High-impact physical activity participation and 12-month risk of joint replacement: a longitudinal mediation analysis of 17 661 patients with knee or hip osteoarthritis

This study aimed to investigate the relationship between high-impact physical activity (PA) and the risk of joint replacement in patients with hip or knee osteoarthritis (OA). The findings revealed that participation in high-impact PA was associated with a 36-48% lower likelihood of total hip replacement (THR) without increasing the risk of total knee replacement (TKR), suggesting that clinicians might consider recommending higher-impact activities for individuals with hip OA while supporting continued participation in knee OA under appropriate conditions.