Objective To determine the prevalence and incidence of musculoskeletal injury in amateur and professional golfers, and to identify common injury sites and factors associated with increased injury frequency. Design Systematic epidemiological review and meta-analysis. Data sources PubMed (Medline), Embase, the Cochrane Library and SPORTDiscus were searched in September 2023. Eligibility criteria Studies published in the English language reporting the incidence or prevalence of musculoskeletal injuries in golfers at all anatomical sites. Results 20 studies (9221 golfers, 71.9% male, 28.1% female) were included, with mean age 46.8 years. Lifetime injury prevalence was significantly greater in professional golfers (73.5% (95% CI: 47.3% to 93.0%)) than amateur golfers (56.6% (95% CI: 47.4% to 65.5%); relative risk (RR)=1.50, p<0.001). Professional golfers had a significantly greater lifetime prevalence of hand and wrist (RR=3.33, p<0.001) and lower back injury (RR=3.05, p<0.001). Soft tissue injuries were most common, and diagnoses were typically non-specific. Injury frequency was not associated with age or sex. Two studies reported a greater injury risk in amateur golfers playing more than three and four rounds per week. Conclusion Over half of golfers are at risk of sustaining a musculoskeletal injury during their lifetime. Risks and patterns of injury differ between professional and amateur golfers, with professionals significantly more likely to develop lower back, and hand and wrist injuries. A recent international consensus statement on the reporting of injury and illness in golf should aid consistency in future research assessing the epidemiology of specific diagnoses, informing golf injury prevention and management strategies. PROSPERO registration number CRD42023408738.

Background: Golf is a popular sport involving overhead activity and engagement of the rotator cuff (RC). This study aimed to determine to what level golfers were able to return to golf following RC repair, the barriers to them returning to golf and factors associated with their failure to return to golf. Methods: Patients preoperatively identifying as golfers undergoing RC repair at the study centre from 2012 to 2020 were retrospectively followed up with to assess their golf-playing status, performance and frequency of play and functional and quality of life (QoL) outcomes. Results: Forty-seven golfers (40 men [85.1%] and 7 women [14.9%]) with a mean age of 56.8 years met the inclusion criteria, and 80.1% were followed up with at a mean of 27.1 months postoperatively. Twenty-nine patients (76.3%) had returned to golf with a mean handicap change of +1.0 (P=0.291). Golf frequency decreased from a mean of 1.8 rounds per week preinjury to 1.5 rounds per week postoperatively (P=0.052). The EuroQol 5-dimension 5-level (EQ-5D-5L) index and visual analog scale (EQ-VAS) score were significantly greater in those returning to golf (P=0.024 and P=0.002), although functional outcome measures were not significantly different. The primary barriers to return were ipsilateral shoulder dysfunction (78%) and loss of the habit of play (22%). Conclusions: Golfers were likely (76%) to return to golf following RC repair, including mostly to their premorbid performance level with little residual symptomatology. Return to golf was associated with a greater QoL. Persistent subjective shoulder dysfunction (78%) was the most common barrier to returning to golf. Level of evidence: Level IV.

Purpose: To contextualize the Forgotten Joint Score (FJS‐12) by identifying a patient acceptable symptomatic state (PASS) threshold for patients undergoing hip arthroscopy and to investigate factors which correlated with postoperative FJS‐12 score. Methods: All patients who underwent hip arthroscopy for femoroacetabular impingement (FAI) under the care of a single surgeon between January 2018 and November 2019 were prospectively identified and included. Exclusion criteria were Tönnis classification grade 2 or greater. Data (including FJS‐12, EuroQol‐5 Dimension‐5L [EQ‐5D‐5L], visual analog scale (VAS), and 12‐item International Hip Outcome Tool (iHOT‐12) scores) were available before surgery and at a minimum of 1 year after surgery. PASS was calculated using an anchor‐based approach and receiver operator characteristic curve analysis. Pearson correlation analysis was used to correlate preoperative and postoperative factors with postoperative FJS‐12 score. Results: Seventy‐seven patients (54 female, 23 male; mean age 30.3 years [standard deviation {SD} 8.2]) were included. Linked longitudinal follow‐up data were available for 65 patients (84%) at a mean of 23.8 months (SD 6.4). Six patients required reoperation. Mean postoperative FJS‐12 score was 46.5 (SD 33.1) and mean change in score was 27.2 (SD 30.6, P < .001). The PASS threshold for the FJS‐12 was 38.5 (sensitivity 80%, specificity 88%), and the area under the curve was 0.852 (95% confidence interval 0.752‐0.951). Overall, 53.8% of patients achieved this score. Postoperative FJS‐12 score has moderate correlations with preoperative EQ‐5D‐5L, iHOT‐12, and FJS‐12 scores, and strong correlations with EQ‐5D‐5L, iHOT‐12 and VAS scores after surgery. Conclusions: We report a postoperative PASS threshold of 38.5 points for the FJS‐12 after hip arthroscopy for FAI in a United Kingdom population. This value can act as a quantifiable target for clinicians using the FJS‐12 to monitor patient outcomes in practice. FJS‐12 has strong correlations with EQ‐5D‐5L, iHOT‐12, and VAS at a minimum 12 months after surgery. Clinical Relevance: We have calculated the patient acceptable symptomatic state of the Forgotten Joint Score to be 38.5 points at short‐term follow‐up. This can assist clinicians in determining whether surgical interventions related to hip arthroscopy for FAI are meaningful to the patient.

Purpose: The Forgotten Joint Score (FJS-12) is a valid tool in the evaluation of patients undergoing hip arthroscopy, assessing the unique concept of joint awareness in the setting of a patient’s hip pathology. The preoperative burden on patients’ mental wellbeing of impaired joint function or symptoms is well established. The purpose of this study was to determine patients’ awareness of their hip joint whilst awaiting hip arthroscopy for femoroacetabular impingement, to explore any association between joint awareness and mental health status, and to determine whether this relates to time spent waiting for arthroscopy preoperatively. Methods: A prospective database of patients undergoing hip arthroscopy between January 2018 and November 2020 was analysed. All patients with a diagnosis of femoroacetabular impingement (FAI) undergoing arthroscopic treatment were included. Questionnaires included the FJS-12, twelve item international hip outcome tool (iHOT-12), EuroQol 5D-5L (EQ-5D-5L) and the Tegner activity score. Pearson’s correlation coefficient was used to assess relationships between continuous variables. Results: Preoperative functional outcomes were completed by 81 patients (97.5%) prior to undergoing hip arthroscopy. Median preoperative FJS-12 score was 16.67 (IQR 8.33 – 29.68). Forty-four patients reported any level of anxiety/depression preoperatively (54.3%). Preoperative FJS-12 showed a significant negative correlation with worsening mental health status (r = − 0.359, p < 0.001), and a significant positive correlation with EQ-5D-5L (r = 0.445, p < 0.001). The duration of symptoms or time on the waiting list did not correlate with increased joint awareness or worsened mental health. Conclusion: Joint awareness is high when awaiting hip arthroscopy for FAI. Increasing levels of joint awareness correlate with poorer mental health status and poorer quality of life measures, however these parameters do not seem to be associated with increased duration of symptoms prior to surgery or time on the waiting list for surgery.