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Average 2.9 of 20 Ratings
A 68-year-old right handed male golfer presents with significant left knee pain which has not been amenable to conservative management. A radiograph is shown in Figure A. He is interested in pursuing total knee arthroplasty (TKA). What can this patient expect with regards to his golf game after undergoing this procedure?
A significant rise in his handicap
No change in his drive distance
Decreased pain compared to undergoing a right TKA
A significant chance of having severe pain during play
Patients are required to use a cart while golfing
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Active golfers who undergo total knee arthroplasty (TKA) typically have a significant increase in their handicap when they return to the game.
Mallon et al studied 83 (80 of which were right handed) active golfers who underwent TKA and found that they invariably experienced a significant rise in their handicap (mean +4.6 strokes) and also a decrease in the length of their drives. Approximately 15% of the cohort experienced a mild ache while playing, and golfers with left TKA's had more difficulty with pain during and after play than did golfers with right TKA's. It also should be stated that statistically significant increased pain ratings occur in golfers with a TKA on the target-side knee. Finally, almost 90% of the patients in this study utilized a cart while playing post-operatively.
Mallon et al also evaluated the effect of total hip arthroplasty (THA) on the game of avid golfers. They found that hybrid and uncemented primary THA's had lower rates of radiographic loosening in active golfers when compared to cemented THA's. However, symptoms of pain while playing or after playing did not differ among these groups.
Arbuthnot et al sent golfing habit questionnaires to 750 consecutive avid golfers who had undergone total hip arthroplasty. They found no significant change from their predisease state to their 1-year postoperative golf performance and level of participation.
Mallon WJ, Callaghan JJ.
J Arthroplasty. 1993 Jun;8(3):299-306. PMID: 8326312 (Link to Abstract)
Mallon WJ, Callaghan JJ.
J Arthroplasty. 1992;7 Suppl:339-46. PMID: 1431914 (Link to Abstract)
Arbuthnot JE, McNicholas MJ, Dashti H, Hadden WA
J Arthroplasty. 2007 Jun;22(4):549-52. PMID: 17562412 (Link to Abstract)
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Average 1.0 of 107 Ratings
A 60-year-old female underwent hybrid total hip arthroplasty with good position of implants and post-operatively is instructed not to extend, adduct, and externally rotate the hip to prevent dislocation. What approach was likely performed?
The position to dislocate a hip anteriorly is extension, adduction, and external rotation which is the position at risk after an anterior approach. Hips are most likely to dislocate the direction of the approach assuming the implants are correctly positioned. Other important variables to THA stability include: component design, component alignment, soft-tissue tensioning, and soft tissue function.
Average 3.0 of 21 Ratings