Joint Replacement and the Golfer
By Larry Foster, M.D., F.A.A.O.S. (“Dr. Divot”)
As my own hairline goes
the way of the buffalo and my beltline gradually expands, I take comfort in
knowing that as I approach my fifties I have plenty of company—particularly on
the golf course. Studies show that there are about six million
Unfortunately, older
players can be afflicted with various medical conditions that might make
playing golf painful or even dangerous.
From an orthopedic point of view, arthritis of the hip and knee are
common and painful problems that can ruin an otherwise good day of golf.
Osteoarthritis usually
develops slowly, taking years to show symptoms and be visible on X-rays. Early complaints may include an ache or a
twinge of discomfort in the joint with activity (such as golf) or with weather
changes. (No, your Aunt Sadie wasn’t crazy when she used to announce at the
dinner table that she could tell it was going to rain soon because her knees
were acting up.) In its late stages,
osteoarthritis of the hip and knee can render an otherwise healthy person
unable to perform common daily activities such as walking, sleeping, or heaven
forbid, playing golf.
There are lots of
nonsurgical treatment options for arthritic joints including rest, weight loss,
medication, physical therapy, and injection treatments. These measures are usually the first course
of action to combat the pain and stiffness of arthritis.
Total joint
replacement—prosthetic replacement of the arthritic hip, knee—is the ultimate
surgical treatment for advanced arthritis that does not respond to nonsurgical
measures. Simply put, a total joint
prosthesis replaces the damaged joint surfaces (the knee hinge or the hip
ball-and-socket) with a device made from various combinations of metal and
plastic.
While total joint
replacement represents a great advance in medical science, it is important to
remember that the replacement is not a normal
joint. Complications such as premature
wear of the metal and plastic components or loosening of the prosthesis
frequently require revision of the prosthesis—a technically demanding procedure
that all orthopedic surgeons want to avoid whenever possible. Surgeons and biomechanical researchers are continually
trying to identify what factors hasten the loosening and/or premature
mechanical failure of total joint prostheses.
The key question for us
golfers, then, is whether golf represents a “risky” behavior after a total hip
or knee replacement. So far, the answer
is encouraging.
Let’s start with total hip
replacement. Well, I have
scoured the medical literature for you, and I have good news! One survey of the Hip Society (a sort of
orthopedic club made up of surgeons who are experts in hip replacement surgery)
was recently published where the surgeons were asked their views regarding the
role of golf and their hip replacement patients. The results should be a delight to
sore-hipped golfers everywhere:
- None of these
surgeons prohibited his patients from playing golf after hip replacement
- None of these
surgeons reported that their golfing patients had higher complication
rates than nongolfing patients
- Many of these
surgeons did recommend a three-to-four month healing period after surgery
before returning to golf. Starting
slowly with easy chipping and putting was recommended before returning to
full swing play
- About seven out of
ten of these surgeons advised the use of a cart for their patients when
they did resume play
Another survey published in the medical literature questioned
professional golfers and active amateur players who had returned to golf after
having a hip replacement. The news is
again good:
- All the
professional golfers reported that they were able to continue playing and
teaching golf after their surgery without problems
- More than ninety
percent of the amateurs responded that they had no hip pain when they
played golf. All the remaining
golfers who reported some degree of hip pain during golf noted that they
still had less pain than they did before the hip replacement
An identical survey of the
members of the Knee Society was conducted to evaluate how experienced knee
replacement surgeons viewed our beloved sport.
Again, the news was good:
- Some 93 percent of the surgeons responded that
they did not object to their patients playing golf after knee replacement
surgery
- Each surgeon responded that every patient of
theirs who expressed a desire to return to golf was able to do so after
total knee replacement surgery
- None of the surgeons reported a higher
complication rate among patients who returned to golf after total knee
replacement surgery
- However, more than three-quarters of the
surgeons recommended the use of a golf cart after surgery and at least
three months of recovery time was advised postoperatively, before a return
to golf
Total knee recipients,
both professional teachers and serious amateurs were also surveyed:
- The pros said they were able to play and teach
golf unhindered by their total knee replacement
- Some 90 percent of the amateurs were able to
play golf without pain. The
remaining players had some pain in their knee during golf, but less pain
than they had before surgery.
Admittedly, the available
surveys and studies linking golf and its effect on total joint replacement of
the hip and knee are not supported by huge numbers of patients or decades of
follow-up. Maybe some day we will have a
Surgeon General who is both a golf nut and a total joint recipient. Then, perhaps a few zillion dollars can be
allocated to do more in-depth research in golf medicine.
Until then, we can take
comfort in the conclusions drawn from the studies that are now available: that
golf seems to be a doctor-friendly, patient-friendly, and total joint-friendly
activity.
Please note: A more complete
discussion of total hip, knee, and shoulder replacement surgery and golf is
available in Chapter 14 of Dr. Divot’s Guide to Golf Injuries. Any
golfer who is contemplating joint replacement surgery is advised to read the
chapter in its entirety. Also, be sure
to discuss with your own surgeon your desire to return to golf after surgery so
that an individualized plan can be devised for you with your own doctor.
Larry Foster, M.D.,
F.A.A.O.S., is a board-certified orthopedic surgeon and self-described golf
nut.
Trained at
Visit Dr. Divot’s website at: www.doctordivotmd.com.
Or call:
1-800-247-6553 ($19.95).
The articles at GolfFitnessProducts.net are for informational purposes only and are not intended to substitute for direct examination and exercise prescription by the appropriate health professional. It is strongly recommended that you do not perform any exercise program without the consent of your personal physician.
