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

PURPOSE: The purpose of this study was to compare gait mechanics, golf mechanics, and knee joint osteoarthritis (OA) between golfers with and without a history of knee surgery. METHODS: Eight golfers (6 men, 2 women were enrolled in this study). Using a markerless motion capture (MOCAP) system, knee flexion angle at initial contact was assessed during two 15-second walking trials for golfers at a self-selected comfortable walking speed. Golfers with history of knee surgery (GKS, mean age: 67.3) and golfers without a history of knee surgery (GWKS, mean age: 66.3) were matched for sex and age. Participants hit 10 shots with a 7-iron in a golf simulator capturing golf shot data, kinematics and kinetics during the golfer's golf swing. Knee flexion angles at ball impact, external peak knee adduction moment and external peak knee abduction moment were assessed for the leading leg. Golfers were evaluated by a certified physical therapist using a 15-item movement screen. CT scans were used to evaluate knee joint OA. RESULTS: Gait analysis demonstrated average peak knee flexion at initial contact similar between the surgical leg of the GKS (5 ± 2°) group and the same respective non-effected leg of the paired GWKS (6 ± 6°) participant. Knee flexion angles at ball impact are as follows (GSK: 26 ± 8°; GWKS: 15 ± 6°), peak knee abduction moment during backswing (GKS: 10 ± 13 Nm; GWKS: 13 ± 10 Nm), and peak knee adduction moment during impact and follow-through (GKS: 61 ± 9 Nm; GWKS: 74 ± 40 Nm). Comparing the 4 GKS and the 4 GWKS, the Kellgran Lawrence grade for GKS was 2.33, while those GWKS was 1, indicating more advanced osteoarthritis in those with a history of knee surgery. The Numerical Pain Rating Scale (NPRS) was 2.4 in GKS and 1.8 for those GWKS. The Single Assessment Numerical Evaluation (SANE) was 87.3 for GKS and 82 for those GWKS. Interestingly, GKS scored better on the movement screen (11) than GWKS (8). Swing Data 7 iron total distance (GWKS:104 ± 43 yds, GKS: 115 ± 12 yds), ball speed (GWKS: 77 ± 21mph, GKS: 84 ± 5 mph, and launch angle (GWKS: 17 ± 3.7°, GKS: 15 ± 2°). CONCLUSIONS: Based on these pilot data, history of knee surgery may result in differences across gait mechanics, golf mechanics, and knee OA as compared to golfers without a history. Further research is necessary to determine the significance of differences.