Walking Gait, Swing Mechanics, And Knee Health In Golfers With And Without Surgical History

PURPOSE: Golf is a common way older Americans achieve the ACSM’s activity guidelines. In 2022, 41 million Americans played golf. Knee osteoarthritis (OA) tends to be common in golfers due to the load on the knee joint during the swing. OA arises in 50% of those who experience ACL or meniscus injuries and surgeries. The purpose of this study was to compare gait mechanics, golf mechanics, and knee joint health between golfers with and without a history of knee surgery. METHODS: Three-dimensional (3D) knee gait kinematics were captured during two 45-second walking trials on two male golfers (age 50 and 51) with (G2) and without (G1) a history of knee surgery. Participants hit 10 shots with a 7 iron in a golf simulator. 3D motion capture (MOCAP) and kinetics were collected using 8 cameras sampling at 300 Hz after applying 59 markers to the upper and lower extremities of the golfers. Golfers were evaluated by a licensed Medical 3 certified physical therapist using a 15 item physical assessment (TPI). CT scans and MRIs were also evaluated for knee health of golfers on the right (R) knee. RESULTS: G2 maintained similar knee flexion angles between the lead (39.8 ± 1.2°) and trail (40.5 ± 1.9°) leg during golf ball impact (p = 0.48) compared to significant side-to-side differences (p < 0.001) in G1 (lead 33.4 ± 6.3°; trail 47.2 ± 6.9°). External peak knee flexion moments were similar in the lead leg between golfers (G1 94.2 ± 9.0 Nm; G2 92.1 ± 4.1 Nm) . However, external peak knee adduction moment was greater in G1 (118.1 ± 7.7 Nm) compared to G2 (65.9 ± 2.8 Nm) in an apparent attempt for G2 unload the frontal plane during the swing. Based on gait reports; G1 achieves 2.3° of hyperextension and G2 has 8.5° of flexion at initial contact. TPI scores were similar: 12/15 (G1) and 11/15 (G2). Using the 7 iron, shot distances of 139 ± 19.9 yds (G1) and 116.2 ± 31.8 yds (G2) were observed. MRI reports OA in the medial compartment (G1) and grade 3 chondromalacia of the patella (G2). CT scans reported no degenerative arthrosis (G1) and chondrocalcinosis medially and laterally (G2). CONCLUSIONS: Based on these pilot data, it is evident that history of knee surgery may result in differences across gait mechanics, golf mechanics, and knee joint health as compared to golfers without a history. Further research is necessary to determine the significance of differences.