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Joint Replacements - Can I dive?
by By Dr Frans J Cronje on March 26th, 2015

DAN often gets questions about metallic implants, joint replacements, amputations and arthrodeses (joint stiffening surgery).
 
In general, once fully recovered, there is no requirement for specific limits or restrictions on diving due to any of these interventions. They are not specifically subject to laws of Boyle, Dalton and Henry in terms of gas compression and inert gas absorption. As such, the usual limits of sport diving are not of particular concern in these situations.

Whilst, at least theoretically, there may be an increased chance of gas bubble formation in scar tissue or areas of deranged blood supply, this has no firm basis in human or animal studies.
 
Mobility and strength are more pertinent concerns, i.e., the ability to walk around with heavy gear prior to entry, endure boat rides in heavy surf, and climb ladders (or rocks) for exits. All wounds should also be completely healed. So, the diver should have been released by the surgeon for full weight-bearing activities. Physical rehabilitation should have been completed.
 
In the case of metallic joint replacements, divers often notice a change in their buoyancy characteristics; they may need to adjust their weighing due to their newly acquired internal weights – the artificial joints. If one hip or knee is replaced, the diver may also tend to tilt or rotate to that side, and may need to redistribute their weights to offset this. A switch to aluminium tanks may also assist in lifting the pelvis to counter the effect of bilateral hip replacements.
 
Much  depends on the original cause of the disease or disability. If the joint destruction is the result of trauma, then other effects (e.g., head-injury or unconsciousness) may be much more important. If due to auto-immunity (e.g., rheumatoid arthritis), other body systems may be affected which have greater bearing on diving fitness. 
 
Lastly, although fitness guidelines for new divers are usually more stringent than for an experienced diver who is returning from an injury, it is unlikely that joint surgery or replacement - in isolation - will result in a recommendation not to dive.

There should be minimal problems, as long as there is good range of motion and the diver is able to bear weight. Therefore, mobility, dexterity, and the ability to withstand the rigors of the diving environment are of greatest significance.
DAN often gets questions about metallic implants, joint replacements, amputations and arthrodeses (joint stiffening surgery).
 
In general, once fully recovered, there is no requirement for specific limits or restrictions on diving due to any of these interventions. They are not specifically subject to laws of Boyle, Dalton and Henry in terms of gas compression and inert gas absorption. As such, the usual limits of sport diving are not of particular concern in these situations.

Whilst, at least theoretically, there may be an increased chance of gas bubble formation in scar tissue or areas of deranged blood supply, this has no firm basis in human or animal studies.
 
Mobility and strength are more pertinent concerns, i.e., the ability to walk around with heavy gear prior to entry, endure boat rides in heavy surf, and climb ladders (or rocks) for exits. All wounds should also be completely healed. So, the diver should have been released by the surgeon for full weight-bearing activities. Physical rehabilitation should have been completed.
 
In the case of metallic joint replacements, divers often notice a change in their buoyancy characteristics; they may need to adjust their weighing due to their newly acquired internal weights – the artificial joints. If one hip or knee is replaced, the diver may also tend to tilt or rotate to that side, and may need to redistribute their weights to offset this. A switch to aluminium tanks may also assist in lifting the pelvis to counter the effect of bilateral hip replacements.
 
Much  depends on the original cause of the disease or disability. If the joint destruction is the result of trauma, then other effects (e.g., head-injury or unconsciousness) may be much more important. If due to auto-immunity (e.g., rheumatoid arthritis), other body systems may be affected which have greater bearing on diving fitness. 
 
Lastly, although fitness guidelines for new divers are usually more stringent than for an experienced diver who is returning from an injury, it is unlikely that joint surgery or replacement - in isolation - will result in a recommendation not to dive.

There should be minimal problems, as long as there is good range of motion and the diver is able to bear weight. Therefore, mobility, dexterity, and the ability to withstand the rigors of the diving environment are of greatest significance.


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