Abstract
Purpose:
The reverse total shoulder arthroplasty (RTSA) was approved for use by the United States FDA in 2004. Since its introduction, its popularity for treating a number of shoulder conditions has grown considerably. However, many patients inquire about the potential to return to playing recreational golf, and at present there are no published data about how the RTSA prosthesis affects the golf swing. The purpose of this study is to evaluate the biomechanics of the golf swing in patients with RTSA, as well as the postoperative changes in handicap, driving distance, and holes played/week.
Methods:
A review of patient records for those that had an RTSA placed between June 2004 and December 2008 was performed. These patients were sent a questionnaire inquiring about details of golfing before and after RTSA. Patients who were still golfing after implantation of the RTSA prosthesis were selected for six-camera motion analysis testing of their golf swing. Computer analysis program was used to calculate parameters to biomechanically describe the golf swing.
Results:
Of the 97 patients that had an RTSA placed during the specified time period, 23 patients responded to the questionnaire and only 3 patients had ever and were still playing golf. A mean increase of 2.3 points in the handicap as well as a 33.3 yard decrease in driving distance was observed. The number of holes played per week decreased by 12 postoperatively. Motion analysis of the golf swings in patients with an RTSA showed decreased motion compared to high handicap golfers at the peak of the backswing at every shoulder parameter measured (forward flexion, horizontal adduction, external rotation); however, these differences were not statistically significant. The mean postoperative external rotation in our patients was 26.2°.
Discussion:
Though patients can return to golf after RTSA, self-reported trends towards worse handicaps, decreased driving distances, as well as decreased number of holes played/week were found. Furthermore, the RTSA prosthesis changes the biomechanics of the shoulder, resulting in alterations in ROM, specifically external rotation. Patients with the prosthesis in the leading and trailing shoulders compensate by increasing rotation through their torso during follow-through or increasing abduction during the backswing, respectively. Slower swing speeds during backswing and downswing were also observed.
Conclusion:
Patients can continue to play golf after RTSA; however, they may observe slower swing speeds, increases in their preoperative handicaps, as well as decreased driving distances. Possible changes in their swing may also occur that will require compensatory mechanisms to complete a full swing.
