Biomechanical characterisation of leg movement during the golf swing following knee surgery

INTRODUCTION The forces transmitted through the knee throughout the golf swing have been found to be as high as those associated with running (Colwell et al., 2005) therefore playing golf with a knee that has undergone surgery may place extra stress on the previously damaged area leading to variances in the golf swing. While it has been established whether it is safe to return to golf after knee surgery (Jackson et al., 2009), the actual effect that knee surgery has on golf movement has as not been researched adequately. The aim of the current study was to characterise knee kinematics for previously knee injured and non injured subjects during the golf swing to ascertain any residual differences in movement, despite full clinical rehabilitation of injured subjects. METHODS 10 previously injured recreational golfers (SURGICAL) (5 female, 5 male, 17.0 ± 5.5 handicap) and 5 control non-injured recreational golfers (CONTROL) (3 female, 2 male, 21.8 ± 2.3 handicap) were recruited. Previously injured subjects had all undergone left (lead) knee surgery for either ACL reconstruction, arthroscopy or total Knee Replacement (TKR) more than six months prior to testing. All subjects were considered fully rehabilitated and had returned to playing golf at the time of testing. Each subject performed 8 swings with their own driver in an indoor golf testing facility. Ethical approval for this study was obtained from EHS-REC and all participants were familiarised with the experimental procedure before providing written consent. Eleven retro-reflective leg markers were tracked at 400 Hz by a 6-camera 3D motion analysis system (MotionAnalysis Eagle, CA, USA); all data were filtered at 12 Hz (Mitchell et al., 2003). RESULTS + DISCUSSION Results from this preliminary study showed that golfers who have undergone previous knee surgery display more within-subject variability in knee movement. Surgical subjects showed deeper knee flexion perhaps as a residual muscle control response to the rotational shear forces experienced at the knee during the golf swing. CONCLUSION Rehabilitated surgical patients were able to comfortably perform the golf swing maneuver but with greater knee flexion variability compared to a healthy control group.