assessment was performed using the ROBINS-I tool. Pooled analysis demonstrated an overall RTS rate of 82% (95% CI, 72%-89%) within the first year postoperatively. Low-impact activities (walking, swimming, cycling) showed the highest participation rates (76-90%), while high-impact sports (running, skiing) demonstrated significantly lower rates (35-48%). Time to RTS ranged from 12 weeks to 12 months. Predictors of successful RTS included male sex, younger age, higher preoperative activity levels, higher education, and non-smoking status. Implant design (cruciate-retaining versus posterior-stabilized) did not significantly influence RTS outcomes. Only 34.6% of patients achieved their desired activity level, highlighting a substantial expectation-outcome gap. Unicompartmental knee arthroplasty demonstrated superior RTS rates for high-impact activities compared to TKA. Most patients can successfully return to sport following TKA, particularly for low-impact activities. However, the gap between desired and achieved activity levels underscores the critical importance of preoperative expectation management. Standardized RTS definitions and evidence-based guidelines are needed to optimize patient counseling and postoperative outcomes.

Key words: Total knee arthroplasty, return to sport, sports participation, physical activity, knee osteoarthritis, patient-reported outcomes


 
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How to Cite this Article
Pubmed Style

Alghnimei S, Alanazi SAK, Alanazi MOH, Alruwaili AQ, Alkhaldi MAA, Alruwaili AAA, Alkathiri AMA, Alruwaili KNA. Return to sport after total knee arthroplasty: a systematic review. IJMDC. Online First: 21 Aug, 2026. doi:10.24911/IJMDC.51-1784293734

Web Style

Alghnimei S, Alanazi SAK, Alanazi MOH, Alruwaili AQ, Alkhaldi MAA, Alruwaili AAA, Alkathiri AMA, Alruwaili KNA. Return to sport after total knee arthroplasty: a systematic review. https://www.ijmdc.com/?mno=328143 [Access: August 21, 2026]. doi:10.24911/IJMDC.51-1784293734

AMA (American Medical Association) Style

Alghnimei S, Alanazi SAK, Alanazi MOH, Alruwaili AQ, Alkhaldi MAA, Alruwaili AAA, Alkathiri AMA, Alruwaili KNA. Return to sport after total knee arthroplasty: a systematic review. IJMDC. Online First: 21 Aug, 2026. doi:10.24911/IJMDC.51-1784293734


Vancouver/ICMJE Style

Alghnimei S, Alanazi SAK, Alanazi MOH, Alruwaili AQ, Alkhaldi MAA, Alruwaili AAA, Alkathiri AMA, Alruwaili KNA. Return to sport after total knee arthroplasty: a systematic review. IJMDC, [cited August 21, 2026]; Online First: 21 Aug, 2026. doi:10.24911/IJMDC.51-1784293734


Harvard Style

Alghnimei, S., Alanazi, . S. A. K., Alanazi, . M. O. H., Alruwaili, . A. Q., Alkhaldi, . M. A. A., Alruwaili, . A. A. A., Alkathiri, . A. M. A. & Alruwaili, . K. N. A. (2026) Return to sport after total knee arthroplasty: a systematic review. IJMDC, Online First: 21 Aug, 2026. doi:10.24911/IJMDC.51-1784293734


Turabian Style

Alghnimei, Saad, Sultan Ayed K Alanazi, Meshari Owaid H Alanazi, Abdullah Qasem Alruwaili, Motaz Abdulsalam A Alkhaldi, Abdulelah Ayad A Alruwaili, Ahmed Mohammed A Alkathiri, and Khalid Nafel A Alruwaili. 2026. Return to sport after total knee arthroplasty: a systematic review. International Journal of Medicine in Developing Countries, Online First: 21 Aug, 2026. doi:10.24911/IJMDC.51-1784293734


Chicago Style

Alghnimei, Saad, Sultan Ayed K Alanazi, Meshari Owaid H Alanazi, Abdullah Qasem Alruwaili, Motaz Abdulsalam A Alkhaldi, Abdulelah Ayad A Alruwaili, Ahmed Mohammed A Alkathiri, and Khalid Nafel A Alruwaili. "Return to sport after total knee arthroplasty: a systematic review." International Journal of Medicine in Developing Countries Online First: 21 Aug, 2026. doi:10.24911/IJMDC.51-1784293734


MLA (The Modern Language Association) Style

Alghnimei, Saad, Sultan Ayed K Alanazi, Meshari Owaid H Alanazi, Abdullah Qasem Alruwaili, Motaz Abdulsalam A Alkhaldi, Abdulelah Ayad A Alruwaili, Ahmed Mohammed A Alkathiri, and Khalid Nafel A Alruwaili. "Return to sport after total knee arthroplasty: a systematic review." International Journal of Medicine in Developing Countries Online First: 21 Aug, 2026. Web. 21 Aug 2026 doi:10.24911/IJMDC.51-1784293734


APA (American Psychological Association) Style

Alghnimei, S., Alanazi, . S. A. K., Alanazi, . M. O. H., Alruwaili, . A. Q., Alkhaldi, . M. A. A., Alruwaili, . A. A. A., Alkathiri, . A. M. A. & Alruwaili, . K. N. A. (2026) Return to sport after total knee arthroplasty: a systematic review. International Journal of Medicine in Developing Countries, Online First: 21 Aug, 2026. doi:10.24911/IJMDC.51-1784293734




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