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Clement N, Robinson P, Murray I, Murray A, MacDonald D, Gaston P, Moran M, Macpherson G. Golfers are physically more active and have greater health associated quality of life than non-golfers following lower limb arthroplasty. J Orthop 2024; 54:158-162. [PMID: 38586599 PMCID: PMC10997996 DOI: 10.1016/j.jor.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024] Open
Abstract
Background The health benefits of physical activity are well recognised. This study assessed whether golfers were more physically active after lower limb arthroplasty when compared to those that did not play golf (primary outcome). In addition pre and postoperative changes in health-associated quality of life (HAQoL) and joint specific outcomes between golfers and none golfers were assessed (secondary outcomes). Methods There were 304 patients [THA (n = 155) or TKA (n = 149)] prospectively registered during a 4-month period undergoing lower limb arthroplasty. The mean age was 70.0 (range 37-92, standard deviation 10.2) years and included 188 (61%) females and 120 (39%) males. They completed pre and postoperative questionnaires assessing recreational activity, physical activity, HAQoL (EuroQol [EQ]), joint specific health (Oxford scores), and satisfaction. Results Golfers (n = 33, 10.9%) were more likely to achieve longer than 3 hours of moderate activity during a week (48.5% vs 38.0%, odds ratio (OR) 3.4, p = 0.045) and achieved their recommended activity level (96.8% vs 77.7%, OR 8.6, p = 0.015) compared to non-golfers following arthroplasty. Postoperative EQ5D (p = 0.034) and EQVAS (p = 0.019) were significantly greater in golfers. The joint specific Oxford hip score was greater in golfers compared to non-golfers (mean difference 5.6, p = 0.022), however no difference was observed in the Oxford knee score following TKA (p = 0.495). Conclusion Golfers were more likely to achieve their weekly recommended level of physical activity and had a greater HAQoL relative to those that did not play golf following lower limb arthroplasty. More specifically after THA golfers also had a greater postoperative joint specific outcome, but no such advantage was observed in those following TKA. Evidence Level Level II, diagnostic study.
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Affiliation(s)
- N.D. Clement
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, UK
- PGA European Tour Health and Performance Institute, Virginia Water, UK
| | - P.G. Robinson
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, UK
- PGA European Tour Health and Performance Institute, Virginia Water, UK
| | - I.R. Murray
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, UK
| | - A.D. Murray
- PGA European Tour Health and Performance Institute, Virginia Water, UK
- Medical and Scientific Department, R&A, St. Andrews, UK
| | - D. MacDonald
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, UK
| | - P. Gaston
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, UK
| | - M. Moran
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, UK
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Gaston P, Clement ND, Ohly NE, Macpherson GJ, Hamilton DF. Can Arthroplasty Stem Influence Outcome: A Randomized Controlled Trial of Stem Length in Cemented Total Hip Arthroplasty. J Arthroplasty 2023; 38:1793-1801. [PMID: 36813218 DOI: 10.1016/j.arth.2023.02.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The primary aim was to assess whether a short (125 millimeter (mm)) stem offered an equivalent hip-specific function compared to the standard (150 mm) stem when used for cemented total hip arthroplasty. Secondary aims were to evaluate health-related quality of life, patient satisfaction, stem height and alignment, as well as radiographic loosenings and complications between the two stems. METHODS A prospective twin-center double-blind randomized control trial was conducted. During a 15-month period, 220 patients undergoing total hip arthroplasty were randomized to either a standard (n = 110) or a short (n = 110) stem. There were no significant (P ≥ .065) differences in preoperative variables between the groups. Functional outcomes and radiographic assessment were undertaken at a mean of 1 and 2 years. RESULTS There were no differences (P = .428) in hip-specific function according to the mean Oxford hip scores at 1 year (primary endpoint) or at 2 years (P = .622) between the groups. The short stem group had greater varus angulation (0.9 degrees, P = .003) when compared to the standard group and were more likely (odds ratio 2.42, P = .002) to have varus stem alignment beyond one standard deviation from the mean. There were no significant (P ≥ .083) differences in the forgotten joint scores, EuroQol-5-Dimension, EuroQol-visual analogue scale, short form 12, patient satisfaction, complications, stem height, or radiolucent zones at 1 or 2 years between the groups. CONCLUSION The cemented short stem used in this study had equivalent hip-specific function, health-related quality of life, and patient satisfaction when compared to the standard stem at mean 2 years post operation. However, the short stem was associated with a greater rate of varus malalignment, which may influence future implant survival.
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Affiliation(s)
- Paul Gaston
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh; Department of Orthopaedics, University of Edinburgh, Edinburgh
| | - Nicholas D Clement
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh; Department of Orthopaedics, University of Edinburgh, Edinburgh
| | | | - Gavin J Macpherson
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh; Department of Orthopaedics, University of Edinburgh, Edinburgh
| | - David F Hamilton
- Department of Orthopaedics, University of Edinburgh, Edinburgh; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow
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Robinson PG, Creighton AP, Cheng J, Dines JS, Su EP, Gulotta LV, Padgett D, Demetracopoulos C, Hawkes R, Prather H, Press JM, Clement ND. Golfing after Orthopaedic Surgery: A longitudinal follow-up (GOLF) study protocol. Bone Jt Open 2023; 4:490-495. [PMID: 37400089 DOI: 10.1302/2633-1462.47.bjo-2022-0156.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
Aims The primary aim of this prospective, multicentre study is to describe the rates of returning to golf following hip, knee, ankle, and shoulder arthroplasty in an active golfing population. Secondary aims will include determining the timing of return to golf, changes in ability, handicap, and mobility, and assessing joint-specific and health-related outcomes following surgery. Methods This is a multicentre, prospective, longitudinal study between the Hospital for Special Surgery, (New York City, New York, USA) and Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, (Edinburgh, UK). Both centres are high-volume arthroplasty centres, specializing in upper and lower limb arthroplasty. Patients undergoing hip, knee, ankle, or shoulder arthroplasty at either centre, and who report being golfers prior to arthroplasty, will be included. Patient-reported outcome measures will be obtained at six weeks, three months, six months, and 12 months. A two-year period of recruitment will be undertaken of arthroplasty patients at both sites. Conclusion The results of this prospective study will provide clinicians with accurate data to deliver to patients with regard to the likelihood of return to golf and timing of when they can expect to return to golf following their hip, knee, ankle, or shoulder arthroplasty, as well as their joint-specific functional outcomes. This will help patients to manage their postoperative expectations and plan their postoperative recovery pathway.
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Affiliation(s)
- Patrick G Robinson
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- European Tour Performance Institute, Virginia Water, UK
| | | | - Jennifer Cheng
- Hospital for Special Surgery, New York City, New York, USA
| | - Joshua S Dines
- Hospital for Special Surgery, New York City, New York, USA
| | - Edwin P Su
- Hospital for Special Surgery, New York City, New York, USA
| | | | | | | | | | - Heidi Prather
- Hospital for Special Surgery, New York City, New York, USA
| | - Joel M Press
- Hospital for Special Surgery, New York City, New York, USA
| | - Nick D Clement
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- European Tour Performance Institute, Virginia Water, UK
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Robinson PG, Kay RS, MacDonald D, Murray AD, Clement ND. Golfers have greater preoperative and equal postoperative function when undergoing total knee arthroplasty compared to non-golfers. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2022; 33:1083-1089. [PMID: 35362779 PMCID: PMC8973671 DOI: 10.1007/s00590-022-03253-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/15/2022] [Indexed: 11/30/2022]
Abstract
Background Approximately 10% to 20% of patients with joint arthroplasties are golfers. The aim of this study was to assess if being a golfer is associated with functional outcomes, satisfaction or improvement in quality of life (QoL) compared to non-golfers following total knee arthroplasty. Methods All patients undergoing primary total knee arthroplasty (TKA) over a one-year period at a single institution were included with one-year postoperative outcomes. Patients were retrospectively followed up to assess if they had been golfers at the time of their surgery. Multivariate linear regression analysis was performed to assess the independent association of preoperative golfing status on postoperative function and health-related outcomes. Results The study cohort consisted of a total of 514 patients undergoing TKA. This included 223 (43.3%) male patients and 291 (56.7%) female patients, with an overall mean age of 70 (SD 9.5) years. The preoperative Oxford Knee Score (OKS) was significantly higher in golfers when adjusting for confounders (Diff 3.4 [95% CI 1 to 5.8], p = 0.006). There was no difference in postoperative outcomes between golfers and non-golfers. There was however a trend towards a higher Forgotten Joint Score (FJS) in the golfers (difference 9.3, 95% CI − 0.2 to 18.8, p = 0.056). Of the 48 patients who reported being golfers at the time of their surgery, 43 (89.6%) returned to golf and 88.4% of those were satisfied with their involvement in golf following surgery. Conclusions Golfers had better preoperative and equal postoperative knee specific function compared to non-golfers. The majority of golfers returned to golf by one year and were satisfied with their involvement in the game. Level of evidence III.
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Affiliation(s)
- P G Robinson
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.,PGA European Tour Performance Institute, Virginia Water, UK
| | - R S Kay
- Edinburgh Medical School, University of Edinburgh, Edinburgh, UK.
| | - D MacDonald
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - A D Murray
- PGA European Tour Performance Institute, Virginia Water, UK.,Sports and Exercise Medicine, University of Edinburgh, Edinburgh, UK.,Medical and Scientific Department, The R&A, St. Andrews, UK
| | - N D Clement
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
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Khan ST, Robinson PG, MacDonald DJ, Murray AD, Murray IR, Macpherson GJ, Clement ND. Infographic: Total hip arthroplasty in golfers. Bone Jt Open 2022; 3:152-154. [PMID: 35172588 PMCID: PMC8886315 DOI: 10.1302/2633-1462.32.bjo-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Shujaa T. Khan
- Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Patrick G. Robinson
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- PGA European Tour Performance Institute, Virginia Water, UK
| | | | | | - Iain R. Murray
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | - Nick D. Clement
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
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