One of the most common concerns Mr Dennis Kosuge hears from active patients considering knee replacement is: "Will I be able to return to the activities I love?" It is a completely reasonable question — and the honest answer is that for most patients, the answer is yes, with some caveats.

Mr Kosuge performs knee replacement surgery at The Rivers Hospital, Sawbridgeworth, and takes a thorough, patient-centred approach to discussing activity goals before any operation. Here is what the evidence — and his experience — suggests.

Why does activity matter in the conversation about surgery?

The decision to have a knee replacement should always account for your lifestyle goals, not just your pain score. An active 58-year-old who wants to return to tennis has different priorities from a 75-year-old whose main goal is to walk to the shops without pain. Mr Kosuge tailors his recommendations accordingly.

Which activities are generally safe after knee replacement?

Research and registry data support return to a wide range of low-to-moderate impact activities after total or partial knee replacement. Activities generally considered compatible with knee replacement include:

• Cycling — both outdoor and stationary; excellent for rehabilitation and long-term fitness

• Swimming — a very joint-friendly activity strongly recommended post-surgery

• Walking — most patients walk significantly more comfortably than before surgery

• Golf — most patients return to golf within 3 to 6 months

• Doubles tennis — generally considered acceptable, though not universally recommended

• Yoga and Pilates — generally well tolerated with appropriate modifications

Hiking on even terrain — achievable for most patients by 6 to 12 months

Which activities carry more risk?

High-impact activities place greater stress on the implant and may accelerate wear. Mr Kosuge discusses the following activities individually with patients:

• Running — not routinely recommended after total knee replacement, though some surgeons permit jogging in younger patients with partial replacement

• Singles tennis and squash — unpredictable pivoting loads are a concern

• Skiing — possible but requires careful discussion, particularly regarding falls risk

• Contact sports — generally not advised

What does the timeline look like?

Recovery varies by individual, but as a general guide:

• 6 weeks — gentle cycling on a stationary bike, swimming (once the wound is fully healed)

• 3 months — most patients return to golf, walking for leisure, light cycling outdoors

• 6 months — most low-impact activities fully resumed; continuing to improve

• 12 months — full recovery; maximum function usually achieved

Does partial knee replacement give better results for active patients?

For patients with single-compartment arthritis who are suitable candidates, partial knee replacement tends to give a more natural knee feel and may permit a slightly broader range of activity. Mr Kosuge will discuss whether you are a candidate for partial replacement at your consultation.

Mr Kosuge's approach

"I want my patients to have realistic expectations — but I also do not want them to write off activities they love unnecessarily," Mr Kosuge says. "Modern knee replacement, when performed well and in the right patient, can allow a genuinely active lifestyle. My goal is always to get patients back to the activities that matter to them."

Mr Kosuge's patient outcomes are monitored Amplitude Clinical and are consistently above the national average for both function and patient satisfaction.

Ready to take the next step?

Mr Kosuge offers private consultations at The Rivers Hospital, Sawbridgeworth and NHS consultations at The Princess Alexandra Hospital NHS Trust, Harlow.

To book an appointment with Mr Kosuge:

• Online booking

• Telephone: 01279 602675

Hip pain and lower back pain can be surprisingly easy to confuse — and it is not uncommon for patients to arrive at Mr Kosuge's clinic at The Rivers Hospital, Sawbridgeworth, believing they have a hip problem when the source is actually their lumbar spine, or vice versa. Understanding the difference is important, because the treatment for each is quite different.

Why do back and hip pain get confused?

The hip and lower back are anatomically close and share nerve pathways. Referred pain — pain that is felt in one location but originates elsewhere — is common in this region. The sciatic nerve runs from the lower back through the buttock and down the leg, meaning a spinal problem can produce symptoms that feel very much like a hip issue.

Similarly, hip osteoarthritis can refer pain to the groin, the inner thigh, the knee, or even occasionally the lower back — making the true source far from obvious without a careful clinical assessment.

Signs that your pain may be coming from the hip

• Pain is felt in the groin — groin pain on walking or at rest is a classic hip symptom

• Pain is reproduced when Mr Kosuge rotates or flexes your hip during examination

• Pain begins gradually and worsens with activity, particularly walking and twisting

• You notice stiffness putting on shoes, socks or getting in and out of a car

• X-ray shows osteoarthritis of the hip joint

Signs that your pain may be coming from your back

• Pain radiates below the knee — hip problems rarely cause pain below the knee

• Pain is associated with pins and needles, numbness or weakness in the leg or foot

• Symptoms vary significantly with posture — worse sitting, better walking, or vice versa

• Pain began after a period of heavy lifting or a specific incident involving the back

• Hip movements in examination do not reproduce the pain

It can be both

One of the most challenging scenarios in orthopaedic practice is when a patient has both hip osteoarthritis and lumbar spine disease simultaneously — sometimes called "hip-spine syndrome". In these cases, it can be genuinely difficult to determine which is the main driver of symptoms.

Mr Kosuge is experienced in assessing this complex presentation and may recommend a diagnostic hip injection — placing local anaesthetic into the joint — to help determine how much of the pain is attributable to the hip. If the injection provides significant temporary relief, the hip is likely the dominant source.

What should I do if I am unsure?

The most important step is to seek a specialist assessment. Mr Kosuge will take a thorough history, examine both your hip and your spine, and review any relevant imaging. If the source of your pain turns out to be the spine rather than the hip, he will advise you accordingly and, where appropriate, refer you to the right specialist.

Ready to take the next step?

Mr Kosuge offers private consultations at The Rivers Hospital, Sawbridgeworth and NHS consultations at The Princess Alexandra Hospital NHS Trust, Harlow.

To book an appointment with Mr Kosuge:

• Online booking

• Telephone: 01279 602675