Golf After Total Knee Arthroplasty: Prospective Analysis of Performance and Return to Play

Golf is a widely played recreational sport, but degenerative osteoarthritis in older adults can limit participation and performance. This study prospectively evaluates recreational golfers' performance metrics of play, and clinical outcomes before and after total knee arthroplasty (TKA). A prospective cohort of 10 recreational golfers undergoing primary TKA were assessed at a professional golf performance center preoperatively, and at 3 months and 1 year postoperatively. The mean age was 72 years, 90% were men, and 50% underwent TKA on the lead leg. Participants averaged 67 rounds in the year prior to surgery, and maintained a handicap index (HCP) of 18. Golf performance metrics (driver and 7-iron), force-plate biomechanics, return-to-play timing, quality of play, and Knee Injury and Osteoarthritis Outcome Score, Junior (KOOS-JR) were analyzed using descriptive statistics. The mean changes at 1 year postoperatively in driver and 7-iron swing speed (+ 1.3 and - 1.5 miles per hour [mph], respectively, 95% CI: - 5, 4.7), ball speed (+ 3.5 and - 2.6 mph, 95% CI: - 12.9, 12.3), carry distance (- 0.8 and + 6.2 yards, 95% CI: - 17.7, 17.1), maximum torque (+ 43 and + 85 pounds per foot [lbs/ft], 95% CI: - 30, 259), and vertical force (+ 93 and + 119 lbs/ft, 95% CI: - 175, 412) were obtained. All patients returned to full golf rounds playing a mean 8 (SD: ± 5.7) and 44 (SD: ± 29.7) rounds by 3 and 12 months, respectively, with no change in HCP (p = 0.9). The KOOS-JR significantly improved (57 to 80, p = 0.01). Recreational golfers safely returned to play after TKA with no significant changes in swing performance or handicap, while patient-reported outcomes improved. These findings suggest TKA enables resumption of golf without compromising performance.