Twenty-one studies [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39] published between 1995 and 2021 were analyzed. Table 1 shows an overview of the study characteristics and results. The studies were conducted in Western countries (Western Europe and the United States), except for one study from Japan [36]. Most studies concerned the hip [19,20,21,22,23,24,25,26,27,28,29,30, 33, 35,36,37, 39], with fewer studies on the knee [21,22,23,24,25,26, 29,30,31,32,33,34,35,36,37,38].

The quality of articles varied. The assessment of each article can be found in Additional file 2: Appendix 2A. Of the 21 articles included, none scored “yes” on all five questions of the MMAT, while 4 positive answers were given in five articles [23, 24, 27, 28, 35], 3 in thirteen articles [19, 20, 25, 26, 29,30,31,32,33,34, 36, 38, 39], 2 in one article [22], 1 in none of the articles, and none in two of the articles [21, 37]. There wasn’t a “no” score in ten articles [20, 23, 24, 27, 28, 30, 31, 34,35,36], while nine articles [19, 22, 26, 29, 32, 33, 37,38,39] received a “no” on one out of five questions. Further, one article [25] scored a “no” on two questions and 1 [21] on four questions. The remaining questions of the MMAT were assessed as a “can’t tell”.

In sixteen studies [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34] the focus was on general sports activities; in the majority of these studies self-constructed (web-based) questionnaires were used, distributed among orthopedic surgeons. One study [34] included physiotherapists. One study [27] focused on the influence of high-impact sports operationalized as a University of California, Los Angeles (UCLA) activity score of 9–10 versus low-intensity activities (UCLA score 1–4) on function, dislocation rate, linear wear and prosthetic survival. One study [26] informed on how far healthcare professionals use health-enhancing PA recommendations to stimulate persons after THA and TKA to become physically active again. No study included recommendations on sedentary behavior.

Five studies [35,36,37,38,39] focused on specific sports, two of which − including persons after THA − concerned alpine skiing and/or cross-country skiing [35, 37]. Focus was on the detrimental effect of skiing on loosening, migration and wear of the prosthesis. Two studies − one in persons after THA and one in persons after TKA − focused on tennis [38, 39]. Purpose was to characterize persons who play tennis after arthroplasty in terms of their functional abilities and degree of satisfaction. One study from Japan focused on playing golf [36] after THA. In a laboratory setting it was determined to what degree the golf swing had a detrimental effect on liner-to-neck contact and cup-head translation.

Overall, there is a general consensus on what kind of sports activities can or cannot be recommended.

In total 11 articles [