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Hitting the links may stress out new knees
Newswise — Until now, the impact of some recreational
activities has been hard to judge when it
comes to protecting artificial knee
replacements.
A study presented today at the 75th Annual Meeting of the
American Academy of Orthopaedic Surgeons (AAOS),
shows that golf, generally thought to be a
low impact activity, can also cause a great
deal of stress on an artificial knee.
“Some of our findings were expected. For example, we were not
surprised to find that jogging and tennis
generate a lot of force on the artificial
knee joint,” said Darryl D. D’Lima, MD, PhD,
primary author of the study.
Dr. D’Lima is director of the research laboratory at the
Shiley Center for Orthopaedic Research and
Education at Scripps Clinic in La Jolla,
California.
“However, we did not expect to find that golf swings can be
so hard on the knees. During the golf swing,
it seems that there is a lot of force on the
forward knee.”
Taking data from a specially designed artificial joint, the
study authors have determined exactly how
much force is put on the implant during some
common physical activities.
Clifford W. Colwell Jr., MD, implanted four total knee
arthroplasty (TKA) patients with joints
equipped to measure forces from inside the
implant. One year following surgery, the
patients performed the following activities,
for which the force on their replaced knees
could be measured:
• jogging
• tennis
• golf swings
• treadmill walking
• biking
Researchers found that jogging, tennis, and golf generated
the highest forces on the knees, while
walking generated a lower force; walking on
a treadmill instead of level ground further
reduced the force. The lowest force was
generated by biking.
Most orthopaedic surgeons agree that high-impact activities
in any form following a knee replacement
have the potential to shorten the life of
the artificial joint. However, nearly all
previous studies of force from different
activities on artificial knees have involved
only external measurements or estimates.
More than 478,000 total knee replacements are performed in
the United States each year. Patients might
have one or both knees replaced.
Total knee replacement is a surgical procedure whereby the
patient’s natural knee joint is replaced
with an artificial one, composed of metal
and plastic.
Some patients might have a unicompartmental replacement, in
which only a portion of the knee joint is
replaced.
The most common reasons for this surgery are:
• severe pain
• swelling
• stiffness in the knee, frequently caused
by osteoarthritis (OA) that cannot be
satisfactorily treated with medications or
other therapies
It is often recommended that TKA patients participate in some
form of exercise following surgery.
Maintaining a healthy weight and
strengthening the leg muscles can benefit
the artificial joints.
This is why it is so important for surgeons to have objective
measures of the amount of force that
different activities exert on the knee.
“Biking is often recommended for TKA patients because
developing the quadricep muscles helps
support the knee joint, and the activity was
assumed to be low impact,” Dr. D’Lima said.
“This study provides the scientific data to verify that
assumption. This is not to say that TKA
patients have to eliminate jogging, golfing
or tennis, but they should consider
modifying those activities will lessen the
impact on their knees.”
For example, the researchers suggest that joggers, who have
first discussed running with their
orthopaedic surgeon, might run on a
treadmill instead of pavement.
Disclosure: Dr. D’Lima and his co-authors received no
compensation for this study.
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