HipKnee Arkansas Foundation

Golf participation has increased dramatically in the last several years. With this increase in participation, clinicians need better evidenced based strategies to advise those golfers with different pathologies when it is safe to return to the game. Golf teaching professionals also need to understand how to alter golf mechanics to protect injured and/or diseased joints in golfers to allow them to play pain free and avoid further injury. This study used a 3-dimensional link segment model to calculate the net joint moments on the large lower limb joints (knee and hip) during golf (lead and trail leg) and two commonly studied activities of daily living (gait and sit-to-stand) in 22 males, healthy, adult golfers. It also examined the correlations between these knee and hip joint loads and club head speed. The external valgus knee moment and the internal hip adduction moment were greater in the lead leg in golf than in the other activities and were also correlated with club head speed. This indicates a strategy of using the frontal plane GRF moment during the swing. The internal hip extension and knee flexion moment were also greater in the golf swing as compared with the other activities and the hip extension moment was also correlated with club head speed. This emphasizes the importance of hip extensor (i.e., gluteus maximus and hamstring) muscle function in golfers, especially in those emphasizing the use of anterior-posterior ground reaction forces (i.e., the pivoting moment). The golf swing places some loads on the knee and the hip that are much different than the loads during gait and sit-to-stand tasks. Knowledge of these golf swing loads can help both the clinician and golf professional provide better evidence-based advice to golfers in order to keep them healthy and avoid future pain/injury.

Substantial postoperative stiffness requiring manipulation is a well-recognized complication of total knee replacement. This study sought to determine whether the Medial-Pivot (MP) knee (Wright Medical, Memphis, TN) or the Double-High (DH) knee (Wright Medical) is more often associated with manipulation under anesthesia (MUA) for post-total knee arthroplasty (TKA) knee stiffness. It was hypothesized that manipulation rates would be similar. Retrospective review of 755 TKA patients showed that 4.1% required MUA, which is comparable to the literature. Manipulation by MUA for DH and MP knees was generally successful, with an average overall improvement in knee flexion of nearly 30°. MP and DH knees appear to have a lower than average prevalence of post-TKA knee stiffness requiring manipulation when compared with the literature. The number of MP and DH knees requiring MUA did not appear to differ substantially.