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Golf Is A Strain On Your Knee Replacement

It’s always been difficult to advise people what they should and should not do after having a total knee replacement. We have suggested that skiing, squash, tennis, running, jumping and contact sports are a bad idea. Good sports were thought to be walking, cycling, bowls and golf. Now a study has thrown this consensus into disarray.

A study recently presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) has shown that golf is not the entirely benign activity it was thought to be. Golf has been considered to be a low impact activity but it seems it can put a significant stress on an artificial knee.

Dr DD D’Lima, the main author of the study, said “…we were not surprised to find that jogging and tennis generate a lot of force on the artificial knee joint. However, we did not expect to find that golf swings can be so hard on the knees. During the golf swing, it seems that there is a lot of force on the forward knee.”

Specially Designed Knee Implants

The team designed a knee replacement able to measure the forces put upon it and implanted this specially designed knee into four patients. A year later the team measured the forces occurring through the knee while the patients performed various activities including cycling, walking on a treadmill, tennis, jogging and swinging a golf club.
The highest forces generated in the knees were caused by jogging, tennis and golf. Walking was less stressful, with treadmill walking even less so and cycling giving the lowest stressses of all.

These results are important as high-impact activities are considered to have the potential to cause loosening of the joint and make revision surgery (a re-do) more likely. This is the first time stress results have been obtained from inside the joint whilst it is being used by a patient, making them more valid and realistic for the normal world.

Knee Replacement

Knee replacement is a very common operation in developed countries and is increasing across the world. In the US surgeons perform almost half a million a year. Knee components are made from alloy steel and high density polyethylene, giving very low friction and smooth movement even under load.

Knee replacement is an operation for pain. To be eligible patients should have significant pain, loss of movement, problems sleeping and reduction in their ability to walk and move about comfortably.

Exercise is an important part of rehabilitation after surgery to strengthen the knee muscles and maintain a moderate and healthy weight. It is important to have scientific results to guide exercise prescription after operation.

Cycling has been assumed to be low in impact and one of our patients recently came in having done 5,000 miles on his new knee in a year without any ill effects. This study confirms that biking is indeed low impact and a very suitable exercise for knee replacement patients.

This study does not imply that jogging, tennis and golf should not be performed when you have a knee replacement, just that alternative strategies should be considered. Jogging could be performed on a treadmill, reducing the stresses while still getting the aerobic benefits of the exercise.

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