Diving with Joint Replacement

Knee or Hip Replacement

There should be no diving limitations or restrictions placed on diving with a knee or hip replacement, or any other metallic inserts or implants. The effects of pressure are not any specific danger for implants which do not contain compressible gases. Gas laws (Boyle’s and Henry’s) don’t effect an implanted solid; the supposition that there is an increased chance of gas bubble formation in scar tissue or areas of deranged blood supply has no firm basis in man or animal studies.

Main limitations would be purely those imposed by rehabilitation from surgery, i.e., ability to walk around with heavy gear prior to entry and climb ladders (or shore) for exits. All wounds should be completely healed and the diver should have been released by the surgeon for full weight-bearing activities. Physical conditioning should have been accomplished.

One should be able to dive the usual limits of sport diving without any restrictions.

Diving After Knee or Hip Reconstruction

Much depends on the original cause of disability. Generally, the guidelines for the new diver are much more stringent than for an experienced diver who is returning from an injury. The sport diver should have no problem as long as there is good range of motion and the diver is able to bear weight.

To become a commercial diver, the candidate must have excellent mobility and dexterity and must be in a robust physical condition in order to meet the demands of the proposed work. For personal safety and that of others, all joints must have a normal full range of mobility.

The knee and hip are especially susceptible to dysbaric osteonecrosis and this must be kept in mind with the injury. Differentiating between residual x-ray findings and osteonecrosis may be difficult.

As far as commercial diving is concerned, it all depends on the examiner and the medical guidelines of the company and the type of work. Baseline radiologic studies are required and clearance by the orthopedic surgeon, that will go a long way to persuading the company doctors to allow return to work.

AUTHOR

Ernest S. Campbell, M.D., FACS

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