“Why golf,” my friends often ask. They, like too many Americans, assume it is a sport for the country club set, and have a hard time fathoming why someone like me — liberal, somewhat intellectual, decidedly anti-elitist — would passionately embrace the game.

My answer is always brief and direct. When I was 35, I tore my right knee’s anterior cruciate ligament during one of my twice-weekly pick-up basketball games in a small gym on the north side of Chicago. The sports medicine orthopedist who treated me (“best in the city, he handles some of the Bulls players,” I was assured by a sports writer friend) said I had two choices. He could conduct arthroscopic surgery and clean out the dangling ends of the central shock absorber of the knee. I would be on crutches for a few weeks and back to normal within three months.

But there was a catch: without an ACL, running and cutting sports would no longer be an option. Basketball? Gone forever. Even baseball, my high school letter sport, is a game marked by sudden spurts of activity, and therefore was dicey.

The other option was total reconstruction surgery, where they would slice off a piece of a nearby tendon and create a new ACL. He’d use arthroscopy, which was relatively new in those days. That meant no major scarring, which was a big plus. But the rehabilitation would take at least nine months, and involve a daily regimen of one to two hours of vigorous exercises to strengthen the muscles around the rebuilt knee.

Being a busy young reporter on the upswing of his career who often hit the road for good stories, the rehab sounded far too time-consuming and restricting. So I took up golf, and today, a quarter century later, I can shoot in the mid-80s on a good day (add ten on a bad one).

I was heartened to see confirmation of my choice in a recent New England Journal of Medicine. A study out of Sweden and Denmark compared two groups of young, active adults who tore their ACLs. One group got immediate reconstructive surgery while the other chose brief rehabilitation without reconstruction. The latter group’s “watchful waiting” strategy paid off. Only a third eventually needed total reconstruction, while both groups reported similar scores for pain, function in sports and recreation, and knee-related quality of life.

There are an estimated 200,000 ACL reconstruction operations in the U.S. every year. Each costs around $10,000 — a $2 billion-a-year industry. Eliminate two-thirds of those operations and you could save $1.3 billion a year in health care costs.

And it might even provide a boost for the golf industry, which has fallen on hard times.

Merrill Goozner is a freelance writer, independent researcher and consultant who blogs at Gooznews on Health.

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