Department of Trauma and Orthopaedic Surgery, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK.
Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, EH8 8AQ, UK.
J ISAKOS. 2024 Jun;9(3):341-347. doi: 10.1016/j.jisako.2024.03.004. Epub 2024 Mar 12.
Golf is a popular sport in older adults and this same population has an increasing prevalence of osteoarthritis affecting major joints such as the knee. To the authors' knowledge, the effect of Total Knee Arthroplasty (TKA) on the movements in the golf swing has not been extensively investigated despite the large prevalence of golfers who have undergone TKA. We aimed to determine lower limb joint kinematics during the golf swing and whether these are influenced following TKA.
A case- control study was undertaken with ten right-handed golfers who had undergone TKA (cruciate-retaining single radius implant) and five matched golfers with native knees. Each golfer performed five swings with a driver whilst being recorded at 200 Hz by a ten-camera motion capture system. Knee and hip three-dimensional joint angles (JA) and joint angular velocities (JAV) were calculated and statistically compared between the groups at six swing events.
The left knee demonstrated large effect sizes for lower external rotation during take away, mid (p = 0.01) and top of backswing in the TKA group. In contrast, the right knee demonstrated large effect sizes for lower external rotation in the TKA group during the downswing, contact and follow-through phases. There were no differences in knee flexion/extension, ab/adduction, or JAV between the groups. Both hips demonstrated statistically significantly (p = 0.02 for left and p = 0.04 for right) lower flexion in the TKA group during the takeaway swing event, and lower internal rotation in the backswing and greater external rotation in the downswing of the right hip.
Normal knee kinematics were observed during the golf swing following TKA, with the exception of reduced external rotation in the left knee during the backswing and the right during the down swing. The differences demonstrated in the hip motion indicate that they may make compensatory movements to adjust to the reduced external rotation demonstrated in the knee.
IV.
高尔夫是老年人中很流行的一项运动，而这一人群中膝关节等主要关节的骨关节炎患病率也在不断上升。据作者所知，尽管有大量接受过全膝关节置换术（TKA）的高尔夫球手，但 TKA 对高尔夫挥杆动作的影响尚未得到广泛研究。我们旨在确定高尔夫挥杆过程中的下肢关节运动学，以及 TKA 是否会影响这些运动学。
进行了一项病例对照研究，纳入了 10 名接受过 TKA（保留十字韧带单半径植入物）的右利手高尔夫球手和 5 名具有天然膝关节的匹配高尔夫球手。每位高尔夫球手在使用发球杆进行 5 次挥杆时，都通过一个 10 摄像头运动捕捉系统以 200Hz 的速度进行记录。计算了膝关节和髋关节的三维关节角度（JA）和关节角速度（JAV），并在 6 个挥杆事件中对两组进行了统计学比较。
左膝在 TKA 组的外旋起始、中（p=0.01）和上挥杆的外旋时表现出较大的效应量。相比之下，TKA 组的右膝在下挥杆、触球和随挥阶段的外旋较大。两组间的膝关节屈曲/伸展、内/外展或 JAV 无差异。两个髋关节在 TKA 组的外旋起始、上挥杆和下挥杆时的内旋明显减少（左侧 p=0.02，右侧 p=0.04），右侧髋关节的外旋增加。
TKA 后，高尔夫挥杆过程中膝关节的运动学基本正常，只有左膝在挥杆时的外旋减少，以及右膝在下挥杆时的外旋减少。髋关节运动的差异表明，它们可能会做出代偿性运动来适应膝关节的外旋减少。
IV 级。
