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• Nordbø, Jakob Vangen; Straume-Næsheim, Truls Martin; Hallan, Geir; Fenstad, Anne Marie; Sivertsen, Einar & Årøen, Asbjørn (2025). Physical activity and the risk of aseptic loosening after total hip arthroplasty: a case–control study from the Norwegian Arthroplasty Register. BMC Musculoskeletal Disorders. 26(1). doi: 10.1186/s12891-025-08865-9. Full text in Research Archive Show summary

  Introduction Previous studies have shown increased wear rate and aseptic loosening of total hip arthroplasty (THA) in patients with high physical activity levels. However, highly cross-linked polyethylene (HXLPE) has a reduced wear rate compared to conventional polyethylene. Thus, studies on the amount of physical activity in THA with HXLPE are needed. We aimed to determine if the level of physical activity in patients with THA containing HXLPE was associated with the risk of aseptic loosening of this implant. Methods In this retrospective case–control study, we identified patients aged 40–75 years with a primary THA containing HXLPE registered in the Norwegian Arthroplasty Register (NAR) from 2005–2012 (n = 10,904). With a mean follow-up of 9.1 years, 176 patients were revised for aseptic loosening of their THA and invited into the study together with a sample of 856 patients with unrevised THA. Participants reported their physical activity level by answering the University of California, Los Angeles (UCLA) activity score at their best-remembered condition after the primary surgery. The peak physical activity levels were compared to the risk of being revised due to aseptic loosening in a multivariate logistic regression analysis. Results Patients treated with revision surgery for aseptic loosening (n = 77 (44%)) had a lower retrospective peak level of physical activity before revision surgery compared to unrevised control patients (n = 429 (50%)); UCLA score median (IQR) 7 (5–8) vs. 8 (6–8). Adjusted logistic regression analyses of these UCLA scores on the risk of revision surgery due to aseptic loosening of the THA, showed that a higher level of physical activity was associated with a decreasing risk of revision surgery (OR 0.8, 95% CI 0.7–0.9, P = 0.001). Conclusion A retrospectively self-reported level of physical activity at the patient`s best-remembered condition after primary THA was not associated with a higher risk of revision surgery due to aseptic loosening of the THA. Patients with THA should be encouraged to gain the health benefits of regular physical activity rather than restricting their activity level because of fear of implant wear and loosening.

• Svinøy, Odd-Einar; Nordbø, Jakob Vangen; Pripp, Are Hugo; Risberg, May Arna; Bergland, Astrid & Borgen, Pål Oliver [Show all 7 contributors for this article] (2025). The effect of prehabilitation for older patients awaiting total hip replacement. A randomized controlled trial with long-term follow up. BMC Musculoskeletal Disorders. 26(1). doi: 10.1186/s12891-025-08468-4. Full text in Research Archive Show summary

  Background Prehabilitation involving a planned exercise program before surgery is proposed to improve rehabilitation and postoperative outcomes. However, the current evidence on the efficacy of prehabilitation for patients awaiting total hip replacement is conflicting. The aim of this study was to evaluate efficacy of preoperative exercises and education (AktivA®) for adults 70 years or older awaiting total hip replacement. Methods In a two-armed randomized controlled trial we recruited 98 participants aged 70 years or older with a Harris Hip Score less than 60 awaiting elective primary total hip replacement. Participants were recruited at three hospitals in Norway between 2019 and 2022. Participants were randomly assigned to prehabilitation or usual care. The prehabilitation group received a tailored exercise program for 6–12 weeks in addition to patient education. Gait speed, the primary outcome, was measured by the 40 m Fast-Paced Walk Test. Secondary outcomes included performance-based tests (Chair Stand Test, Timed Up & Go Test, 6-Minute Walk Test, Stair Climb Test) and patient-reported outcomes (Hip Disability and Osteoarthritis Outcome Score (HOOS) and EQ-5D). Outcomes were assessed at baseline, post intervention, and further 6 weeks, 3-, 6-, and 12 months post-surgery. Results For the primary outcome gait speed at the primary endpoint (3 months post-surgery), no significant between-group differences were observed. However, post-intervention (before surgery), we found a significant improvement in favor of prehabilitation for both gait speed (0.15 m/s, 95% CI 0.02–0.28) and the HOOS quality of life subscale (11.93, 95% CI 3.38–20.48). No other significant differences were found at any post-surgery follow-up for these outcomes. For other secondary outcomes, there were no between-group differences at any point of assessment. Both groups showed improvement across all outcomes 3–12 months after surgery. Conclusions The AktivA®program, used as a prehabilitation intervention during a period of 6–12 weeks before total hip replacement did not improve gait speed or any other post-operative outcomes compared to usual care. Both groups demonstrated significant improvement in gait speed and performed well relative to Western reference values 12 months post-surgery. Thus, replacing painful hip joints through total joint replacement seems to outweigh the efficacy of prehabilitation. Trial registration ClinicalTrials.gov Identifier: NCT03602105—initial release: 06/06/2018.

• Nordbø, Jakob Vangen; Straume-Næsheim, Truls Martin; Hallan, Geir; Fenstad, Anne Marie; Sivertsen, Einar & Årøen, Asbjørn (2024). Patients with total hip arthroplasty were more physically active 9.6 years after surgery: a case-control study of 429 hip arthroplasty cases and 29,272 participants from a population-based health study. Acta Orthopaedica. ISSN 1745-3674. 95, p. 268–274. doi: 10.2340/17453674.2024.40815. Full text in Research Archive Show summary

  Background and purpose: Few studies report on long-term levels of physical activity after THA compared with a control population. This case-control study aimed to find the long-term habitual level of leisure-time physical activity after THA and compare it with a large control group. Patients and methods: A randomized sample of 856 patients, treated with primary THA, were identified from the Norwegian Arthroplasty Register. 429 (50%) responded to a questionnaire with a mean follow-up time of 9.6 years. We compared them with a control group of 29,272 (64%) from a population-based health study. Physical activity was measured with a questionnaire and categorized into groups according to the general recommendations for physical activity. Results: 245 (63%) of the THA cases reported a level of leisure-time physical activity meeting the general recommendations, compared with 10,803 (39%) in the control group. The difference persisted at all ages (50–90 years). In sex, age, and BMI-adjusted regression models the chance of meeting the physical activity recommendations was higher in the THA group than in the control group (OR 2.9, 95% confidence interval 2.4–3.6). Conclusion: The majority of the patients with THA reported a level of leisure-time physical activity meeting the general recommendations for physical activity. THA patients were more physically active in their leisure time than a control group representing a normal population.

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• Nordbø, Jakob Vangen; Arnarson, Örlygur; Paulsen, Aksel; Pollmann, Christian Thomas; Lange, Jakob de & Årøen, Asbjørn (2024). Fjerning av bevegelsesrestriksjoner etter elektiv hofteproteseoperasjon økte ikke 90-dagers luksasjonsrate. Full text in Research Archive
• Nordbø, Jakob Vangen; Frihagen, Frede Jon & Solberg, Lene Bergendal (2020). Fastlegens rolle ved osteoporosebehandling etter brudd. 17, p. 1738–1739. doi: 10.4045/tidsskr.20.0822. Full text in Research Archive
• Nordbø, Jakob Vangen (2026). Physical activity after total hip arthroplasty. Universitetet i Oslo. ISSN 9788234807961. Full text in Research Archive Show summary

  Physical activity improves quality of life and reduces the risk of disease. People with hip osteoarthritis are often inactive due to pain and stiffness. After total hip arthroplasty (THA), pain is usually relieved, and many wish to increase their activity level. However, high activity has been associated with wear and implant loosening. This thesis aimed to assess how physically active patients become after surgery, whether a preoperative training program (prehabilitation) enhances postoperative activity levels, and whether higher activity is associated with the risk of loosening in wear resistant implants. The thesis comprised two case-control studies using self-reported physical activity levels, with participants drawn from the National Arthroplasty Register and HUNT3, and a randomised controlled trial evaluating whether prehabilitation improved gait speed after THA. THA patients were more physically active than a control group, similar to the general population, with 63% meeting the general physical activity recommendations. Prehabilitation did not improve gait speed after THA compared to usual care, but the gait speed improved similarly in both groups after THA. Patients who needed a second operation (revision) due to implant loosening reported a lower peak level of physical activity before revision surgery than unrevised control patients. Thus, high physical activity was not associated with implant loosening. Overall, THA increased physical activity levels in patients with hip osteoarthritis. High physical activity did not seem to be a risk factor for loosening of wear-resistant implants. Individuals with THA should be encouraged to embrace the health benefits of physical activity.

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