Tibiofemoral axial rotation during the golf swing is influenced by total knee arthroplasty bearing type and foot rotation
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Date
2025-10
Publication Type
Journal Article
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yes
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Abstract
Purpose
Golf remains a popular sport after total knee arthroplasty, although many patients report mild pain during or after play, particularly in the lead knee (knee on the target side). Lead knee kinematics during the golf swing are characterised by high tibiofemoral axial rotation at low joint flexion. However, it remains unclear whether the same range of tibiofemoral axial rotation is observed with mobile versus fixed bearing designs. This study aimed to evaluate the influence of two implant designs (mobile‐bearing and fixed‐bearing) and lead foot rotation (self‐selected, 0° and 30° externally rotated) on implant kinematics during the golf swing.
Methods
In a total of 11 healthy subjects (five mobile‐bearing and six fixed‐bearing), kinematic and kinetic data during the golf swing were assessed using videofluoroscopy, an opto‐electronic three‐dimensional (3D) motion capture system and two force plates.
Results
Significantly greater ranges of tibiofemoral axial rotation in the lead knee during the golf swing were observed for the mobile‐bearing compared with the fixed‐bearing design, independent of foot rotation at the start. Furthermore, the present data showed that a change in foot rotation from a 0° to a 30° externally rotated lead foot increased tibiofemoral axial rotation of the mobile‐bearing design but not the fixed‐bearing design.
Conclusion
The present results suggest that the mobile‐bearing design allows a greater range of tibiofemoral axial rotation in the lead knee than the fixed‐bearing design during the golf swing, likely due to the differences in internal transverse plane constraints between the two implant designs. However, it remains unclear whether the greater rotation is preferable in terms of longevity and soft tissue loading in total knee arthroplasty patients playing golf. The present data serve as input for musculoskeletal and finite element modelling with the future goal of guiding implant selection and foot positioning recommendations for golf after total knee arthroplasty.
Level of Evidence
N/A.
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published
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Journal / series
Volume
12 (4)
Pages / Article No.
Publisher
Wiley
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Edition / version
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Date collected
Date created
Subject
implant design; injury risk; kinematics; stance; videofluoroscopy
Organisational unit
03994 - Taylor, William R. / Taylor, William R.
03915 - Ferguson, Stephen / Ferguson, Stephen