Knee replacement

[bironi]

Nice to see an active conversation about knee replacements 10+ years after my partial knee replacement. When I asked for advice from those who had the same issues and possible surgery, it was pretty much crickets on the bike forums. I have multiple friends that have had both knees done, and one that had both his knees done at the same time. I've been mostly pain free on the bike since, but my knee doesn't like twisting walking activity. A walk in loose beach sand is not for me. Anyway, it's good this conversation is now available for those looking for some advice from those with the experience.

[jamesdak]

Originally Posted by djg21

I was given PT to do immediately, and PT is crucial if you ever want to do anything athletic again. And when OA becomes debilitating, a TKR may be the only viable option. I went though years of Synvisc injections and anti-inflammatories because I supposedly was too young for a TKR (useful life of prosthetic is 15-20 years supposedly). It’s about picking the surgeon and facility, and understanding that there is a risk of a poor outcome with any surgery, even is it is considered a low-risk procedure.

Yep, this! The VA kept telling me I had to wait until I was 65 as if some standard age had anything to do with how bad my knees were. I was bone on bone in my right one before I was 40. Went through all the shots and PT and such and continued to decline. The tipping point for me was back two years ago when I hiked in maybe a mile up in Yellowstone to a place I routinely photograph bears. My knees swelled up so bad it took me about two hours to hobble out and I was concerned if I was going to make it. I pretty much demanded knee replacements after that. It sucked to be as young as I am and unable to keep up my own yard. And cleaning my house became an all day deal just because I couldn't stay on my feet but for a few minutes at a time. Ridiculous.

[teleguy57]

While I've posted in several threads on knee stuff I don't have a specific place to point you. So here is some info and opinions (Jeff's view of the world):

TKA Sep 2020 at age 66 after years of self-inflicted overuse injuries (running when younger, skiing, loaded hiking, and cycling. Had my knee scope/cleaned up when I was 26 after several half-marathons, meniscus trim on that knee when I was 56, prolotherapy on both knees (with my primary care guy we decided against hyaluronic acid injections for several reasons).

When I had the meniscus trim the surgeon said "let me know when you're ready for replacement -- and you'll know when that is."

Both knees were giving me problems so I took advice #1: do your research on surgeons -- ask everyone you can. I got great advice from my PT (personal friend cyclist, nordic skier and trail runner) as well as from other medical professionals including orthos who didn't specialize in knees/hips. Found an highly-recommended knee guy and met with him. We did the usual x-rays/exams/etc and then he asked me a lot of questions. Turns out he's very particular in selecting patients who he feels with do the rehab to deliver the best results and who want to continue to be active. He told me to pick which knee to do first because both need work....

Advice #2 -- prehab is perhaps even more important than rehab. Getting to the best strength/mobility before hand makes a big different.

Advice #3 -- check out info from active people who have had experience. I really appreciated Kelly Starrett's Surgery Series (met him in person at the Crossfits Games after we both had similar surgeries). Also had a great email exchange with Scott Johnson about his experience.

Also have become a big fan of Ben Patrick/kneesovertoesguy on prevention and rehab. (He has so much content it's a little challenging to get started learning about his approach).

So, my srgery went well and I immediately began rehab. Advice #4 -- keep working on that balance of too much/too little.
It's about the long game. I was on the bike on the trainer in my garage a week or so after surgery (seat went higher to accommodate very limited knee flexion and dropped from my normal 170s to 165s to help with that too). On the road again in about 6 weeks per the surgeon's advice. Easy nordic skiing in about 3 1/2 months.

I was told in 6 months I'd feel good, one year quite good, but it would be a full 18-months for recovery. I found that to be very true -- all of a sudden one day I realized I hadn't thought about my knee for a couple of days. Every once in a while I notice something, but the big picture is that it's stable and pain-free and doesn't limit me in any way.

Was anticipating TKA on my other knee in Fall 2023, but I put that on hold while dealing with my cardiac stuff (finished cardiac rehab today, surgeon cleared to get back on the roads next week with no limitations other than work my way back into it!) Have to consider timing -- not eager to jump into another major surgery soon.

So, do your homework on surgeons, prehab the heck out of yourself, rehab diligently, and be smart. You'll do great!

[kmla320]

Thanks! Good Advice!