Published 6/26/2025
Although participation in pickleball and other racket sports is growing, data on returning to play after total joint arthroplasty (TJA) are limited. Presented at the AAOS 2025 Annual Meeting, a new study found that most patients who played racket sports were able to return to play after TJA within 6 months and at a similar skill level without an increase in reoperation rates. Patients who returned to play also had higher physical function scores after surgery compared to those who did not return to play.
An online survey was sent to 7,200 patients who had undergone at least one primary TJA at a single academic center over 10 years (January 2014 to October 2023). The survey asked patients about their prior and current racket sports participation, including ability level, expectations, limitations, and reoperations. Demographics, patient-reported outcomes (PROs), and reoperations were also captured through chart review. All surveys included Patient-Reported Outcomes Measurement Information System v2.0 Physical Function and Short Form v1.1 Global Health, regardless of playing status.
Of the 1,284 respondents, the average follow-up time was 3.6 years, and the average age was 66.9 years at the time of the survey.
Of the total respondents, 61.7 percent (n = 792) had never played a racket sport, 25.3 percent (n = 325) had last played a racket sport more than two years before TJA (remote players), and 13.0 percent (n = 167) had played a racket sport within 2 years prior to TJA (recent players). Of the recent players, 71.9 percent returned to play after surgery, compared with 30.2 percent of remote players.
The most common timeframe to return to play was 4 to 6 months for each sport, with return-to-sport rates of 44.4 percent for pickleball players, 36.2 percent for tennis players, and 39.1 percent for other racket sport players. Compared with remote and never players, recent racket sports players had the highest PROs across physical function, physical health, and mental health.
For those who returned to play, the majority reported an increase or similar level of enjoyment in playing their desired racket sport. Most patients reported being very satisfied or satisfied with their TJA in allowing them to return to their desired sport.
Of the recent players, there was no difference in return to play based on preoperative self-reported skill levels, with 72.5 percent of beginners, 76.2 percent of intermediate, and 65.6 percent of advanced players returning. The most common reasons for recent and remote players to avoid returning to play were fear of injury in tennis players (29.7 percent) and loss of interest in pickleball players (35.3 percent).
Rates of reoperation were not significantly different between patients who did and did not return to play. The study’s limitations included being survey-based and susceptible to biases; having participants self-report skill levels, which could lead to inaccuracies; and having no objective mechanism for tracking racket ability changes over time.
The authors of “Return to Pickleball and Other Racket Sports after Total Joint Arthroplasty” are Adam J. Taylor, MD; Brenna Blackburn, PhD, MPH; Christopher E. Pelt, MD, FAAOS; Christopher L. Peters, MD, FAAOS; Dalton L. Braathen, BS; Jeremy Gililland, MD, FAAOS; Lucas Anderson, MD, FAAOS; and Michael J. Archibeck, MD, FAAOS.