Study Finds tennis, jogging and even golf are more demanding for joint
replacement. A recent study indicates that thousands of Americans who undergo
knee replacement surgeries each year may wish to dispose of their tennis rackets
and recover their bicycles.
According to Dr. Darryl D’Lima, director of orthopedic research laboratory of
the Scripps Clinic in La Jolla, California, researchers found that bicycles and
walking bands seem to be two of the most gentle for those who have undergone a
knee replacement by an artificial joint, while higher impact sports such as
jogging and tennis generated higher forces on the knee.
Even more surprising that the golf swing will also be demanding in the knees,
although D’Lima was quick to point out that the swing is just one part of the
exercise is done while playing golf.
Is scheduled to present his research Thursday at the annual meeting of the
American Academy of Orthopedic Surgeons in San Francisco. The study was
initiated by Dr. Clifford W. Colwell, director of the Center for Orthopedic
Research and Education of the Scripps Shiley.
According to the researchers, it is estimated that each year are performed in
the U.S. 478,000 surgical total knee replacement (known as arthroplasties). At
surgery, the joint is replaced by an original made of various materials such as
plastic and metal.
Typically, surgeons will recommend that patients resume physical activity as
possible. However, the advice about which activity is best has been subjective,
D’Lima said. So his team decided to measure forces on the knee when patients
participated in various exercises.
In the study, D’Lima team measured forces on the tibia in four patients who had
undergone a total knee arthroplasty. These four patients had a specially
designed joint that allowed forces to be measured from inside the implant.
One year after surgery, each of the four patients jogging, playing tennis, golf
swing made, walked (on a road and in banda ground level) and rode a bicycle
while measuring the forces in the area of the knee.
Researchers found that the golf swing produced 4.5 times the body weight in the
forward knee and 3.2 times in the other.
D’Lima noted that the forces produced by the golf swing, however, occur in an
instant, while the forces produced jogging are constant. I think golf would be
good, "he believes. "It’s more of scientific interest."
There were other surprises, D’Lima said. "We expected to walk in the walker
banda, which is more controlled, was better than biking [in terms of impact on
the knee]," noted the researcher. Cycling actually won, he said.
Below are details on the results.
- Cycling generated less force with an impact of about 1.3 times the body
weight.
- The next best was walking in the walker banda forces 2.05 times the body
weight.
- Walking on flat terrain generated forces of 2.6 times the body weight.
- Tennis occurred between 3.1 and 3.8 times the body weight and the
services were the most impact.
- Jogging produced forces 4.3 times the body weight.
Modification of certain high-impact exercises could help, he said. For
passionate golfers, you can change the swing, "says D’Lima. Golfers could get a
high-tech rolling, several manufacturers of golf clubs offer. They can also ask
a professional about how to modify the swing to exert less force on the knee,
D’Lima recommended.
However, for more strenuous activities such as jogging, high-impact, people who
have undergone knee replacement should be changed permanently to another
exercise, the expert recommended.
Dr. Daniel Oakes, an orthopedic surgeon from the floor of the UCLA Orthopedic
Hospital in Santa Monica, California, said the study confirms advice he
generally gives his knee replacement patients.
"We do not so strong trot," he says. "I tell them that what they can do is
walking, biking, hiking, biking, you use a walker and using an elliptical walker
banda.
Suggested to play doubles tennis, not singles, because there is so aggressive.
Generally allows patients to do their skiing on a slope or as soon healed. He
also thinks that golf is good.
Although the study confirms the suspicions of the experts on what a new knee put
increased pressure, can not be determined from the study if the increased forces
will lead to a higher rate of failure of the joint, said Oakes, who is also
professor assistant chief of orthopedic surgery and joint replacement service of
the David Geffen School of Medicine, University of California at Los Angeles.
SOURCES: Darryl D’Lima, MD, Ph.D., Director, Orthopedic Research
Laboratory, Scripps Clinic, La Jolla, Calif., Daniel Oakes, MD, Orthopedic
surgeon staff, Santa Monica-UCLA & Orthopedic Hospital, Santa Monica, Calif. .,
assistant professor, orthopedic surgery and chief, joint replacement service,
University of Southern California Los Angeles, David Geffen School of Medicine,
March 6, 2008, presentation, American Academy of Orthopedic Surgeons annual
meeting, San Francisco
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04 23rd, 2009| 