Can you maintain a competitive golf swing after total shoulder arthroplasty?

PURPOSE: Return to sports after joint arthroplasty is mainly evaluated for lower limbs procedures. When a return to a specific sport is mentioned, no technical approach nor level consideration are specified. We suggested that patients who undergo total shoulder arthroplasty will be able to maintain playing golf at same high level. METHODS: We performed a retrospective study on active golf players who have undergone shoulder arthroplasty. Inclusion criteria were: (1) over 50 years old (2) handicap < 54 (3) playing golf before the procedure (4) minimum follow-up of 1 year. Patients were divided into two groups: ASA group and RSA Group. A clinical assessment was performed using the following scores: Constant, ASES and QuickDash. RESULTS: Sixty-one patients were retrospectively included in the cohort. Mean age was 69.1 years old. Mean follow-up was 79 months. Preoperative golf frequency and handicap were similar between the two groups. Surgery resulted in significant pain relief in both groups. No difference was shown between the two groups in clinical assessment. Satisfaction rate was 95%. Return to golf time was done progressively from the twentieth week for putting until the twenty-seventh week for playing on the course. Handicap analysis did not show any difference between the level before surgery and the current level in ASA group (23.7 vs. 22.9,p = 0.33) and RSA group (24.2 vs. 23.3,p = 0.63). CONCLUSION: Our study suggested that both patients with ASA or RSA can maintain an active lifestyle with moderate to high frequencies of participation after surgery, particularly in golf. Surgeons can reassure their patients about their recovery and show confidence with regard to their ability to return to a similar golf practice also after RSA. Prospective study with larger cohort is required to confirm the results. LEVEL OF EVIDENCE: Level IV, cases study.

Golf Swing Biomechanics: A Systematic Review and Methodological Recommendations for Kinematics.

Numerous studies have been conducted to investigate golf swing performance in both preventing injury and injury occurrence. The objective of this review was to describe state-of-the-art golf swing biomechanics, with a specific emphasis on movement kinematics, and when possible, to suggest recommendations for research methodologies. Keywords related to biomechanics and golf swings were used in scientific databases. Only articles that focused on golf-swing kinematics were considered. In this review, 92 articles were considered and categorized into the following domains: X-factor, crunch factor, swing plane and clubhead trajectory, kinematic sequence, and joint angular kinematics. The main subjects of focus were male golfers. Performance parameters were searched for, but the lack of methodological consensus prevented generalization of the results and led to contradictory results. Currently, three-dimensional approaches are commonly used for joint angular kinematic investigations. However, recommendations by the International Society of Biomechanics are rarely considered.

Return to Competitive Level of Play and Performance in Regular Golfers After Total Hip Arthroplasty: Analysis of 599 Patients at Minimum 2-Year Follow-Up.

BACKGROUND: Total hip arthroplasty (THA) is performed in an increasingly younger and athletic population. Regular and competitive golfers are concerned with the likelihood of recovering their preoperative level of play. The purpose of this study was to assess the impact of primary THA on golfers' game, with a minimum follow-up of two years. METHODS: Questionnaires were sent to the French Golf Federation's golfing members. Those who were older than 40 years and had undergone a unilateral primary THA provided information on the timing of return to play, pain during golfing, transportation mode, drive length, handicap and weekly playtime, before hip replacement, and postoperatively. In addition, data relating to the surgical procedure were collected. RESULTS: Surveys were completed by 883 competitive golfers of which 599 were eligible for inclusion. The mean time to return to a complete 18-hole course was 4.73 months (SD 4.15, range: 0.7-36). Participants surveyed at a minimum 2 years after THA played at a higher level than before surgery with a handicap improvement of 1.8 (P < .01) and increased their mean weekly playtime from 8.8 to 9.3 hours (P = .24, NS). Eighty-eight percent reported an increased or no change in drive distance. Hip pain while playing golf decreased after surgery (6.8 to 2.5 on the visual analog scale, P < .001). CONCLUSION: This study highlighted that hip arthroplasty allowed regular and competitive golfers to return to the course with better golfing comfort than before surgery and with an objective improvement in driving distance and level of play.

A Playtime and Handicap Analysis of 143 Regular Golfers After Total Knee Arthroplasty at Minimum 2-Year Follow-Up.

BACKGROUND: Regular and competitive golfers are concerned by the ability to recover their previous activity golfing after total knee arthroplasty (TKA). The purpose of this study was to conduct targeted analysis of the effect of unilateral total knee replacement on the playtime and golf level in a population of experienced golfers, with a minimum follow-up of two years. METHODS: Questionnaires were distributed to the French Golf Federation's golfing members. Those who were older than 50 years and had undergone a unilateral primary TKA provided information on the timing of return to play, mode of movement on the course, pain during golfing, physical activity via University of California Los Angeles scale, level of golf and weekly playing time, before and after surgery. In addition, surgeons' recommendations and level of arthroplasty satisfaction were collected. RESULTS: Questionnaires were completed by 290 competitive golfers, of which 143 were eligible for inclusion. The average time to return to the 18-hole course was 3.7 months. Participants surveyed at a minimum 2 years after TKA played at a higher level than before surgery with a handicap improvement of 0.85 and increased their average weekly playtime from 8.9 to 10.2 hours. Knee pain while playing golf decreased after surgery (6.13 to 1.27 on the visual analog scale) and the University of California Los Angeles score improved (7.02 to 7.85). CONCLUSION: This study demonstrated the ability of regular golfers to return to golf within six months after unilateral total knee replacement, with increasing level of golf and weekly playtime and better golfing comfort.

Biomechanical analysis of the golf swing: methodological effect of angular velocity component on the identification of the kinematic sequence.

PURPOSE: The golf swing is a complex whole-body motion for which a proximal-to-distal transfer of the segmental angular velocities from the pelvis to the club is believed to be optimal for maximizing the club head linear velocity. However, previous experimental results about such timing (or kinematic sequence) are contradictory. Nevertheless, methods that were used in these studies differed significantly, in particular, those regarding the component of the angular velocity vector selected for the identification of the kinematic sequence. Hence, the aim of this study was to investigate the effect of angular velocity vector component selection on the identified kinematic sequence. METHODS: Thirteen golfers participated in this study and performed driver swings in a motion capture laboratory. Seven methods based on different component selection of segmental angular velocities (vector norm, component normal-to-sagittal, frontal, transversal and swing planes, segment longitudinal component and a method mixing longitudinal and swing plane components) were tested. RESULTS: Results showed the critical influence of the component chosen to identify the kinematic sequence with almost as many kinematic sequences as the number of tested methods for every golfer. CONCLUSION: One method seems to show the strongest correlation to performance but none of them can be assessed as a reference method for the identification of the golf swing kinematic sequence. Regarding the limited time lag between the different peak occurrences and the uncertainty sources of current materials, development of simulation studies would be more suitable to identify the optimal kinematic sequence for the golf swing.