Daisuke Hara1, Yasuharu Nakashima2, Satoshi Hamai1, Hidehiko Higaki3, Satoru Ikebe3, Takeshi Shimoto4, Kensei Yoshimoto1, Yukihide Iwamoto1. 1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 2. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan yasunaka@ortho.med.kyushu-u.ac.jp. 3. Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, Fukuoka, Japan. 4. Department of Information and Systems Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, Fukuoka, Japan.
Abstract
BACKGROUND: Although most surgeons allow their patients to play golf after total hip arthroplasty (THA), the effect on the implant during the golf swing is still unclear. PURPOSE: To evaluate hip kinematics during the golf swing after THA. STUDY DESIGN: Descriptive laboratory study. METHODS: Eleven hips in 9 patients who underwent primary THA were analyzed. All patients were right-handed recreational golfers, and these 11 hips included 6 right hips and 5 left hips. Periodic radiographic images of the golf swing were taken using a flat-panel x-ray detector. Movements of the hip joint and components were assessed using 3-dimensional-to-2-dimensional model-to-image registration techniques. Liner-to-neck contact and translation of the femoral head with respect to the acetabular cup (cup-head translation) were examined. Hip kinematics, orientation of components, and maximum cup-head translation were compared between patients with and without liner-to-neck contact. RESULTS: On average, the golf swing produced approximately 50° of axial rotation in both lead and trail hips. Liner-to-neck contact was observed in 4 hips with elevated rim liners (2 lead hips and 2 trail hips) at maximum external rotation. Neither bone-to-bone nor bone-to-implant contact was observed at any phases of the golf swing in any of the hips. Four hips with liner-to-neck contact had significantly larger maximum external rotation (37.9° ± 7.0° vs 20.6° ± 9.9°, respectively; P = .01) and more cup anteversion (26.5° ± 6.1° vs 10.8° ± 8.9°, respectively; P = .01) than hips without liner-to-neck contact. No significant differences between hips with and without contact were found for cup inclination (42.0° ± 2.5° vs 38.1° ± 5.5°, respectively; P = .22), combined anteversion (45.3° ± 8.9° vs 51.4° ± 7.9°, respectively; P = .26), or maximum cup-head translation (1.3 ± 0.3 mm vs 1.5 ± 0.4 mm, respectively; P = .61). CONCLUSION: In this analysis, the golf swing did not produce excessive hip rotation or cup-head translation in any hips. However, liner-to-neck contact during the golf swing was observed in 36% of the hips, with unknown effects on the long-term results. CLINICAL RELEVANCE: Golf is an admissible sport after THA because dynamic hip stability was observed. However, the implant position, especially cup anteversion and the use of elevated rim liners, promoted liner-to-neck contact.
BACKGROUND: Although most surgeons allow their patients to play golf after total hip arthroplasty (THA), the effect on the implant during the golf swing is still unclear. PURPOSE: To evaluate hip kinematics during the golf swing after THA. STUDY DESIGN: Descriptive laboratory study. METHODS: Eleven hips in 9 patients who underwent primary THA were analyzed. All patients were right-handed recreational golfers, and these 11 hips included 6 right hips and 5 left hips. Periodic radiographic images of the golf swing were taken using a flat-panel x-ray detector. Movements of the hip joint and components were assessed using 3-dimensional-to-2-dimensional model-to-image registration techniques. Liner-to-neck contact and translation of the femoral head with respect to the acetabular cup (cup-head translation) were examined. Hip kinematics, orientation of components, and maximum cup-head translation were compared between patients with and without liner-to-neck contact. RESULTS: On average, the golf swing produced approximately 50° of axial rotation in both lead and trail hips. Liner-to-neck contact was observed in 4 hips with elevated rim liners (2 lead hips and 2 trail hips) at maximum external rotation. Neither bone-to-bone nor bone-to-implant contact was observed at any phases of the golf swing in any of the hips. Four hips with liner-to-neck contact had significantly larger maximum external rotation (37.9° ± 7.0° vs 20.6° ± 9.9°, respectively; P = .01) and more cup anteversion (26.5° ± 6.1° vs 10.8° ± 8.9°, respectively; P = .01) than hips without liner-to-neck contact. No significant differences between hips with and without contact were found for cup inclination (42.0° ± 2.5° vs 38.1° ± 5.5°, respectively; P = .22), combined anteversion (45.3° ± 8.9° vs 51.4° ± 7.9°, respectively; P = .26), or maximum cup-head translation (1.3 ± 0.3 mm vs 1.5 ± 0.4 mm, respectively; P = .61). CONCLUSION: In this analysis, the golf swing did not produce excessive hip rotation or cup-head translation in any hips. However, liner-to-neck contact during the golf swing was observed in 36% of the hips, with unknown effects on the long-term results. CLINICAL RELEVANCE: Golf is an admissible sport after THA because dynamic hip stability was observed. However, the implant position, especially cup anteversion and the use of elevated rim liners, promoted liner-to-neck contact.
Authors: Anna C Severin; Sally G Barnes; Stewart A Tackett; C Lowry Barnes; Erin M Mannen Journal: Sports Biomech Date: 2019-01-30 Impact factor: 2.832
Authors: James Madrid; Maria Bautista; Juan F Guio; Guillermo Bonilla; Akillefs Betancourt; Adolfo Llinas Journal: Int Orthop Date: 2019-02-19 Impact factor: 3.075