# Total Knee Replacement



## gobylvr (Oct 27, 2012)

Hello,

I would like to know if anyone out there that mountain bike rides and or races has had a total knee replacement ? I am facing a total knee in june and love to mountain bike race but I am really nervous that I might not be able to ride as aggressivley as I do now.

Any advice is greatly appreciated.

Liz


----------



## bnelson (Jan 25, 2004)

had a total left done 12-28-12 started riding 4 weeks after surgery.pt was going good so they gave me the ok.It has been a learning adventure.Been putting in long base miles and ride according to discomfort.Just listen to dr an pt therapist.what is reason for tkr? if you dont mind asking.


----------



## Cult Hero (Apr 30, 2007)

take a look at this product before you pull the trigger on the knee. I have been working in the medical device world for years now. I carry this product along with several others (including total knee devices) and I have seen fantastic results with it.

I personally have about 250 patients in the Santa Barbara area on the BioniCare and have seen fantastic results. Not an overnight fix, but if you are trying to buy some time before you have to get the replacement this could help

Knee Osteoarthritis Treatment Hand Rheumatoid Arthritis Treatment


----------



## Murph53 (Apr 17, 2013)

Hi Liz, Im Paul and I'm posting here because I strongly believe that sharing my sister's story can help others - before you are done testing and make a decision please read..

About 2 months ago my sister had a TKR. It happened to be that I had the same surgery myself 2 years ago. It's not an easy thing to go through, and I made sure to be as supportive of my sister as possible. The surgery went well, she was recovering, and then, all of a sudden, 2 days after the procedure she almost bled to death. There're many things you take into consideration when going through knee replacement - will the surgery go well? Will I wake up from anesthesia? Will my new knee be rejected or not. I discussed these things with my physician in detail, and so did my sister. But apparently, there's a risk of internal bleeding caused by anticoagulants that are injected after surgery, to prevent the blood clots formation. The risk is not exceptionally frequent, but my sister happened to be in the unlucky part of statistics. When she was in an emergency room, I realized that going through the similar procedure in a different hospital I wasn't even prescribed anticoagulants. I remembered being on baby aspirin and a portable compression device for about 10 days after the surgery. During my recovery period, I didn't think too much of it. But when my sister was bleeding to death, I kept thinking that if she was prescribed that device instead of anticoagulants, her life would probably not be at risk.

I did some research and found the name of the device. It's called ActiveCare+SFT, it applies soft compression to your legs, and somehow prevents clots formation without a need of anticoagulants. Here's their website. They also have a list of hospitals where this device is prescribed.

Read about it, and please spread the word! This is the best life saving tip anyone can give you if you're going through any lower limb replacement surgery.

MCS Learn How to Reduce DVT Risks .

Another site to help you with your concerns for riding again..

Bike Riding After A Total Knee Replacement | LIVESTRONG.COM

I was back to riding (road) within a cple months, I really feel it depends on the person and how determined they are... Do that physical therapy and strengthen and condition your knee and you will be riding in no time... Best of luck, Paul


----------



## gobylvr (Oct 27, 2012)

Sorry for the late reply , but my knee has so much arthritis from an old injury and I also have basically no miniscus so it rubs bone on bone. It almost looks deformed from all the arthritis and I also have 3 bone spurs and that all combined is limiting my range of motion and making any type of cycling uncomfortable . It stinks and I'm scared ! All I want to be able to do is cycle and weight lift and mountain bike race , thats all I ask...


----------



## Moementum (Oct 21, 2006)

I did not have knee surgery but bilateral (2 at once) hip resurfacing about 4 years ago, it is similar to THR. I also had very bad arthritis in both hips and was bone on bone. I have no problems mountain biking and zero pain although I do ride with more caution. I could race if I wanted to but I did plenty of that in the past and do not desire to do it any more. There is a procedure called knee resurfacing that is now available but I do not know much about it, but it is worth looking into. There can be cycling after joint replacement, but the surgeon and device choice is critical. They are not all created equal. If the surgeon screws up or is not super experienced you in for a very tough road, you will not be able to live w/o painkillers never mind ride a mtb. I cannot emphasize that enough. Good luck


----------



## Wherewolf (Jan 17, 2004)

*Both five years ago*

Had both replaced five years ago. My 63rd birthday ride:


----------



## banditfl (Nov 17, 2012)

I am 5 weeks and 2 days post total knee replacement surgery, I have been on the stationary bike over 3 weeks now. my flexibility is actually better now than before my surgery. still doing my rehab gaining strength and stamina again. this stiffens up when walking for extended periods of time. my therapist is impressed of my progress and says the good progress is due to riding before surgery. my doc said the only thing I can't do is mogul ski. I might try the actual bike this coming week just riding around the neighborhood. I think it will be a couple months before starting some easy trails. I'll see what the doc says.


----------



## Low Pressure (Nov 27, 2006)

No moguls, FTS!

I see a lot of heli skiing in my future.


----------



## Obgod3 (Oct 21, 2011)

I had a TKR last April (2013), biking is key to recovery I promise, did a lot of stationary for a little while the started on bike paths about week 4 and worked up from there. I was riding my dirt bike at 4 months and doing MTB trails about the same time. I am doing fine right now riding both, no limitations other than a little scar tissue still breaking up from time to time. Only thing I wish was is that I had not waited so long, lived in pain way to long, mine started by shattering the top of my tib June 2010, tibial plateau fracture.

TKR = no more running, you can but your knee won't last as long! no more moguls' as someone already mentioned. But pretty much the rest is fair game.

TKR's are pretty much routine surgeries these days, there really isn't a bad prosthetic but do meet with a couple doc's and make sure you agree with their recovery plan, aggressive, passive etc. resurfacing ( not even sure they do that)is nothing more than a interim solution, you'll get a knee eventually anyway, same for partials. Most people that get one are not like us,they are already not active and live sedentary lifestyles, probably don't do their PT like they should after surgery and complain later. 

I met with four or five surgeons before mine, honestly and this is just an opinion, if they mention an osteotomy, resurface or partial I say run, don't walk..away. Most knees are considered 90% knees meaning at 15-20 years 90% of folks across the board still don't need a revision. Honestly after breaking my tib I would take a knee replacement surgery any day, the recovery was 10 times easier. It is rare that people reject the prosthetic and infection protocols are very complete these days. My wife is also a surgical RN so between my own research and her I have a pretty good feel for it. Let me know if you have any other questions.

My avatar is after I broke the tib, 4 hours putting it back together, bone grafts, plates and screws, ACL, cartilage and MCL damage...long long recovery plus they had to removed the plates and all screws during the TKR surgery, overall the TKR was easy.


----------



## LadyDi (Apr 17, 2005)

Gobylvr I wonder how you are doing now??


----------



## MTB Dad (Sep 22, 2012)

I am at the start of this myself. I've had several scopes and micro fraction and knee is shot. I still ride but need lots of Advil to continue and avoid standing and grinding up hills. Running or even good walks cause lots of pain so my only decent exercise has been my rides. Had two doctors say I need TKR but because I'm 48 they say they would do partial first. I really don't want a partial as I've heard lots of negative stories. 

Should I be forceful in not wanting a partial?


----------



## Wherewolf (Jan 17, 2004)

*Second opinion*



MTB Dad said:


> ...Should I be forceful in not wanting a partial?


Get a second opinion. One orthopedist said I wouldn't be able to bike, while the second opinion encouraged me to bike. I took the second opinion and I have biked thousands of miles since!


----------



## MTB Dad (Sep 22, 2012)

I had a third doc (friend) look at my MRI as well and agreed TKR is gonna be needed but just cause I'm under 50 they keep pushing a partial. I'm only 14 months short of 50 so I don't get it...
As long as I can continue riding I don't care just don't feel like going through major surgery twice as it seems partials don't seem to last from what I've read and heard. 

Anyone have an opinion on partial?


----------



## LadyDi (Apr 17, 2005)

MTB Dad- my orthopedic surgeon told me good candidates for PKR are rare and that he can't know for sure until he's in there. I am also in that pre-surgery limbo and hoping to make some good decisions. I can no longer climb out of the saddle because the bad knee doesn't have the strength to make the full rotation. It really pisses me off. I am 56.


----------



## MTB Dad (Sep 22, 2012)

Finally got the attorneys on both sides to allow surgery. Injuries were all at work so I've been jumping through all the WC hoops. I am to have surgery in 36 days. I found a doctor I like and as you stated LadyDi the doc says once in there he'll know for sure but he is still leaning toward PKR as the other side looks really good on all MRI's. 

Only thing I can do exercise wise is ride and that's with lots of Advil. I'm riding close to my fastest times on my 20 mile loop with about 40% of it being climbs. If I do more miles I get pain and swelling.

Anyone riding with PKR and if so are you still going as hard as before? I gave up all other sports due to pain and swelling but cycling has been my saving grace which is perfect as it's always been my #1 past time. If I can still ride is all I care about.


----------



## LadyDi (Apr 17, 2005)

Looks like we'll need to ask George Bush how he's doing with two new PKRs.

(please people don't jump on me for posting a Fox news article- it's knees, not politics).

What we can all learn from Bush's partial knee replacement surgery | Fox News


----------



## MTB Dad (Sep 22, 2012)

Ok I'm typing this in my hospital room after having a PKR early this morning. I'm still a bit out of it but it wasn't too bad. I've already walked up and down the hall with the PT specialist. Says I can prob get on the bike in about 3 weeks, wahoo!!!!

Boy I wish I was on my bike!!


----------



## LadyDi (Apr 17, 2005)

Okay, now I wish I hadn't started a new thread (and titled it exactly the same!). I was in a pain fog at the time.


----------



## mrothmel (Sep 2, 2008)

*Total Knee Replacement.*



gobylvr said:


> Hello,
> 
> I would like to know if anyone out there that mountain bike rides and or races has had a total knee replacement ? I am facing a total knee in june and love to mountain bike race but I am really nervous that I might not be able to ride as aggressivley as I do now.
> 
> ...


I had TNR of right knee 10 days ago. Swelling is starting to go down in my calf. Still can't go 360 degrees on stationary bike. I rode aggressively (for New Jersey) leading up to the surgery so I was in great shape when I went in. (Heart rate 49). Doc was so impressed day after surgery I was discharged with a cane instead of a walker. Biggest problem is knots in my calf from walking bow legged so long before surgery (he straightened my leg during surgery as beforehand it was half inch shorter than my good leg). Reading the posts is inspiring. I hope to get 360 degrees by Monday 12/29 and on asphalt by 1/15. Biggest problem is that I ride with my dog three days a week and he is getting ripped off because I am off the bike. He is a great trail dog, well mannered with other dogs, other riders and horses. There is asphalt off rode trail near my house. We'll keep you posted.

Mike


----------



## Call Me FJ (Jan 29, 2015)

gobylvr said:


> Hello,
> 
> I would like to know if anyone out there that mountain bike rides and or races has had a total knee replacement ? I am facing a total knee in june and love to mountain bike race but I am really nervous that I might not be able to ride as aggressivley as I do now.
> 
> ...


I am 14 days post TKR, but my road to the OR covered 27 years and 6 surgeries and one non FDA approved treatment . I originally blew my knee part snow skiing that resulted in a full reconstruction. 7 years later, I had the knee "cleaned up." Roughly 8 years after the clean up, I had the two step Carticel (cartilage implants) procedure performed. Two years ago I tore my meniscus wake surfing. As a last ditch effort, I had a PRP and stem cell procedure. While I believe this procedure has merits for knew injuries, I did not benefit from this procedure.

While I was hoping to be further along in my range of motion, the past scar tissue is slowing this down. Both the Dr and PT are pleased with the progress given my history. Currently I am at 85 degrees flexion and -5 extension. Leg strength is improving daily due to 3 times weekly PT and PT at home on the off days.

Ironically, I was asked by a nurse during pre op, why would I go through with a TKR at 53 years old. My reply was simply so I could ride again as the post ride pain became so great, that I do not ride in the months prior to the procedure.

Not so ironic was the decision to have this done. My Dr (who is also a MTB rider) said that when the pain kept me from riding, I would know it was time.

I will post notable updates as I progress.


----------



## mrothmel (Sep 2, 2008)

*My Experience*

I had a total knee replacement seven weeks ago. I am 55. I trained for the surgery by pushing myself riding 3 days per week. I began my own bending exercises in the hospital bed that night and asked for a home program the next day. I started physical therapy three days per week three days after surgery.

I worked out twice a day, either PT plus evening or morning before work plus evening.

I was greatly rewarded. At my appointment today the doctor said my strength is six months post surgery and my range of motion is one year post surgery.

I have only gotten on the bike outdoors once because of schedule, PT three mornings a week and horrific northeast weather. I am now cleared to ride and just picked up new bike shoes and cleats from LBS.

I do not think a total knee replacment will hurt you at all as long as you follow pre op instructions (to avoid risk of infection) and are dilligent in your PT. Given the fact you are getting surgery in June, you could be back on the bike in August.

I would not anticipate any limitations.



Call Me FJ said:


> I am 14 days post TKR, but my road to the OR covered 27 years and 6 surgeries and one non FDA approved treatment . I originally blew my knee part snow skiing that resulted in a full reconstruction. 7 years later, I had the knee "cleaned up." Roughly 8 years after the clean up, I had the two step Carticel (cartilage implants) procedure performed. Two years ago I tore my meniscus wake surfing. As a last ditch effort, I had a PRP and stem cell procedure. While I believe this procedure has merits for knew injuries, I did not benefit from this procedure.
> 
> While I was hoping to be further along in my range of motion, the past scar tissue is slowing this down. Both the Dr and PT are pleased with the progress given my history. Currently I am at 85 degrees flexion and -5 extension. Leg strength is improving daily due to 3 times weekly PT and PT at home on the off days.
> 
> ...


----------



## mrothmel (Sep 2, 2008)

Eight weeks post surgery and I am trail riding. 5.5 miles Saturday on flats, today on my normal weekday before work trail. About 1/3 slower; 44 minutes instead of 34 minutes but there was ice I had to walk over so its not a real gauge. Did the log overs and easy hills. Some stiffness afterward but by mid day I was fine. All in all a good first ride. When the ice melts we'll get a true test. 

Keep on plugging away at two a day PT/exercise. Every day you will do more. Slowest thing now is quad growth. That's the next step.


----------



## LadyDi (Apr 17, 2005)

You all are doing great! I'm 3 1/2 months post LTKR and back on the cyclocross bike so far, and clipless. I did 14 easy bike path miles Sunday and am paying for it with some increased swelling & stiffness. This "two steps forward/one to three steps back" nonsense has been a theme in my recovery. I'm okay with it as long as the eventual outcome is good. This far out I just need an occasional extra-strength Tylenol. I don't have full flexion yet, so I've got a shorter (170 vs 175mm) crankset ready to swap out on my 29er. I estimate I'll be trail-ready in a couple weeks. My knee feels MUCH stronger overall, no issues clipping in or out at lightest tension on Time atacs, residual quad weakness because of the surgical approach. I'll get there!


----------



## mrothmel (Sep 2, 2008)

*Updates*

Rode for 45 minutes yesterday with my dog who is a veteran trail dog and my daughter's dog who is a newbie we are babysitting while she is in Paris. No problems riding but overnight the IT band (ligament on the outside of the knee) was sore and woke me up several times. Worked itself out over the course of the day although tender in the morning. Guess that's what we mean when we say three steps forward two steps back. However, no pain while riding is great. I'll take the pain the next day.


----------



## LadyDi (Apr 17, 2005)

Hi mrothmel- I'm up to 20 mile road/bike path rides, and I believe I'm ready for fireroads and easy trails. I feel better riding than just about anything else. Does your incision scar's appearance change throughout the day depending on your activity? Mine sure does!


----------



## mrothmel (Sep 2, 2008)

*Scar*

Hi Lady Di:

I've not noticed any change in my scar during the day but I only look at it twice a day. I don't wear dresses. ;-{ )

Seriously though, since the scar fully closed up I put Vitamin E cream on it every morning and it is healing nicely. Mine is extra long 6.5 inches because he had to remove a screw from my prior reconstructive surgery.

Mike



LadyDi said:


> You all are doing great! I'm 3 1/2 months post LTKR and back on the cyclocross bike so far, and clipless. I did 14 easy bike path miles Sunday and am paying for it with some increased swelling & stiffness. This "two steps forward/one to three steps back" nonsense has been a theme in my recovery. I'm okay with it as long as the eventual outcome is good. This far out I just need an occasional extra-strength Tylenol. I don't have full flexion yet, so I've got a shorter (170 vs 175mm) crankset ready to swap out on my 29er. I estimate I'll be trail-ready in a couple weeks. My knee feels MUCH stronger overall, no issues clipping in or out at lightest tension on Time atacs, residual quad weakness because of the surgical approach. I'll get there!


----------



## stberhard (Aug 6, 2010)

I had a TKR in December of 2012... after that, the extreme pleasure of a hospital acquired MRSA infection. To get that under control, a spacer is put in my knee and a PIC line inserted to dose antibiotics directly into my heart for several weeks, then a few weeks off followed by opening the knee to swab. Tested positive for the bug, another replacement, another 2 weeks... multiply this until you get to four replacements. The last time, Dr. says "I think we got it this time". So at least I got a knee this time, except when the cultures came back to check for slower growing bacteria; still positive for MRSA. I take antibiotics daily (Doxycycline) to keep it under control, no problems after 6 years but if I don't take the meds for a few days, knee starts feeling "funky". Got back on the bike, good news, no problems! Mtn. biking has been my salvation through and after all this. If you are in a similar situation, you can do it!


----------



## Call Me FJ (Jan 29, 2015)

I am now a few days shy of 5 weeks. While quad strength is coming around slower than I hoped for, I am riding the Aerodyne for 10 minutes three times per week while in PT. My range of motion is 0-110 with reduced swelling. I am using just a cane when out of the house and feel the cane will not be needed at all in 7-10 days. Stopped all prescription pain meds two weeks ago and rarely take Advil. The knee still hurts and I use a sleep aid as I was so tired from not sleeping. I notice pain in my shin and soft tissue around the knee that I would classify as a 4-5 on a ten scale. Ice and massage have been key as well as minimal heat. Ready to set up the trainer and move into the next phase. Good luck to the other TKR people that have posted.


----------



## LadyDi (Apr 17, 2005)

stberhard stubborn infections like that are a nightmare! So sorry about all the problems and revisions, glad you can ride.


----------



## mrothmel (Sep 2, 2008)

Curious about other experiences. I am 2.5 months post knee replacement. I initially had a problem with my calf spasming at night because the doctor lengthened my leg in the process to make it even with my good leg. That pain is gone. However now I wake up with overall stiffness in the joint. I ride the stationary bike for seven minutes and go back to sleep. Just interested if other people's healing process involves different "pain" as the swelling goes down and other issues heal. I am cutting back my home exercise program from twice a day to once a day hoping it expedites healing. Any thoughts would be welcome.


----------



## mrothmel (Sep 2, 2008)

The weather here in New Jersey has precluded outdoor riding for most of February. The issue cold below 20 and ice, some covered by snow, which obviously creates dangerous riding conditions. We are doing an easy 11 miles of trail riding tomorrow morning in Wharton State Forest. Longest since surgery. I will let you know how I do.


----------



## LadyDi (Apr 17, 2005)

mrothmel said:


> Curious about other experiences. I am 2.5 months post knee replacement. I initially had a problem with my calf spasming at night because the doctor lengthened my leg in the process to make it even with my good leg. That pain is gone. However now I wake up with overall stiffness in the joint. I ride the stationary bike for seven minutes and go back to sleep. Just interested if other people's healing process involves different "pain" as the swelling goes down and other issues heal. I am cutting back my home exercise program from twice a day to once a day hoping it expedites healing. Any thoughts would be welcome.


Your stiffness is likely due to edema in the joint. It can persist for half a year or more. At 10-12 weeks out I still had considerable swelling and stiffness. One thing I have learned is to treat "stiffness" as pain and take something for it. Extra-strength Tylenol works for me.

I'm currently four months post op and back to work at a job that involves lots of walking and long hours on my feet. The first week back was *Not Fun*, but I am acclimating. Last night the Restless Leg Syndrome that plagued me earlier in my recovery came back. It's very annoying, but I can't call it pain- it's more like a need to keep moving and stretching that entire leg. I'm going to try a hot soak with good 'ol epsom salts.

Every recovery is different, and folks who were previously accustomed to a physically active lifestyle have the most difficulty with enforced downtime. Weeks 8 through 13 were honestly my darkest hour; I was doing everything by the book yet not progressing as quickly as I though I should. Just one week ago I was cursing my decision to have this surgery, but today my knee feels strong and I'm very happy. I'm back on both road and mountain bikes, and slowly building my miles. Yesterday I did 23 miles and 1250 ft of climbing and practically forgot about my knee. Like you, I jump on my exercise (spinner) bike several times a day just to loosen up.

It sounds like you're doing really well, and making good decisions about your activity. Rest is super important. Maybe consider some gentle warm water exercise, but don't neglect ice & elevation "toes above nose"- you still need it- yes, still!


----------



## mrothmel (Sep 2, 2008)

Dear Lady Di:

Thank you for your encouraging post. You should be a doctor. I do have a bit of edema on the outside of my knee where the pain and stiffness are. I will keep exercising twice a day but ice after my nightly exercise as well.


----------



## Call Me FJ (Jan 29, 2015)

mrothmel I had calf and shin pain in the beginning and now have slight to moderate shin pain and still have stiffness at night. Heat and ice as well as acupuncture help the calf and shin immensely. My PT says this pain is part of the process and is due to re gaining my gait. I also experienced pain in the tendons in the back of the knee and that has minimized as well. I massage the knee and ice as well as stretch 3-4 times per day and do strength exercises one-two times per day. Twice daily biking is too much at this juncture, so I do this once per day. Good luck.


----------



## mrothmel (Sep 2, 2008)

I have been noticing that as one pain goes away, you notice a new one. I think its because the brain can only handle pain from one place at a time. However, I see it as progress each time one pain goes away. Next areas are swelling around patella. (I kept my own because it was in good shape) and slight pain along shin muscle due to leg lengthening. Snow still keeping me from outdoor bike riding. Hopefully next week. It has to melt some time.


----------



## mrothmel (Sep 2, 2008)

Just do your exercises two times a day every day as prescribed by PT and you will progress. I am 12 weeks post. Still have swelling and some knee pain when hiking and stiffness in the morning. You will shed the cane. I would ride more but ice and snow in NJ are killing those plans.


----------



## Drew Purdy (Mar 12, 2015)

I had double TKR two years ago. I am 54 and still road race (mostly crits). I was racing 4 months after my TKR. My knees feel much better than before the TKR. I can't run because it feels awkward, but riding is great. Yes I have had some spills but no problems with the knees. I'm riding dirt bikes (motorized) with Don Joy braces and still enjoying life. Make sure you stretch regularly and keep fit. I thought the double TKR was not bad but my knees were way past there replacement time when I finally gave in. It was like a new beginning for me. Finished 4th overall Cat 3-4 crit series in UT last year.


----------



## mrothmel (Sep 2, 2008)

*fun and observations*

Fun: Last Sunday got to ride with my Trigger (2.5 inch tires) in the snow. Only fell once when I went to slow. Boy was knee sore next day. (3 months post TNR). Tuesday I rode again 4.5 miles after snow melted and my knee felt great afterward.

Observations. In my surgery Doctor kept my knee cap because it was in good shape. However, it was sore. Started taking Cartilage Companion (glucosamine/chondroten) and it feels better. Now my pain is along IT band (outside tendon) and a bit in lower quad. Not bad pain though. Stiff knee still wakes me up in the middle of the night. Also top outside of calf is a bit tender. However, nothing interferes with any activities. Just allowing healing process to continue.


----------



## MTB Dad (Sep 22, 2012)

Had my PKR Oct. 28 and just wanted to give a quick update. Prior to PKR I rode a lot and have for yrs. I was able to lightly ride after 5 weeks. Slowly ramped up after that to really racking up miles. I still have pain but not as bad as pre-surgery. 
There is light at the end of the tunnel!! Remember cycling and swimming are the best rehab for TKR and PKR!!


----------



## LadyDi (Apr 17, 2005)

I am 5 months post TKR. Had a rough few weeks transitioning back to 12 hour workshifts and am now on a low-dose prescription anti-inflammatory called Meloxicam. I am doing leg presses, etc. at the gym and riding more. I am back on clipless pedals, and I replaced the 175mm cranks on my 29er with 170's. While I was at it I replaced my cf bars and seatpost. I love my bike more than ever. No pain at all over rocks. I always have initial stiffness in my surgical knee for the first few pedal strokes. This eases up after a while, and I hope it goes away completely over the next year or so.

Someone mentioned "other" leg pains- I get IT band pain, also at the hamstring and calf muscle insertion points. So bad it intereferes with sleep sometimes. That is why I am taking it slow and only gradually increasing my miles. Next week I will attempt the climb to Griffith Observatory (in L.A.). I figure if I can complete that climb, no matter how long it takes, I am well on my way. Fingers crossed!


----------



## Wherewolf (Jan 17, 2004)

Checkup yesterday. Almost eight years now for both knees and had x-rays and thorough checkup yesterday. Knees are perfect. I do virtually all climbing pulling rather the pushing and doc said continue what I've been doing. Average ride last year 40 miles and 5.5k climbing, twice a week.


----------



## mrothmel (Sep 2, 2008)

*Thank you for road map*

You are about 1 1/2 to 2 months ahead of me. Nice to know my symptoms are normal. First ride longer than 4.5 miles tomorrow. Pretty flat but maybe about 10-15 miles. It will be 32 degrees when we start. (Jersey is the new Arctic). Looking forward to leg feeling good afterward. The nice thing is that I'm starting to get definition in my quad.



LadyDi said:


> I am 5 months post TKR. Had a rough few weeks transitioning back to 12 hour workshifts and am now on a low-dose prescription anti-inflammatory called Meloxicam. I am doing leg presses, etc. at the gym and riding more. I am back on clipless pedals, and I replaced the 175mm cranks on my 29er with 170's. While I was at it I replaced my cf bars and seatpost. I love my bike more than ever. No pain at all over rocks. I always have initial stiffness in my surgical knee for the first few pedal strokes. This eases up after a while, and I hope it goes away completely over the next year or so.
> 
> Someone mentioned "other" leg pains- I get IT band pain, also at the hamstring and calf muscle insertion points. So bad it intereferes with sleep sometimes. That is why I am taking it slow and only gradually increasing my miles. Next week I will attempt the climb to Griffith Observatory (in L.A.). I figure if I can complete that climb, no matter how long it takes, I am well on my way. Fingers crossed!


----------



## mrothmel (Sep 2, 2008)

*First Big ride*

Rode 16 miles today. Mostly flat. Wharton State Forest in New Jersey. Knee is stiff at part of quad right above knee cap. I'm sure I'll pay. I'm icing it now. Kept up with the front of the group. Denny my dog did his first major ride of spring as well and did fine too.



LadyDi said:


> I am 5 months post TKR. Had a rough few weeks transitioning back to 12 hour workshifts and am now on a low-dose prescription anti-inflammatory called Meloxicam. I am doing leg presses, etc. at the gym and riding more. I am back on clipless pedals, and I replaced the 175mm cranks on my 29er with 170's. While I was at it I replaced my cf bars and seatpost. I love my bike more than ever. No pain at all over rocks. I always have initial stiffness in my surgical knee for the first few pedal strokes. This eases up after a while, and I hope it goes away completely over the next year or so.
> 
> Someone mentioned "other" leg pains- I get IT band pain, also at the hamstring and calf muscle insertion points. So bad it intereferes with sleep sometimes. That is why I am taking it slow and only gradually increasing my miles. Next week I will attempt the climb to Griffith Observatory (in L.A.). I figure if I can complete that climb, no matter how long it takes, I am well on my way. Fingers crossed!


----------



## Call Me FJ (Jan 29, 2015)

LadyDi - Your post is timely. I'm still dealing with IT Band pain as well as other soft tissue pain. I'm 10 weeks post OP and while I was hoping to be back on the bike, I know this will take more time that I hoped for. I have to remind myself that after 6 surgeries, this will not be a normal recovery. I was consistently at 115 degrees and on a good day could get to 120, the past two weeks my best effort is 110, which is what I had pre surgery. I'm hopeful this will continue to improve. Best of luck on your climb.


----------



## Call Me FJ (Jan 29, 2015)

Wherewolf- This is awesome news. You're climbing to mileage ratio is impressive and my style of riding and I can't wait to get back on the trail. While every TKR is different, do you recall where you were at 10 weeks and what was the first 6 and 12 months post surgery like?


----------



## LadyDi (Apr 17, 2005)

Right FJ, it takes time to stretch out all those tendons and ligaments. Same presumably with scar tissue. Whenever I do something new, or get overly aggressive on the bike or at the gym, I pay with a week of extra pain & swelling. Last week I was just sitting and chilling in a kid's swing at the park when I accidentally flexed my knee too much. OUCH! I did not hear a crack but it would be nice if I at least broke up some adhesions. I don't advocate this technique, by the way- very painful!

My surgeon says it's normal to lose ROM during recovery when we're on our feet a lot, then regain it after rest, ice, and elevation. Ugh, this recovery ordeal is getting old, and so am I.


----------



## mrothmel (Sep 2, 2008)

Dear Call Me FJ: 
110 degrees at 10 weeks is fantastic. Keep stretching and home exercise program twice a day. The IT band is the biggest issue as mine will still wake me up 3 1/2 months post surgery. As long as you can pedal stationary bike you can pedal a rode bike.


----------



## Wherewolf (Jan 17, 2004)

*You don't want to know*



Call Me FJ said:


> Wherewolf- This is awesome news. You're climbing to mileage ratio is impressive and my style of riding and I can't wait to get back on the trail. While every TKR is different, do you recall where you were at 10 weeks and what was the first 6 and 12 months post surgery like?


Don't get alarmed, but I have continued to have severe knee pain. I took two years off the bike due to the pain, and I still hurt, even after seeing a pain specialist for a whole year. So I went back to riding. I got a spinal cord stimulator implant about four years ago, which makes everyday activities tolerable. But I still hurt a lot on the bike despite taking codeine every three hours. Virtually all my climbing is done pulling via clipless pedals, because pushing on climbs hurts more. I had the knees checked last week and the doc said they are still perfect and I can pull and ride all I want, or can tolerate.


----------



## mrothmel (Sep 2, 2008)

By accident I found a good stretch for the IT band. Before surgery one of my stretches was to sit cross legged and bend forward to try to touch my nose as close to the floor as possible. To stretch sit cross legged with operated leg ankle under unoperated knee. Lean forward and try to touch your nose to the floor. You will feel it in your IT band. 

Six weeks post surgery I rode asphalt. The the February freeze came to New Jersey and riding was impossible. Rode 16 miles Sunday. Leg was like rubber on Monday. Rode 4.5 miles on Tuesday and leg was stiff. Rode 4.5 miles today and leg felt great. Just keep riding until your knee gives up trying to hurt you because it realizes you won't give in. (Did ankel weight exercises and stretches on the off days plus half hour walk up the "Mount" in Mt. Holly (a whopping 200 feet above sea level).


----------



## mrothmel (Sep 2, 2008)

Rode 15 miles yesterday and I feel like I got rid of all the scar tissue in my knee. Not as stiff when I get up after sitting for an extended period. I think mountain biking is excellent therapy for total knee replacement.


----------



## LadyDi (Apr 17, 2005)

mrothmel said:


> Rode 15 miles yesterday and I feel like I got rid of all the scar tissue in my knee. Not as stiff when I get up after sitting for an extended period. I think mountain biking is excellent therapy for total knee replacement.


So true!


----------



## Call Me FJ (Jan 29, 2015)

mrothmel, this is great news. While I still have swelling and stiffness at the end of the day (12 weeks post op) I am seeing the light at the end of the tunnel. I had my 3 month follow up and the Dr said everything is healing fine. I will take to the road tomorrow for a 3.5 mile ride and hope to be on the dirt in the coming months once i can handle climbing. The rides in my area have a fair amount of climbing and I know I am not ready yet. Keep up the great work.


----------



## mrothmel (Sep 2, 2008)

*reply to fj*



Call Me FJ said:


> mrothmel, this is great news. While I still have swelling and stiffness at the end of the day (12 weeks post op) I am seeing the light at the end of the tunnel. I had my 3 month follow up and the Dr said everything is healing fine. I will take to the road tomorrow for a 3.5 mile ride and hope to be on the dirt in the coming months once i can handle climbing. The rides in my area have a fair amount of climbing and I know I am not ready yet. Keep up the great work.


I don't know when swelling goes away. I still have a bit four months post. Not obsessing over it. knee is stiff for a few minutes when I wake up. It can also get stiff after riding or sitting for extended periods.. However stiffness. doesn't mean you hurt anything and its the only way to rebuild the muscle. At 3 months you are ready for flat trails. Four months you are ready
for whatever your body can take. Keep on riding.


----------



## mrothmel (Sep 2, 2008)

*Good and Bad*



mrothmel said:


> I don't know when swelling goes away. I still have a bit four months post. Not obsessing over it. knee is stiff for a few minutes when I wake up. It can also get stiff after riding or sitting for extended periods.. However stiffness. doesn't mean you hurt anything and its the only way to rebuild the muscle. At 3 months you are ready for flat trails. Four months you are ready
> for whatever your body can take. Keep on riding.


Had good and bad with IT band over the past month. Went back to PT to have it worked on and they really worked out the part above the knee to the hip. Went to Colorado and only had welling one day after a hike. Had a massage and the operated IT band was softer than the non operated one.

Now the bad: I was stretching Thursday (sitting cross legged and leaning forward) when the portion of the band that runs over the knee popped like a gun shot. I figured that was an adhesion that "unadhesed." However, now my knee is swollen and more tender than it has been in months. We'll see how it goes the next few days and then call the doctor.


----------



## LadyDi (Apr 17, 2005)

mrothmel said:


> ...Now the bad: I was stretching Thursday (sitting cross legged and leaning forward) when the portion of the band that runs over the knee popped like a gun shot. I figured that was an adhesion that "unadhesed." However, now my knee is swollen and more tender than it has been in months. We'll see how it goes the next few days and then call the doctor.


Holy Heck! It's been about a week since your incident- did this ever resolve??
I haven't had any big "pops", but I've heard of them. Maybe I'm not trying hard enough. :lol:


----------



## mrothmel (Sep 2, 2008)

*Adhersion pop*



LadyDi said:


> Holy Heck! It's been about a week since your incident- did this ever resolve??
> I haven't had any big "pops", but I've heard of them. Maybe I'm not trying hard enough. :lol:


Still stiff when I sit for a long time . . Like driving a box truck fro.m NJ to Arkansas where my son is moving. Feels better as the day wears on which is good. Nurse practicioner said that's why we say it takes year to heal. Gonna order a foam roller from amazon. She said take ibuprofen which works.


----------



## LadyDi (Apr 17, 2005)

Update: I am now 10 months post op left total knee replacement and feeling so much better! I battled stiffness, inflammation and fatigue for a long time, but it seems those issues have finally resolved. I am up to 75 miles (road + mtb)/week and slowly adding elevation. After more than a decade of not being able to mash, and actually forgetting _how to mash_, I can climb out of the saddle again. I'm a little awkward because it's been so long, but I will re-learn. My knee is stronger than it has been in many years. This makes me incredibly happy!

So, to anyone potentially facing knee replacement, I'd like to offer reassurance that the surgery was worthwhile for me, and I am very glad I did it. Yes, I was off the bike for some time during recovery, and yes it sucked, but I am back and stronger. Will I race? Nah, competition isn't in my blood. But I can ride and hike with my friends, and do what I want to do. This means a lot to me.

My left leg is nice and straight. Unfortunately, when I ride I can look down and see that my other knee is beginning to twist inwards (valgus malformation) from osteoarthritis. It needs to be replaced, too. I'm hoping to hold off until next year. If the meniscus -what little remains- tears again I'll go sooner.


----------



## Call Me FJ (Jan 29, 2015)

LadyDi - This is great news. TKR is a big decision to make and and even larger commitment to PT. Congrats on your mileage, that is impressive. I was not able to get out of the saddle until about three weeks ago. I am approaching 8 months and while it has been a slow but steady road to recovery, I am glad I did this. I stiff suffer from sore tendons on the back of the knee which leads to stiffness and soreness, I am confident this will resolve its self and would recommend my ortho in a minute. Keep hammering!!


----------



## mrothmel (Sep 2, 2008)

Dear Lady Di:

Glad to hear you are doing great. I had a set back with an Adhesion pop two or so months ago, but I am close to normal again. Stretching is back and I just did 30 miles of mountain biking over two days at Raystown Lake Pa. Still a little stiff in the morning when I wake up or after I sit in the car a long time but other than that ok. I just measured my thighs this morning and there is a one inch difference between operated leg and non operated leg. Glad I had it too. (December 15 2014 so I'm 8 mos post surgery)


----------



## LadyDi (Apr 17, 2005)

LadyDi said:


> ...
> My left leg is nice and straight. Unfortunately, when I ride I can look down and see that my other knee is beginning to twist inwards (valgus malformation) from osteoarthritis. It needs to be replaced, too. I'm hoping to hold off until next year. If the meniscus -what little remains- tears again I'll go sooner.


Quoting MYSELF^, little did I realize when writing it that last week's post would prove ominous and foreboding; days later I tore the last bit of lateral meniscus in my right knee and am now bone-on-bone there. My next total knee replacement is in the works, and I'll have it hopefully within the next few weeks. For anyone wondering how I can look forward to such a big surgery, it's the anticipation of two strong knees that drives me.


----------



## mrothmel (Sep 2, 2008)

Dear Lady Di

Sorry to hear right knee needs work but I like the attitude. I am 10 months post knee replacement. Very good. Stiff in the morning but I stretch every day. Can pull my heel back and touch my butt. Leg strength very good. Passing people 15 years younger pedaling uphill. Happy with result.


----------



## Call Me FJ (Jan 29, 2015)

Lady Di,

All the best for the second TKR. You will do just fine.


----------



## cyclopath1000 (Feb 22, 2009)

*Is anyone able to. Stand and climb after a partial knee replacement*

im about seven weeks post right medial makoplasty (pkr). I've been pushing it hard and my knee isn't too happy with my tactics. Sure sittin on my butt and ridding the flats is reasonably good but two things sure aren't. A) trying to get off my seat and pedal standing. B) climbing. Even seated

The worse by far is the standing when my right pedal is around 12:00. For those maniacs like myself who climb standing, all your body weight and all your strength is momentarily 100% through thT right side and much if it is routed via the patellar tendon , so enormous compression of the underside of the patellar femoral joint onto the structures below occurs. Very very very intense pain.

I am actually a anesthesiologist so I have no one to blame but myself for the rebound in inflammation that occurred. But I am willing to wait for the inflammatory cells to slowly move on out. That according to some of my surgical friends could be as long as a year if you actually look scientifically at the process.

My question is : anybody with a partial or total knee able to get out of the saddle,and really put the power out.

I originally dis paired over my f Ed up knee from a horrific ski accident. 
One day I met a damn good rider in the Santa Cruz mountains when my son and I were poaching the good stuff and he was post total and riding up a freakin storm. BUT HE WAS DOING IT SEATED. and I couldn't get it out of him if it was by choice or necessity. My greatest joy is off my keister.


----------



## mrothmel (Sep 2, 2008)

Dear Cyclopath:

I did not even start to ride until 7 weeks post knee replacement. You are being too aggressive for the point in time you are post surgery. Do not despair. Take your time.

Do your physical therapy twice a day!

Mike


----------



## cyclopath1000 (Feb 22, 2009)

mrothmel and others , there is a specific question I'm looking for an answer. " are you able to stand and pedal ? For how long and on what kind of incline. Our mountains are very young out here which makes them super steep. I appreciate your input.


----------



## mrothmel (Sep 2, 2008)

Dear Cyclopath:

I can now ride fully 10 months post surgery. I would say six months post surgery I was still stiff after riding.
Getting range of motion is a long process. I was doing well and then had an adhesion pop in my IT band along the knee cap which set me back. Ultimately you will be able to do everything you did pre surgery, just not 7 weeks post surgery. In my experience at 7 weeks post surgery you should be riding easier trails and building up flexibility and strength. Listen to your body. If you can't do something, its because your body is not ready to do it. 
Mike Rothmel


----------



## LadyDi (Apr 17, 2005)

@cyclopath 1000, following my left total knee replacement I regained the ability to mash (climb out of the saddle) after 11 years of not being able to. But it took me 11 months to get there! Then my right knee failed- as we knew it would- and was replaced yesterday. You will be back to climbing sooner than me, but seriously don't push it. Healing, whether partial or total knee, is a long process.


----------



## mrothmel (Sep 2, 2008)

CYCLOPATH
Listen to Lady Di. She was an inspiration and help to me during my recovery.


----------



## cyclopath1000 (Feb 22, 2009)

So I just returned from a post op visit (7 weeks) with my surgeon. So basically everything looks great ie X-rays shows the implants in perfect position etc. he thinks my knee is fabulous with over 150 degrees of flex ion etc. " it's the soft tissue that can take up to a year to recover" " you have to appreciate that you knee alignment is significantly altered by the return of the proper height and angles by putting in the medial compartment, in essence the patella and the patellar tendon IS tracking along a slightly altered path" 
This was aware of. Basically I has nothing left medically and. Was using all sorts of tricks to route my weight and force through the lateral half of the knee. My surgeon is confident that within months this will quiet down and while he doubts I can cause any real damage in the absence of a real compressive fall, it obviously makes sense to not push myself so hard that my effusion and my pain kicks up too hard. 

So I'm going to stay seated and ramp up as tolerated. I will stand and climb when it feels right. 

He a.so showed me how my right quad is basically atrophied vs my left. It's like a jelly roll. he said Marc this happens the moment I take a knife to your knee". It's 100% predictable. When that comes fully back its all gonna be good. 

He actually mountain bikes and knows what I'm talking about when I say my joy is the climb way more than the descent. All my friends know this. 


I posted this for two reasons
1. To see what others experience was 
2. To help others who are wearing out get some tangible advice.

My previous Google search yealded up a bunch of bs ads from docs and worse hospitals putting out advertising bereft of details. 

Anybody in the future that wants to contact me I will be happy to oblige.


----------



## cyclopath1000 (Feb 22, 2009)

wow i had an amazing day. I reached a goal of my recovery: i am about day 59 of a mako partial medial uni knee replacement. Today I stood and climbed on middle /middle of my 29 er pivot with an old school triple. Not that is was 100%pleasant but it was 1000%more pleasant than the 8 miles of standing on a flat Davis, ca bike path. Yeech for the flat pavement next to my/ur goal:sweeeet single track winding through untrammeled beauty. but i checked with my surgeon , got films last week or so and was encouraged to push it to tolerance. Ya know I am an physician who has a pretty good gestalt on physiology and just what eactly is going on during surgery. as in I spend most of my life in the or. So my anterior patellar pain is probably due in part but not entirety on inflammatory cells and even fibroblasts infiltrating the prepatellar fascia. The infiltration takes the natural flex like a bow and arrow away so when moved the arc is disrupted and its efficiency fall and it puts excessive strain on the periphery of the injury causing severe overload pain. ie your body is signaling that the tendon is weak and could disrupt. But you gotta get the flexibility back so the tendon uniformly stresses and relaxes. That is the trick to work it out and to build back atrophied muscle so that the body can begin to deliver wattage to your pedals and not further injure itself but restore normal function. This is why professional athletes from injury and surgery get to maintaining muscle vitality and connective tissue loading.

Anyway call me crazy but I want to get off my bum. This is my riding style and its a pure joy to climb in this manner. 
And it was what a steep 25 -30 ft embankment.. come on kids stuff!But when i stood up on a pretty steep deal for four pedal strokes i muscled that baby up that hill. Day 59!So while i was at it i threw in 20 repeats! Damm that's good even if i have to run the ice machine all night.


----------



## mrothmel (Sep 2, 2008)

Good job. I was doing great then several months ago had an adhesion pop onmy IT band. Set me back but now I am great. Can touch my heel to my butt stretching and did 40 miles througj NJ Pone Baamrrens on Saturday. 10 months post surgery.


----------



## Call Me FJ (Jan 29, 2015)

Cyclopath- I was not able to stand and climb until 5 months post op.


----------



## cyclopath1000 (Feb 22, 2009)

well on Wednesday i decided to really try it all out. so i went to Rockville hills regional park with my tall boy. yes i had a blast. yes i was a dumb f to try it. i was able to pretty much climb it all but seated. whereas under more controlled climbs out of my nearby drainage ditch was fine, on real singletrack it was verey unwise because i couldnt really produce the power and the pain was not good. unfortunately sitting at Rockville on the good stuff is an invitation to disaster and i had a couple of tumbles. sort of hit that knee a little on the side but i had pads on. nothing permanent. we are going to Mcdowell mountain park in Fountain Hills for a week and I plan on easy riding there and afterwards if i am still alive we found a sweet rv site in Sedona and at 
Flag.


----------



## cyclopath1000 (Feb 22, 2009)

Thanksgiving day, so three months post partiall Right medial makoplasty. I'm making great progress in the past week. Now I'm able to stand and ride under many but not all conditions. I've decided to ride what I feel I can do and to avoid doing segments that I might be able to clear pre op. So I can do 98% of Rockville park which is pretty good. My knee is still not totally there and it's sore and stiff but hell I'm riding and not just enduring the ride. I'm feeling the passion. So anybody out there contemplating this ... Take heart.


----------



## bentrimcycle (Nov 23, 2015)

You have to do some cycling and let see how much pain you are feeling. If you are not feeling any pain then it is ok to go ahead for the Race.


----------



## cyclopath1000 (Feb 22, 2009)

Never intended to race. I only ride for joy not recognition.


----------



## stumo (Feb 29, 2008)

Hi, 

Before my TKR i couldn't straighten my knee and had a 20degree bend, my leg was also bent inwards by about 15 deg (at the knee) so i was bow legged.

I'm 4 weeks post op, i'm easily walking 2 miles without a stick, and the knee stiffens up quite a bit afterwards but is ok after some ice and stretching.

I'm at 4 degrees off straight and not bow legged anymore and have approx 110-115 deg bend.

I started on a turbo setup last week and have problems/pain for the first minute as i struggle to get over the top of the stroke (170 cranks which i used pre op) , after that i'm ok and can cycle for 10 mins without problems. 

When doing my straightening and bending exercises it's incredibly painful but the physio is ok with what i'm doing.

In your experience will my range of motion keep increasing as i seem to be stuck at the same point all week? Unfortunately because of the christmas holidays i won't be seeing my physio this week who says he's very happy with my progress especially considering my pre op condition.

I continue to be upbeat as i can walk further than i have been able to in years but one or two doubts have snuck in.

Thanks for reading.


----------



## cyclopath1000 (Feb 22, 2009)

Stumo,
So that pain coming around the pedal is pretty much my experience. I am four months out of a medial side uni not a Tnr. I am an anesthesiologist and it's from needing to literally flip the patella up and away to gain access to the joint. You with a total also had the underside of the patella "resurfaced" which is a euphemism for it the cartilidge being chopped off and a piece of plastic cemented there.

The good news is that it will gradually improve. Take a look at your quadricepts on that side vs your other knee and you will find it is way way smaller and atrophied. That happens from the torniquet that was inflated over the muscle. It reportedly takes a year for that to return and by them the patella should gradually stop hurting as the tendon heals from the trauma and inflammation of surgery.

I really really pushed my rehab. I now can mostly ride standing and can climb semi steep standing. Every day that horrid patellar pain gets a bit better. I actually did a powder day at Heavenly on Xmas day. Lots of snow and I stayed on open stuff without any extremes because my right leg is weak still but I linked fifty plus turns and in some ways seeing that I actually had a functioning medial side it felt more stable.

If you don't have a powered knee cooler buy a don joy on the Internet. I sleep on my back with a zillion pillows to get the fetal position. My knee is on a square giant bolster plus pillows. It keeps the leg elevated without lateral pressure which seems to work best.

Slowly work on knee bends but stabilizing yourself. That walker they gave you is a good exercise aid btw. I now do a bosu ball on one leg. You want to slowly ramp it up. Be careful believing physical therapists wisdom too much. They are used to old frail people.



stumo said:


> Hi,
> 
> Before my TKR i couldn't straighten my knee and had a 20degree bend, my leg was also bent inwards by about 15 deg (at the knee) so i was bow legged.
> 
> ...


----------



## mrothmel (Sep 2, 2008)

Dear Stumo:

Keep on plugging away. At 11 months I was able to touch my heel to my butt. More importantly, you should have a home exercise program. I exercised two times a day. If I had PT, I exercised one additional time. On days with no PT, I did home exercises twice a day. It dramatically increases your recovery time. 

Also, don't be afraid of set backs. I was doing great and than an adhesion on my IT band popped. Lost alot of range of motion, but kept plugging away stretching every morning and riding. 

You should be able to start riding easy stuff six weeks post surgery. As you get your wind and strength back keep going as tolerated. I think riding makes the healing faster.

Best of luck.

Mike Rothmel


----------



## Crankyone (Dec 8, 2014)

Thanks for all the great conversation. I am a lurker with lurking knee issues. I have been curious for years at what point people made the decision to have the knee(s) replaced. 
I joke with my wife about replacing the left leg with a peg leg with a SPD cleat on the end. Would be great for tap dancing as well!


----------



## stoplight (Mar 8, 2009)

I read this thread with great interest. Thanks to all those who told their stories of recovery. In particular Lady Di, you've not posted since having your second TKR. I hope you are doing well and are recovering quickly!!!! and would love to hear from you. 
I just got my TKR date, Feb 4. Both knees have been a long standing issue but my right is by the far the worse. This Summer on a short but steep climb something went pop and I could not finish the ride. It was the kind of pain ya feel in your gut. I stayed off the mountain bike and road my hybrid on our local bike path and at the beach. After two long months, lots of ice and pain meds I was able to get back on the mountain bike. Climbing was okay but it was not the same. The knee felt like it might explode at any time especially on the steeps.
I have begun a program of daily stretching to increase ROM and use a foam roller. I plan on riding the hybrid at least 3 days a week and the mountain bike one day a week till the surgery. When the knee feels like its gonna give out on the steeps I stop and walk the bike. When not riding I do scaled down version of P90x of strength maintenance. 

Any other advice on increasing my recovery time would be greatly appreciated!!!!!!


----------



## stumo (Feb 29, 2008)

thanks guys. 
ive got an Aircast cryocuff (similar to the donjoy)which is a great piece of kit, im using it a lot. ive got exercises to straighten my leg and also increase the bend which are working but progress is slow. ive gone from 7 deg off straight to 4 deg in a week and 105 to 110 also last week. maybe im expecting too much and it'll take time but i'm doing the full list of exercises 3 times a day( straightening, bending, stepups etc) and walking 2+miles . im not going easy on myself because the phyiotherapist is happy as i want to be able to cycle and ride my KTM dirt bike. Mike, you said at 11 months you could touch your heel to your butt..... so in those 11 months you've slowly made progress.... maybe im expecting miracles and it to happen too quickly but i also know i'm in for the long haul which will be painful and at times demoralising. my thigh is still swollen ( calf is back to normal size) and i feel that i'm fighting the swelling as well as the muscle when doing my bending exercises. unfortunately i cannot take NSAIDS due to use over many years has made me sensitive to them and gives me asthma for a few days after using them. i still have a very positive attitude and know there will be setbacks which i hope will not lessen my enthusiasm. i think that once i can get outside on a bike and not suffer the pain at the top of the stroke i will be even happier. thanks again for reading my rambling post and thanks for all the help and inspiration. cheers guys


----------



## stumo (Feb 29, 2008)

Crankyone said:


> Thanks for all the great conversation. I am a lurker with lurking knee issues. I have been curious for years at what point people made the decision to have the knee(s) replaced.
> I joke with my wife about replacing the left leg with a peg leg with a SPD cleat on the end. Would be great for tap dancing as well!


i initiallly got knocked off a motorbike 20 years sgo and suffered the joint at the back of my femur breaking. it was fixed with 2 screws and recovery took a long time due to the 8 weeks or so for the joint to heal then the long physio to enable weight bearing and mobilisation. from that point on ive never been able to straighten the leg and over the years the inward bend of my lower leg got worse and worse. all the time i could mountainbike (whistler twice doing a lot of the stuff there, crabapple hits, a line, dirt merchant etc etc) but i could never walk far. over the years i have knocked my knee( sometimes incredibly hard) and its always recovered but in May this year i very lightly knocked it and must have hit it in the right spot as it swelled up bigger than it ever had done and i also couldnt put any weight on it. the doctor and i said we will wait for the swelling to go down and see how the knee is then. the swelling took time to go but unfortunately the knee didnt recover well enough and certainly nowhere near the preknock condition. at that point we decided to get the TKR done. ive always been told to try to keep your knee for as long as possible before getting TKR. once it starts to severly impact on your daily life (including sports/hobbies) then do someghing about it. hope thst helps your decision as its not one to be taken lightly. good luck whichever way you go.


----------



## stoplight (Mar 8, 2009)

I have done a fair amount of research on TKR and mountain biking in hopes of finding a common thread of those who have chosen the TKR over approved methods, strength conditioning, stretching, ROM, meds, etc. While reading a post on another site I realized something I had not thought of. I know 15 guys who have had TKRs and all said the same thing, feels great, no more pain, glad I did it. Then I realized none of those fellas are active exercisers, none of them ride road or mountain bikes, none of them hike or walk for exercise and none belong to a gym. When I started deep reading this and other threads I realized many of you who have had TKR have knees that are basically blown apart or weakened to the point that a TKR is really the only option. As I read further I also realized that many who had the TKR and are riding are often doing what I am doing now, ride, ice, ibuprofen. That got me thinking maybe my knee is not that bad after all, a question only I can answer for sure. Then I read this....periphrased from a fella who had a TKR...."TKR's are designed for the passive, not the active athlete".... I got some thinking to do for sure and am certainly interested in any observations from those with fair knees to knees on the edge of explosion and those who have chosen the TKR...


----------



## Wherewolf (Jan 17, 2004)

*You'll know*

You will know when it is time for a TKR. I had knee problems, and multiple surgeries, for many years. When the kees finally went I knew it, and a MRI confirmed so. Few people ride as much as I do, 40 - 66 mile rides with over 5K of climbing, about 2 1/2 times per week. And I do one hour at the gym 3 1/2 times per week. After more than seven years the knees are still perfect mechanically (just confirmed by an orthopedist). However, I still have some sort of mysterious nerve pain in both knees and they hurt all the time. However, they hurt whether I bike or not, so I bike.


----------



## cyclopath1000 (Feb 22, 2009)

Stoplight there is wisdom in your very conservative view of what a Tkr can and cannot do. I am an anesthesiologist and your view is the traditional orthopedic view, though they don't necessarily say it point blank. I in fact thought that was the reality until i ran into an excellent rider in Santa cruz way last spring who was riding well with a Tkr , WITH THE ENCOURAGEMENT OF HIS SURGEON. 

NOW I AM IN THE OR most days until recently and was persuaded by one of the total reps to consider a robotic uni. I didn't think I was a candidate due to the fact that I had stretched and at least partially torn my acl 25 years ago when I had a huge medial meniscus bucket handle tear from hitting a mogul on ice wrong. 

To my delight I was judged a good candidate. Now for some more truth to the comman man: not all orthopods are created equally. And some will advise surgery that should or could be either done otherwise or even not at all. 

I am insanely active at 65 and anybody who has ridden with me knows I prefer insane climbs. It takes a year to recover to your fullest. Fullest doesn't mean to when your God given knee was perfect! Fullest means as good as it's going to get. 

Just like gearheads know all the details of how a shock or a multilingual suspension works, your knee and what is put in to replace the faulty parts is a technical issue and requires understanding of mechanics and anatomy etc etc. googling stuff just is going to give you advertisement s by hospitals and docs that want your business. Most ortho pods are not in the position to do a uni let alone a total. And a robotic uni is even a smaller group. My guy has done over 300 robotics. That's the minimum number I would let a guy mess with my knee to have under his belt. Can you truthfully find out the true number he has done :NO. 

AS for the guy selling tens units : give me a break!!! 
For less active people there is a medial block with radio frequency ablation of the nerves around the joint line that can delay Tkr. 
Peeps get all sorts of viscous s..t injected into their damaged joint. My advice is based on seeing septic joints: dont put anything into your knee smaller than your elbow.


----------



## stumo (Feb 29, 2008)

Day 32 and I can now use Spuds on the turbo, before today it was very painful at the top of the stroke and couldn't carry on and i seemed to be limited to around 5 mins when using flats (due to there not being any float).

It's a milestone for me as that's where i was at pre-op so from here on in it's all a bonus. 

A 2.8 mile walk, step ups and bending/stretching exercises were my day today.


----------



## LadyDi (Apr 17, 2005)

Here I am! My knees were replaced one year apart. I'm currently 11 weeks post op RTKR and back on the bike(s). Cycling is easier than walking! Happy New Year, everyone!


----------



## stoplight (Mar 8, 2009)

cyclopath1000 said:


> Stoplight there is wisdom in your very conservative view of what a Tkr can and cannot do. I am an anesthesiologist and your view is the traditional orthopedic view, though they don't necessarily say it point blank. I in fact thought that was the reality until i ran into an excellent rider in Santa cruz way last spring who was riding well with a Tkr , WITH THE ENCOURAGEMENT OF HIS SURGEON.


Yes sir!
The more I read the clearer my answer has become
Before I make my final decision I will go ahead with the appt on Tuesday with a PT set up by the TKR team. I appreciate those who offered their experiences and opinions and with that in mind I offer this to those who are considering a TKR.

In context of this conversation I realized there are two kinds of knee pain. Day to day consistent knee pain and knee pain while cycling. Chances are pretty good if one is experiencing day to day knee pain they are experiencing it while cycling. I would have to think the motivation for a TKR in that scenario would be to reduce the day to day knee pain and then cycle as recovery permits.

My day to day pain is not debilitating except for roughly two months out of the year, Summer into Fall. It wakes me up and night, is stiff, aches and hurts throughout the day and of course that pain carries over to cycling. 
This has been the case since 2008 when it was clear the 7 surgeries over the years for torn meniscus and arthritis has resulted in a bone on bone condition. If my knee hurt the other 10 months there would be no doubt I would pursue a TKR but it doesn't. Oh it can rear its ugly head on occasion but for the most part the pain is quite manageable.

Until recently I have a had little knee pain while riding except for the most recent small but steep climb resulting in a pop which also happened from Summer into Fall. I was able to rehab the knee with pancake rides, ice and ibuprofen. A couple months later the pain subsided but it was a long two months. It was during this time I conceded to the long standing invitation from my Ortho Pod(I thought I was the only who called them that) to take advantage of the TKR I had been approved for in 2008

Part of my concession was feeling like my cycling future was in doubt and if the TKR prolonged my cycling I was all for it. That is when I began reading this and other threads pertaining to TKRs and mountain biking and made the realization what I was putting at risk. The very thing I want to prolong and protect, cycling in the manner I do now, is what I would be putting at risk by going forward with the TKR. Of course before I decide for sure I will have another meet my Ortho Pod and whoever else I can sway into a conversation!!


----------



## Crankyone (Dec 8, 2014)

Thanks for your input stoplight! I appreciate all the honest insight regarding knee replacement! Sometimes I snowboard and mountain bike with some pain. More accurately , it hurts after. I would rather deal with the pain than giving up on the activity. 
Cheers,


----------



## Crankyone (Dec 8, 2014)

Crankyone said:


> Thanks for your input stoplight! I appreciate all the honest insight regarding knee replacement! Sometimes I snowboard and mountain bike with some pain. More accurately , it hurts after. I would rather deal with the pain than giving up on the activity.
> Cheers,


Oh, by the way, that's why I am so crappy at both, and crash on my face, if anyone asks!


----------



## stoplight (Mar 8, 2009)

Crankyone said:


> Thanks for your input stoplight! I appreciate all the honest insight regarding knee replacement! Sometimes I snowboard and mountain bike with some pain. More accurately , it hurts after. I would rather deal with the pain than giving up on the activity.
> Cheers,


that pretty much sums up where I am currently.


----------



## Wherewolf (Jan 17, 2004)

*Surgeons*



cyclopath1000 said:


> ... i ran into an excellent rider in Santa cruz way last spring who was riding well with a Tkr , WITH THE ENCOURAGEMENT OF HIS SURGEON. ...
> Peeps get all sorts of viscous s..t injected into their damaged joint. ....


The first ortho I saw said I would not be able to bike after TKRs. The one who did both of mine encouraged me to bike. And that was 20,000 miles and 2,622,611 ft. of climbing ago (yes 2.6 mil.) . I rarely ever do less than a 40 mile ride with at least 5k climbing. Had them checked out last Spring and the doc said they are still perfect, and to keep doing what I've been doing.

I did have regular Synvisc injections for about two years and they helped. But I had an allergic reaction on the last one and that ended them.


----------



## stumo (Feb 29, 2008)

my surgeon said the only things he wouldn't recommend after TKR are running and skiing ( i guess they are major, well known sports) i asked about cycling, specifically MTB and he said keep doing it ( road riding would kill me with boredom).


----------



## stoplight (Mar 8, 2009)

Met with a good friend of mine who had a TKR Mid Oct. I asked him to dig deep and discuss with me why after all this time he finally decided to have the TKR. Turns out 4 months prior to agreeing to have TKR his mostly manageable knee pain became unmanageable. He opted for 800 milligrams of Motrin daily and ice and rest and his pain level was a difficult 6-7. Eventually that level of pain led to the realization he may have to give up bird hunting and ocean fishing. That is when he decided it was time for the TKR. 

All I have communicated with and those stories I have read all share one common attribute, their daily pain level was so great it became unmanageable with pain meds and/or their exercise/recreational activities were threated by their unmanageable knee pain. 

I advised my Doc today to cancel the knee surgery. When the day comes as it has come for all you I will man up for the TKR...until then....I will ride like the wind.....pack with ice and Ibuprofen as needed


----------



## LadyDi (Apr 17, 2005)

Stoplight, it sounds like you're making the right decision for you at this time. My story is different, apparently, in that my left knee prior to TKR had grinding bone-on-bone Grade 4 osteoarthritis with NO PAIN. I remember a time when it used to hurt, but that was years ago. Nah, it was just extremely weak. My orthopedic surgeon says he sees painless OA occasionally, but it's rare. As you can imagine, the decision to proceed with TKR was difficult and took me the better part of a year. My epiphany occured when I realized how limited my life had become due the stupid weak knee; I could no longer balance on my left foot, climb or descend stairs, dash across an intersection, hike without trekking poles, keep up with friends, or start pedaling on an uphill. I healed well from LTKR and was beginning to enjoy life again. I knew my right knee was deteriorating, but I wanted to hold off on replacement for as long as I could. Unfortunately I kept suffering degenerative meniscus tears at work. Now THAT was painful, not to mention inconvenient! The last time it tore xrays confirmed that this knee was also bone-on-bone. By then I was completely fed up and ready to get 'er done. Recovery from two TKR's has been brutal but I have no regrets.


----------



## stoplight (Mar 8, 2009)

LadyDi said:


> Stoplight, it sounds like you're making the right decision for you at this time. My story is different, apparently, in that my left knee prior to TKR had grinding bone-on-bone Grade 4 osteoarthritis with NO PAIN. I remember a time when it used to hurt, but that was years ago. Nah, it was just extremely weak. My orthopedic surgeon says he sees painless OA occasionally, but it's rare. As you can imagine, the decision to proceed with TKR was difficult and took me the better part of a year. My epiphany occured when I realized how limited my life had become due the stupid weak knee; I could no longer balance on my left foot, climb or descend stairs, dash across an intersection, hike without trekking poles, keep up with friends, or start pedaling on an uphill*. I healed well from LTKR and was beginning to enjoy life again.* I knew my right knee was deteriorating, but I wanted to hold off on replacement for as long as I could. Unfortunately I kept suffering degenerative meniscus tears at work. Now THAT was painful, not to mention inconvenient! The last time it tore xrays confirmed that this knee was also bone-on-bone. By then I was completely fed up and ready to get 'er done. Recovery from two TKR's has been brutal but I have no regrets.


If you do not mind me asking LadyDi, are you able to ride in a manner you thought you might post TKR? and how long did it take to get there? and are mainly road or combo mountain bike rider?


----------



## LadyDi (Apr 17, 2005)

Sure thing. I forgot to mention that I had been unable to stand and mash the pedals for 10+ years. To my shock and delight I was standing and mashing approximately 10 months post LTKR. I might have been able to do it sooner, but it didn't occur to me to try! By 10 months I was climbing 1800 ft. over 15-30 miles road or mtb and working on overall fitness. Unfortunately the OA in my right knee progressed rapidly and I needed the second surgery. I am now 3 months post op RTKR/15 months post op LTKR. At this point I am still on road & paved path, max 15 miles and 300 ft elevation gain. I'll tackle an easy trail next week if the weather cooperates. Remember that I was pretty de-conditioned leading into both surgeries with significant quad atrophy, so return to where I'd "like to be" will take a while. And I'm not getting any younger, lol. Complete recovery from TKR takes a good 18 months, but my first knee felt almost normal by 10-12 months. 

I hope my story helps. Some patients are back on the bike sooner, some later. My non-cycling friends are amazed (and aghast) that I ride at all, but of course they wouldn't understand. I will post a riding pic when I'm back on the trails.


----------



## stoplight (Mar 8, 2009)

LadyDi said:


> Sure thing. I forgot to mention that I had been unable to stand and mash the pedals for 10+ years. To my shock and delight I was standing and mashing approximately 10 months post LTKR. I might have been able to do it sooner, but it didn't occur to me to try! By 10 months I was climbing 1800 ft. over 15-30 miles road or mtb and working on overall fitness. Unfortunately the OA in my right knee progressed rapidly and I needed the second surgery. I am now 3 months post op RTKR/15 months post op LTKR. At this point I am still on road & paved path, max 15 miles and 300 ft elevation gain. I'll tackle an easy trail next week if the weather cooperates. Remember that I was pretty de-conditioned leading into both surgeries with significant quad atrophy, so return to where I'd "like to be" will take a while. And I'm not getting any younger, lol. Complete recovery from TKR takes a good 18 months, but my first knee felt almost normal by 10-12 months.
> 
> I hope my story helps. Some patients are back on the bike sooner, some later. My non-cycling friends are amazed (and aghast) that I ride at all, but of course they wouldn't understand. I will post a riding pic when I'm back on the trails.


Thanks LadyDi, appreciate your narrative!!! It sounds like you are doing great!!! 
and yes it most def. helped!!! One day I will be amongst those bionically modified...but until then...ride like the wind until I can't!!


----------



## stumo (Feb 29, 2008)

thanks for everyones replies. im now 6 weeks post op and very happy so far but youve given me more insight as to what's ahead. i too havent been able to stand and pedal for many years but will hopefully will be able to do so now.


----------



## Barbaramoore (Dec 29, 2015)

Physiotherapy helps?


----------



## stumo (Feb 29, 2008)

Barbaramoore said:


> Physiotherapy helps?


Physiotherapy is very important but you've got to do your prescribed exercises and push yourself all the time. you'll know when you've overdone it so just drop it back a bit.


----------



## LadyDi (Apr 17, 2005)

LTKR October 2014
RTKR October 2015
Update: I can stand and mash! I tried the other day and was happy to find that it was no problem aside from general post-op weakness. That was just a test- I prefer to avoid excessive force through the healing knee as I continue to build muscle and flexibility at the gym. I am increasing road miles and expect the knee to tell me when it is ready for more climbing and mtb.


----------



## MTB Dad (Sep 22, 2012)

I am over a year on my RPKR and per X-rays it's doing well. Rest of knee and my other knee not so great. As others have posted I too have pain and am still taking the max of Advil every day I ride, but the pain is much worse with other activities. I did over 5k miles last year almost all dirt so it hasn't slowed me down. I believe had I not had something done surgically I would not have been able to keep riding. I have adjusted how ride a bit by limiting standing big gear pushing. I also moved to a FS frame which has helped. I am slower but after rides the rest of my body is happy.


----------



## woody.1 (Jun 10, 2008)

Wherewolf said:


> I did have regular Synvisc injections for about two years and they helped. But I had an allergic reaction on the last one and that ended them.


Interesting - I had Syvisc injections twice a year for years. Never had a problem until the last time late summer 2015. I had an allergic reaction as well and I needed crutches to walk to the bathroom. Man that was brutal. 
I had 13 knee surgeries on left and 3 on right over the last 40 years and that Synvisc reaction was the last straw. Had TKR on left in October and right was done in December.


----------



## LadyDi (Apr 17, 2005)

woody.1 said:


> ... Had TKR on left in October and right was done in December.


Big history with those knees. How are you feeling now? Are you able to pedal a stationary bike?


----------



## LadyDi (Apr 17, 2005)

MTB Dad, I'm sorry your RPKR knee still hurts. Is your left knee headed for a replacement, too? 

My RTKR recovery has accelerated these past few weeks. I am up to 20 mile rides on both mtb and cyclocross ("road") bikes. I've been deliberately avoiding big climbs, but I think I'm ready now. I am back at the gym, and between riding days I hike. Last weekend I did a half-day of volunteer trailwork and felt fine afterwards, just tired. I have not needed a pain med since about 5 weeks post op. I used Tylenol occasionally for aching through December, but nothing now. Last evening I was resting some hours after a fast, steep hike and detected a sharp stinging sensation near my right incision scar. This was a new one on me. It didn't last long, but it was interesting. I think it was just a nerve knitting itself together- in fact the numb area around my scar seems smaller today. In other news, I am training a rescue pup and am frequently jumping up to deal with his shenanigans and escort him outside. Puppies are labor intensive at best, and this little guy is no different, but I'm frankly impressed at how great I feel now that I'm no longer struggling with damaged knees. 

LTKR October 2014
RTKR October 2015


----------



## woody.1 (Jun 10, 2008)

LadyDi said:


> Big history with those knees. How are you feeling now? Are you able to pedal a stationary bike?


Left feels pretty good and after post 6 weeks I was out riding gravel roads between 5-10 miles every other day.
Right is post 10 weeks now and knee joint feels good, but quad is sore. I'm riding a stationary bike 3 days a week and as soon as the roads (snow) dry out I'll be out riding again. 
Walking 2-3 miles everyday as well.
So far no regrets.


----------



## stumo (Feb 29, 2008)

I'm 10 weeks today(LTKR),
I'm pedalling up to 10 miles (no hills) but not fast but i'm steadily improving. Walking every day, up to 5 miles with 1100feet ascent, up is definately easier than down. 
Before the op i could only manage a couple of hundred meters walk due to pain (been like that for years). No meds needed now. 
Muscles seize up a bit when i've been standing and just need a quick stretch.
I've now got some plantar fasciitis pain and my ankle is giving me some pain from an old injury but they're both slowly getting better.


----------



## LadyDi (Apr 17, 2005)

Wow, you are doing great! Are you still in PT or are you done? At 10 weeks post op walking/hiking was still very difficult for me because my quad wasn't firing appropriately. It finally got the message closer to 12 weeks. That's when I was able to begin strength training. It is gratifying to note progress at the gym, on the bike, hiking.. everything.

I've also had transient foot and ankle pain. I attribute this to "unlearning" unconsciously adopted gait accomodations for a previously crooked leg. After my second post-op ride I realized that something about my right cycling shoe was uncomfortable- I had forgotten to remove the shim! In the months leading up to surgery my foot could barely stay clipped in without that valgus shim in my shoe. Hallelujah, I don't need it anymore!


----------



## stumo (Feb 29, 2008)

thanks. i've put a lot of effort in and am now getting the reward. my leg was very crooked too and now it's straight and like you have had to learn how to walk again and i think that my foot/ankle pains are from that and previous lack of use. i use specialized shoes for their angled shims but dont need them anymore..... id forgotten about them till i figured why it felt funny and removed them. i've finished with the physio for my knee but might get one for my ankle, see how it goes. seeing the surgeon at 12 weeks and think they xray the knee to see how well its gone. keep at it and fingers crossed you'll be ripping it soon.


----------



## MTB Dad (Sep 22, 2012)

RIP Wherewolf
My thoughts are with your loved ones

Never met in person but enjoyed your posts and thank you for your advice on knee.

Original post on NorCal page.


----------



## stoplight (Mar 8, 2009)

MTB Dad said:


> RIP Wherewolf
> My thoughts are with your loved ones
> 
> Never met in person but enjoyed your posts and thank you for your advice on knee.
> ...


Wow...my thoughts and prayers go with his family..he will be missed !!!


----------



## LadyDi (Apr 17, 2005)

Oh no!!! Wherewolf has been a great source of inspiration over the years. My condolences to his friends and family.


----------



## stumo (Feb 29, 2008)

Sad news, condolences to his family.


----------



## LadyDi (Apr 17, 2005)

A while back someone asked about climbing out of the saddle after total knee replacement; I am happy to report that I am mashing again only five months after right TKR. Now that both knees are replaced, climbing out of the saddle feels strong and symmetrical. I still have some residual stiffness, but it is only noticeable sometimes near the end of a brutal 12 hour work shift. Everything about cycling -mountain or road- feels fantastic. I have no pain and no regrets. If you know that you need knee replacement surgery, don't delay. Find a good surgeon and get it done!


----------



## woody.1 (Jun 10, 2008)

15 weeks out from RTKR and 23 weeks out from LTKR and rode singletrack today. Boy it felt good to be on dirt again. Nothing serious, 15 miles out at Phil's World in Cortez. Zero knee joint pain just some quad pain, but nothing too bad.
Like LadyDi said above, "if you know that you need knee replacement surgery, don't delay."
Feeling better than I have in years.
Likewise here on the no regrets.


----------



## LadyDi (Apr 17, 2005)

woody.1 said:


> 15 weeks out from RTKR and 23 weeks out from LTKR and rode singletrack today. Boy it felt good to be on dirt again. Nothing serious, 15 miles out at Phil's World in Cortez. Zero knee joint pain just some quad pain, but nothing too bad.
> Like LadyDi said above, "if you know that you need knee replacement surgery, don't delay."
> Feeling better than I have in years.
> Likewise here on the no regrets.


Phil's (esp. RIBCAGE) is on my Bucket List. Hooray for your new knees!


----------



## stumo (Feb 29, 2008)

That's great woody.


----------



## Robg68 (Oct 27, 2013)

Well I'm home from the hospital after having a total knee replacement. I injured my knee at work Last year in July and have been waiting patiently for workers comp to repair my knee properly. In 3 days I start physical therapy on my knee to start getting healthy again. God do I miss riding my bikes, I can't wait till I'm all healed up so I can ride!!


Sent from my iPad using Tapatalk


----------



## LadyDi (Apr 17, 2005)

Congratulations on your new knee!


----------



## Robg68 (Oct 27, 2013)

LadyDi said:


> Congratulations on your new knee!


Thank you!! I'm very excited about the new knee and then reading the progress you all have made. I'm 47 and have a lot of life and riding still in me. The injury happened 13 months ago and I've only ridden a couple hundred miles because of pain.

Sent from my iPad using Tapatalk


----------



## andrewbgardner (Mar 6, 2007)

I've enjoyed reading all the optimistic and encouraging posts on this thread spanning a few years. I'm set to receive my new left knee (I'm 38) in 2 weeks after 20 years of battling OCD or osteo-chondral-defect of my left knee. Many surgeries, scopes, osteotomy and micro-fractures later, I'm pretty much bone on bone and can't function even close to how I want to. Funny thing is, I can and have been able to ride and ride hard over this time as my wear and tear isn't effected by the pedal stroke, just in everything else from hiking, sports and especially walking. But I could bike and can presently bike and that's what I love most and all I want to do anyway so I wasn't quick to do a LTKR due to the fears of not being able to bike nearly as well anymore. 

Honestly, I've really questioned having this procedure because of how well I can bike, though I'm severely limited in ALL other aspects of my active life. I'm an aggressive enduro style rider and love to hit the single track and hit it hard and though I'm petrified of the surgery and the unknown of what's to come, I take immeasurable comfort from reading your posts and stories about your successes when it comes to getting back on the bike and living a healthier more active life.

Knowing this surgery was coming for over 6 months now, I've been riding hard and I'm in the best biking shape I've been in for quite some years now, hence the fear of surgery as I'm nervous I'll never be the same again. But at least my recovery should go better and more smoothly as I'm coming into this surgery in a good physical state, well that's what I'm hoping will be the case. 

I've got the tools, equipment and time to rehab and get this knee back to a better state than what's it's currently in, so wish me luck. -Andrew


----------



## woody.1 (Jun 10, 2008)

Andrew,
You will do great. You're young and in great shape, you'll bounce back quickly and there is life and biking after knee replacements. That was my biggest fear because that's my thing riding mountain bikes. Keep us posted and if you have any questions shoot me a PM or post them.
Good luck,
Woody


----------



## andrewbgardner (Mar 6, 2007)

So can you continue to ride hard and aggressive or is riding looked upon as "I"m just happy to be riding" mentality?


----------



## woody.1 (Jun 10, 2008)

Has hard as I can and its not because of my knees at all.
Last week I did an endo and I hit hard, cracked my helmet in half and sat there a while thinking damn I hope my knees are ok and I got up shook and continued the ride.
I love my new knees...


----------



## andrewbgardner (Mar 6, 2007)

woody.1 said:


> Has hard as I can and its not because of my knees at all.
> Last week I did an endo and I hit hard, cracked my helmet in half and sat there a while thinking damn I hope my knees are ok and I got up shook and continued the ride.
> I love my new knees...


That's great news. My biggest fear is that I'll be able to ride, but a formal shell of what I can do or used to do. It's nice to know that the knees aren't the limiting factor as to how aggressive one can ride, but rather their strength, endurance or prowess. I've never enjoyed riding as much as I have this year and I hate to think this is the pinnacle of my riding career and it's never going to be the same. But, having this bad knee does get me out of household chores so I'm not sure I want to give it up quite yet :thumbsup:


----------



## andrewbgardner (Mar 6, 2007)

I wish you a speedy recovery and keep us updated on your progress. I'll be joining you soon enough!


----------



## woody.1 (Jun 10, 2008)

Hey Andrew,
How's it going? Raining here so I was just looking through MTBR. I just finished a 4 day 3 night bikepacking trip around Cedar Mesa Utah. My knees did grea even able to hike and of course push my loaded bike through sand, which the locals call powder because it's so fine.
Hope your progress is speedy


----------



## andrewbgardner (Mar 6, 2007)

Sounds like a sweet trip! The weather's been really nice here in Utah lately making for great late season riding. I'm almost two weeks out from TKR and it's been a roller coaster. But, that's how these recoveries go. I'm getting stronger everyday and have made great progress this week especially. I'm close but not quite there yet to spin a full revolution on the bike but have barely managed to squeak one out using my heel so I'm close. Therapy is going well and it feels good doing something proactive that directly benefits my knee. Right now, my biggest issue is just trying to get decent sleep at night due to knee discomfort. I'm really not on any meds other than anti-inflammatories as my body just doesn't seem to cope well with them and they just cause more issues than they solve. Anyway, can't wait to get some on the bike therapy going, that will be a huge boost and milestone!


----------



## woody.1 (Jun 10, 2008)

Sounds like you're going the right way. Those pain meds can really mess a person up and only two weeks out without any meds is good. Sounds like that full revolution will happen this week. I remember with my first TKR after I was able to make a full revolution on the exercise bike at PT I went out into the garage setup my bike on a trainer. I was going 1/2 circle to 3/4 circle back & forth being careful and all of a sudden it went all the way around. It hurt and I screamed.
A good night sleep took me a while, just can't get comfortable for a long period of time.
You're doing great for two weeks out and keep up the good work. And remember there is biking after TKR.


----------



## LadyDi (Apr 17, 2005)

andrewbgardner said:


> Sounds like a sweet trip! The weather's been really nice here in Utah lately making for great late season riding. I'm almost two weeks out from TKR and it's been a roller coaster. But, that's how these recoveries go. I'm getting stronger everyday and have made great progress this week especially. I'm close but not quite there yet to spin a full revolution on the bike but have barely managed to squeak one out using my heel so I'm close. Therapy is going well and it feels good doing something proactive that directly benefits my knee. Right now, my biggest issue is just trying to get decent sleep at night due to knee discomfort. I'm really not on any meds other than anti-inflammatories as my body just doesn't seem to cope well with them and they just cause more issues than they solve. Anyway, can't wait to get some on the bike therapy going, that will be a huge boost and milestone!


Hey, Congrats on the new knee!

Both of mine are replaced. They are now one and two years old- toddlers, ha ha! TKR recovery is a ridiculously long process, but -trust me- your patience and perserverance will be rewarded.

After my LTKR it took me two weeks to accomplish that first full pedal rotation on my spin bike. Like you I just keep rockin' it back and forth until I could get over the top that first time (saddle way high, heel on pedal). A year later I had my RTKR and was on the spinner pedaling smoothly on post op day 4. Though my LTKR recovery lagged in every milestone vs my RTKR they are equally strong now. My left knee was simply more damaged going in.

You are in the major healing phase. Get as much rest and ice and elevation as possible this first six or eight weeks. You will be exhausted, and yes it will be difficult to sleep in solid blocks, so do naps. I hated opiates and quit them asap. I found that an extra-strength Tylenol at bedtime and, early on, a low dose muscle relaxant were enough to take the edge off and let me sleep.

Keep us posted on your progress!


----------



## Martinb46 (Nov 16, 2016)

Wow Andrew, I feel the exact same way as you do. I stumbled onto this board because after years of trying to buy time I'm pulling the trigger on a TKR on December 27th. I'm about your age (will be 47 in Jan). Unlike you, I haven't ridden much in a couple of years but when i was riding a lot, riding didn't really hurt my knee. It was the other things that hurt (anything involving walking). I tore the little bit of meniscus I had left about 18 months ago and it's been all downhill from there. Have lost a ton of stength in my quads and have pretty much just had a pity party for the last 18 months. Well, that's not an entirely accurate statement as I have tried my best to continue to work out but have not been able to stay consistent due to pain and instability in the joint. I also had some kind of back issue at the same time as my final meniscus tear which caused the nerves to stop firing to my quad. I lost about 5.5cm of muscle in my quad in about 8 weeks. This resulted in more pain, as very strong quads has been pretty much the only thing giving me stability in the joint for several years now. This just resulted in a downward spiral and gets me to where I am now.......a little over a month away from having surgery

Like you, I'm scared to death. Scared of what I may not be able to do after (even though I can't do any of that now). Scared of how quickly it will wear out and when I will be having another. I'm glad you're doing well and I look forward to following yours and others progress as I embark on my journey

It's been really cool to read through 2-3 years of posters and their journeys and it certainly does inspire me. I just wish I could fast forward a year and be fully recovered but it's not the hand I was dealt and I'm sure there is something I'm supposed to learn from my upcoming journey


----------



## JoeHowe (Sep 21, 2015)

*TKR at 42 yrs old?*

Thank you all for your post's, I've found them encouraging and terrifying all at once. One thing that's not mentioned in most of your post's is your age.

I'm in a unique position, only 42 and need both Knees replaced. Lot's of years of basketball playing above the rim took it's toll (picture attached).

I used to ride a lot of ramps and bmx as a kid and fell in love with MTB once basketball was no longer an option. It's been 4 years now since I stop balling and started biking and my legs are stronger than EVER. However, the joint's not so much.

I'm looking to have the worst of the two done in Jan / Feb of 2017 if the doctor give's it the green light, but I'm worried they'll deny me because of my age. The pain is tolerable, but does give me fit's on long flights and long rides.

I'm anxious to hear some feedback on you ages, and if you would have done sooner if you could have.


----------



## cyclopath1000 (Feb 22, 2009)

Yes your x-rays are quite convincing as to what you are up against. Not sure if the right is amenable to a uni but that's between u and the surgeon. The key is to realize that you want to maximize the duration of your replacement so as not to subject yourself to a revision. That means avoiding excessive compressive forces. But go for it. I am 66and very active but I won't run on my uni or jump off heights. I do take insane risks on my tall boy.


----------



## JoeHowe (Sep 21, 2015)

Thanks Cyclopath. I'm not looking to do any running or jumping on my feet, just pain free riding and being able to sit for a 2-3 hour flight. I'm all for the risk's on the bike


----------



## woody.1 (Jun 10, 2008)

JoeHowe said:


> Thank you all for your post's, I've found them encouraging and terrifying all at once. One thing that's not mentioned in most of your post's is your age.
> 
> I'm in a unique position, only 42 and need both Knees replaced. Lot's of years of basketball playing above the rim took it's toll (picture attached).
> 
> ...


I'm 57 and I'm glad I did it. I kind of wished I'd done it earlier. It's great to be able to hike again. 
I don't think they will deny you TKRs because of your age. More and more people are getting it done earlier. 
Good luck and keep us posted.


----------



## JoeHowe (Sep 21, 2015)

Thanks woody, I meet with the surgeon Friday, I'll keep posting.

I also forgot to mention some other PROS for getting it done now. 

1) Legs are super strong, quick rehab 
2) 100% coverage from insurance 
3) My job is flexible enough where it won't be a disruption.


----------



## woody.1 (Jun 10, 2008)

You'll bounce back quick.


----------



## Martinb46 (Nov 16, 2016)

andrewbgardner said:


> Sounds like a sweet trip! The weather's been really nice here in Utah lately making for great late season riding. I'm almost two weeks out from TKR and it's been a roller coaster. But, that's how these recoveries go. I'm getting stronger everyday and have made great progress this week especially. I'm close but not quite there yet to spin a full revolution on the bike but have barely managed to squeak one out using my heel so I'm close. Therapy is going well and it feels good doing something proactive that directly benefits my knee. Right now, my biggest issue is just trying to get decent sleep at night due to knee discomfort. I'm really not on any meds other than anti-inflammatories as my body just doesn't seem to cope well with them and they just cause more issues than they solve. Anyway, can't wait to get some on the bike therapy going, that will be a huge boost and milestone!


Any updates? I'm now 2 weeks away from my surgery. Would love to hear how your recovery is going.


----------



## Martinb46 (Nov 16, 2016)

I'm almost 47 Joe and having a left TKR in 2 weeks. I pushed mine off as long as I could but have gotten to where I can no longer do a lot of things that I love to do.


----------



## JoeHowe (Sep 21, 2015)

Martin, let me know how it goes and any advice for pre-surgery would be great!


----------



## JoeHowe (Sep 21, 2015)

JoeHowe said:


> Thank you all for your post's, I've found them encouraging and terrifying all at once. One thing that's not mentioned in most of your post's is your age.
> 
> I'm in a unique position, only 42 and need both Knees replaced. Lot's of years of basketball playing above the rim took it's toll (picture attached).
> 
> ...


Update from my appointment today. There was no hesitation from the surgeon whether or not he would replace them. GREAT NEWS!!! Schedule for late January or early Feb.

Is there any helpful pre-surgery advice any of you can offer?


----------



## woody.1 (Jun 10, 2008)

Nice man, if your core isn't strong I'd work on that. Makes for getting out of bed and out of chairs easier.
You going one at a time or both at the same time?
I did mine 7 weeks apart and it worked out nicely.
Keep us posted


----------



## JoeHowe (Sep 21, 2015)

Thanks for the core tip  

One at a time, right one first. Then do the second one 3 months after.... However, that would ruin the peak riding days here in NY, so I may do the left one in November or January of 2018. It really depends on how fast on can recover. I'm doing everything I can to get everything strong to help speed up recovery. Again thanks for the tip on the core, I do work it, but not enough


----------



## LadyDi (Apr 17, 2005)

JoeHowe said:


> Update from my appointment today. There was no hesitation from the surgeon whether or not he would replace them. GREAT NEWS!!! Schedule for late January or early Feb.
> 
> Is there any helpful pre-surgery advice any of you can offer?


JoeHowe check out Bonesmart.org. You will find many tips there, including proper ice and elevation, pain management, home prep.. just lots of good advice.

During my recovery I was really glad that I happened to own a spin bike. I was on it every day. I am not suggesting you rush out and buy an expensive spinner, but consider a sturdy trainer set-up in an accessible corner of your home. No resistance at first, flat pedals, and raise the saddle a bit. Some only manage to rock the pedals slowly back and forth for the first couple of weeks, while others can pedal right away. This can even vary from knee to knee.

My TKRs were a year apart. I was roughly planning the second for _after_ my youngest's high school graduation, but that knee utterly failed months ahead of my "schedule". It worked out fine that way, if not better. I was back on the bike and even had a few fun rides with my son before he left for college.

Best wishes on your upcoming surgery!


----------



## JoeHowe (Sep 21, 2015)

Thanks LadyDi!


----------



## JoeHowe (Sep 21, 2015)

Okay, I've joined a TKR group on Facebook and am not sure this is a good group for me. All though my knees are in terrible shape, the rest of me is not. I'm 42 yrs old, 6' 3", 222 lbs and very active. I'm at the gym everyday if I'm not on the bike in the woods, and some days both since the gym I go to is in the building I work in. 

So back to this FB group. I asked question about how long people were out of work if you have a desk job.... Some said 3 Months, others said 8-12 weeks. ARE YOU KIDDING ME!!! First, there is no way I could be inactive that long, second who has a job after being gone 3 months.

So I ask you, fellow riders of bikes, keepers of trails, jumpers of jumps. What should I expect with regards to going back to work given I have a desk job? Also, what about traveling, like flying cross country or international?


----------



## LadyDi (Apr 17, 2005)

JoeHowe said:


> Okay, I've joined a TKR group on Facebook and am not sure this is a good group for me. All though my knees are in terrible shape, the rest of me is not. I'm 42 yrs old, 6' 3", 222 lbs and very active. I'm at the gym everyday if I'm not on the bike in the woods, and some days both since the gym I go to is in the building I work in.
> 
> So back to this FB group. I asked question about how long people were out of work if you have a desk job.... Some said 3 Months, others said 8-12 weeks. ARE YOU KIDDING ME!!! First, there is no way I could be inactive that long, second who has a job after being gone 3 months.
> 
> So I ask you, fellow riders of bikes, keepers of trails, jumpers of jumps. What should I expect with regards to going back to work given I have a desk job? Also, what about traveling, like flying cross country or international?


Don't underestimate this surgery- it's a major ordeal and a long recovery no matter how young and fit you are. I was on medical leave for 18 weeks both times, but my job entails 12+ hour shifts on my feet and running around. Maybe you will feel ready to return to a desk job at 4 to 6 weeks but -trust me- you will be tired and uncomfortable. Take frequent short breaks to ice and elevate your knee. Pause occasionally to stand up, walk around, and stretch. Periodically straighten your leg and tighten the quad; this helps push fluid away from the joint. At six weeks post op almost everyone is doing (or just starting!) outpatient physical therapy, but more and more are finding that formal PT is not strictly necessary. Once you learn what to do you can easily perform the exact same stretches and exercises at home or at your gym. I greatly preferred doing my own rehab therefore I pretty much completely skipped PT after my second TKR and I did fine.

Pain management is another factor and highly individual. I was done with opiates after two weeks, but lots of folks stay on much longer. And then driving. Assuming you drive yourself to work, pain meds and the operative knee dictate how soon you can drive. After my LTKR I was driving myself around (automatic transmission) after about two weeks, but I needed five weeks after RTKR.

Talk to your employer's HR department about FMLA job protection.


----------



## LadyDi (Apr 17, 2005)

As for flying, sign up for TSA pre-check so you won't have to take off your shoes or pull your toiletries. Tell the screener you have an artificial joint _before_ you enter the metal detector so they can send you to the full body scanner instead. Otherwise you will *100% guaranteed* set off the metal detector and require a pat-down.

I flew domestically 6 months after my first TKR and had no real problems. My knee got a little stiff and swollen, that's all.


----------



## rockman (Jun 18, 2004)

I'm just checking back on this thread, one to say RIP to wolfman. I discussed knees with him a few times on long rides and was impressed with his will power.

I'm 55 and not sure if I have a 90% knee or what but bone on bone with osteophytes growing like pot plants in a dispensary. ACL reconstruction in 1989 and arthroscopic clean up in 2002. Things went down rapidly after the 2nd operation with osteo-arthritis become more of a player. It doesn't give me much issue mtn biking but skiing has become more difficult each year. I can no longer telemark and even hitting a powder day with a fixed heel has become quite painful. Hiking downhill is also not much fun. Seems like it's time and I've put that off for a long time with first, synvisc shots and when those no longer seemed to help (and ins. stopped paying) I've been getting the knee aspirated and then a cortisone injection which definitely helps with the inflammation. Of note, is that I can sleep at night so the arthritis isn't killing me or anything. I've got a doctor picked out that is considered the best in Flagstaff for a TKR but can't make up my mind.

The question really is has anyone had luck with the Regenerative stuff like PRP (platelet-rich plasma treatments) or stem cell treatments? The ortho guy that did my cortisone injection yesterday is hip on either procedure but not big on details. He's not a surgeon either. Seems like putting lipstick on a pig; maybe putting off a TKR for a couple of years. Thoughts from those who are walking this road?


----------



## JoeHowe (Sep 21, 2015)

rockman, I'm 42 and having both knees replaced this year. The right one in 3 weeks. I abused my knees by jumping, basketball and track. Great memories of clearing the bar in the high jump and dunking on dozens of unsuspecting players. But that came to and end 7 years ago. I tried the lubrication injections, two different types, the steroid injections, physical therapy. All worked for a short period of time, but at the end of it all I'm still bone on bone. I looked in to the stem cell but not too deep. The cost was not covered by insurance and I couldn't afford $10K to see if it would work. I could probably go another 5 years before I really needed TKR, but my insurance covers the procedure at 100%, and who know's what's going to happen the next 4 years with our new President. Plus, my doctor said "Live your life" get it done now and have the quality of life you want now, now 5-10 years from now. The only draw back, I'll have to pay closer attention to the drops and gap jumps on trails. Good luck and you can follow my progress here if you are really, really bored: https://mynewknees.blog/


----------



## rockman (Jun 18, 2004)

JoeHowe said:


> rockman, I'm 42 and having both knees replaced this year. The right one in 3 weeks. I abused my knees by jumping, basketball and track. Great memories of clearing the bar in the high jump and dunking on dozens of unsuspecting players. But that came to and end 7 years ago. I tried the lubrication injections, two different types, the steroid injections, physical therapy. All worked for a short period of time, but at the end of it all I'm still bone on bone. I looked in to the stem cell but not too deep. The cost was not covered by insurance and I couldn't afford $10K to see if it would work. I could probably go another 5 years before I really needed TKR, but my insurance covers the procedure at 100%, and who know's what's going to happen the next 4 years with our new President. Plus, my doctor said "Live your life" get it done now and have the quality of life you want now, now 5-10 years from now. The only draw back, I'll have to pay closer attention to the drops and gap jumps on trails. Good luck and you can follow my progress here if you are really, really bored: https://mynewknees.blog/


Sound advice, thanks! Basketball is how I tore my ACL as well playing intramurals. There's was that dang pesky 6 week period where I could actually dunk at 6'. So, I would try over and over and over again in chucky taylors on asphalt or concrete. Ah, youth.

I don't really like hitting gap jumps over 10' and certainly drops of more that 3 or 4'. Drops to flat suck. But in the end, I could give up skiing and really have no need to telemark again but by all accounts most folks with TKRs are killing it on the bike. Hiking with my kids and not wanting to go is a strong motivational desire as well.


----------



## chris7777 (Mar 17, 2006)

LadyDi said:


> During my recovery I was really glad that I happened to own a spin bike. I was on it every day. I am not suggesting you rush out and buy an expensive spinner, but consider a sturdy trainer set-up in an accessible corner of your home. No resistance at first, flat pedals, and raise the saddle a bit. Some only manage to rock the pedals slowly back and forth for the first couple of weeks, while others can pedal right away. This can even vary from knee to knee


I am am getting close to my first of two Total Knee Replacement, but no date yet. I have enjoyed reading all the posts in this thread.

What kind of spin bike do you recommend for at home PT? I have my mountain bike and my recumbent bike. Should i just buy a trainer for either of them? Or, i should buy a stationary bike. They dont cost all that much. Which would be better for TNR rehab... an upright or a recumbent?

I am 66. I am teaching my 189th mountain bike clinic to about 40 students next week. Biking makes my knees feel better, not worse. It is the walking and especially standing that does me in.

I Have had OA for 10 years. Its getting worse all the time. Injections dont help anymore like they used to. I have had 3 injections of stem cells in my right knee and one in my left, but it didnt help.

I am trying to find a doctor that does the newer "minimally invasive total knee replacement". It requires new skills, tools and facilities to accomplish. Much less soft tissue is cut. They come in from the side, through a 4 or 5 inch cut. Much less trauma to the quads. Anyone have any insight about that proceedure?

Thanks for all the sharing.


----------



## cyclopath1000 (Feb 22, 2009)

Are you talking about a partial uni knee replacement called makoplasty.


----------



## rockman (Jun 18, 2004)

JoeHowe said:


> rockman, I'm 42 and having both knees replaced this year. The right one in 3 weeks. I abused my knees by jumping, basketball and track. Great memories of clearing the bar in the high jump and dunking on dozens of unsuspecting players. But that came to and end 7 years ago. I tried the lubrication injections, two different types, the steroid injections, physical therapy. All worked for a short period of time, but at the end of it all I'm still bone on bone. I looked in to the stem cell but not too deep. The cost was not covered by insurance and I couldn't afford $10K to see if it would work. I could probably go another 5 years before I really needed TKR, but my insurance covers the procedure at 100%, and who know's what's going to happen the next 4 years with our new President. Plus, my doctor said "Live your life" get it done now and have the quality of life you want now, now 5-10 years from now. The only draw back, I'll have to pay closer attention to the drops and gap jumps on trails. Good luck and you can follow my progress here if you are really, really bored: https://mynewknees.blog/


Joe, nice blog. Sorry about the setback. I'm tentatively on for Nov. Just want to make it through the summer.


----------



## chris7777 (Mar 17, 2006)

no, I am not. I am talking about Minimally Invasive Total Knee Replacement

Minimally Invasive Total Knee Replacement-OrthoInfo - AAOS


----------



## Desert Diesel (Aug 9, 2014)

Done...


----------



## cyclopath1000 (Feb 22, 2009)

Ok as an anesthesiologist / 66 yo shredder with a makoplasty r uni knee replacement I haven't worked in a room doing " minis". And have never seen a lateral or medial side incision. Where was the mini done and where did the guy learn it. In sacramento there is one makoplasty computer guided machine and it's at Mercy San Juan and Dr Sasaura is it's master having done hundreds. You don't want a makoplasty type thing unless the surgeon has many under his belt. Alot of the internet info to the non insiders is pure rubbish. I only got aware of things from an implant rep on the middle of a complex back fusion who tipped me off. And I'm in or s for a living. I guess u could travel somewhere but there are myriad reasons to stay somewhat local. As in as few hours drive as possible. In any case u want a decent surgical /. Anesthetic regimen. Preop cocktail with a potential cox 2 inhibitor, something like some oxycontin maybe , a female nerve block or a selective one at the adductor canal so u can walk that day , a spinal single shot neuraxial block , mild/ moderate sedation...Good blocks are amazing. I was riding a bike around our greenbelt by 3 weeks. I was in Sedona in a few months and took two blue runs off the Nevada side of heavenly on Xmas day approx 3 mo post op. I always wear 661 knee pads when riding. You never want to lacerate that knee.


----------



## cyclopath1000 (Feb 22, 2009)

Femoral not female block but hey try that too!


----------



## chris7777 (Mar 17, 2006)

there is a clinic about 2 miles down the road that does them. The Carrell Clinic. They have benn in business since 1922 and have several doctors on staff, many of which are highly respected and have made the Best Doctors in Dallas list. Read the description of the proceedure youself. OH, and what is a "uni"?
https://www.carrellclinic.com/minimally-invasive-knee-joint-replacement/

Minimally Invasive Knee Joint Replacement:

Total knee replacement is a very successful surgical treatment for knee arthritis. Over the years, minimally invasive knee replacement surgical techniques have been developed to lessen tissue trauma and improve patient outcomes. This minimally invasive approach involves much smaller incisions than the usual 10-12 inch incisions used in the traditional knee replacement and spares the quadriceps muscle and tendon, which control bending of the knee, from being cut to access the knee joint.
The smaller incisions with minimally invasive surgery means less tissues are cut resulting in quicker healing and recovery. The potential advantages of minimally invasive joint replacement surgery are:
Minimal surgical dissection
Shorter recovery period
Shorter hospital stay
Reduced postoperative pain
Minimally invasive surgery for knee replacement involves the use of smaller incisions which are only 4 to 6 inches in length as compared to the 10-12 inch long incision used in the traditional procedure.
Surgery is performed under sterile conditions in the operating room under spinal or general anesthesia. You will be lying on your back on the operating table with a tourniquet applied to your upper thigh to reduce blood loss. Your surgeon will then make an incision along the affected knee to expose the knee joint. The surgeon first focuses on the femur (thighbone). The damaged portions of the femur are cut at the appropriate angles using specialized tools. Then the femoral component is attached to the end of the femur with or without bone cement. The next step involves removal of the damaged area of the tibia (shinbone) and the cartilage. It allows for a smooth surface to which implants can be attached. The tibial component is then secured to the end of the bone using bone cement or screws. Your surgeon will place a plastic piece called an articular surface between these implants to ensure a smooth gliding movement. This plastic insert acts in a similar way as the original articular cartilage and helps in supporting your body weight as well as allows the femur bone to move over the tibia. The femur and the tibia bone with their new components are put together to form the new knee joint. To ensure that the patella (knee cap) glides smoothly over the new artificial knee, its rear surface is prepared to receive a plastic component. With all its new components in place, the knee joint is examined through its range of motion. All excess cement will be removed and the entire joint will be irrigated or cleaned out with a sterile saline solution. The incision is then closed and drains are usually inserted. A surgical dressing or bandage is then placed over the incision.
As there is less tissue damage around the knee during the minimally invasive procedure surgery, you can expect a shorter hospital stay, faster recovery and also avoid unsightly smaller surgical scar.


----------



## chris7777 (Mar 17, 2006)

did you look at the link I posted? it would appear that you have not. Check it out: 
Minimally Invasive Total Knee Replacement-OrthoInfo - AAOS


----------



## cyclopath1000 (Feb 22, 2009)

Go and watch all the you tubes of all the various claimed "minimally invasive knee replacements" and decide for yourselves if they materially differ. Cutting a pasting marketing material is useless. 

My uni was basically directed by a computer. The bone wasn't cut in jigs. It was basically a CNC mill that the surgeon followed on a screen. It's all on YouTube I bet. If you have a decent surgeon 2 miles away why are you posting?


----------



## cyclopath1000 (Feb 22, 2009)

Traditional knne replacement uses a set of jigs that are guides for cuts by a reciprocating saw blade with the teeth at the front of a approx 2" wide blade. No cuts are ever done free hand. The jigs fit across the knee and to be done correctly so the components fit at the correct orientation and pitch. This requires the ability to catch in the jig all the area to be cut. After each cut the jig comes off and the next one is secured. At the end underside of the prothesis fits nice and snug like a piece of custom furniture. 

To do the same truly minimally invasive the jigs are either heavily modified or replaced with a completely different method to orientate, remove and perfectly model the bones resection. 

The makoplasty method uses a CT scan of your knee specifically meant to load into a CNC type computer your knee. As I recall the ct scans are .5 cm apart. Two sighting devices are attached in to the femur and the other to the tibia. The CT scan is loaded and the sighting devices communicate and guide a device with a cutting ball. I've got to meet martinat mescal trailhead at Sedona now so I have to cut this explanation short. Basically the less exposure (smaller incision) the more other methods to ensure accuracy are needed.


----------



## rockman (Jun 18, 2004)

Lots of good info in this thread. Setting up my appointment this week.

cyclo, Mescal should be pretty busy today. Love the dry creek area. Except for Girdner but a loop with chuckwagon, Mescal, Western Civ, and Last Frontier will take the mind off the knee pain any day. Mostly.


----------



## chris7777 (Mar 17, 2006)

cyclopath1000 said:


> Go and watch all the you tubes of all the various claimed "minimally invasive knee replacements" and decide for yourselves if they materially differ. Cutting a pasting marketing material is useless.


Cyclo, you doubted there even being a minimally invasive proceedure for total knee replacement. So, I posted a link that describes exactly what a minimally invasive knee replacement surgery is, by both the American Academy Orthapedic Surgeons, AND a link to the description given by the clinic offering them in my neighborhood. Sorry you only see it as marketing. I did so, because you seemed to doubt the existence of a minimally invasive proceedure. You tout that you are a doctor, and a shredder, and have all this medical knowledge about total knee replacement, and I just wanted you, and the readers of this thread, to know that there IS an alternative, minimally invasive proceedure. I wasn't just making it up. And now that I show you that there is such a proceedure, you dimmiss it as just "marketing." Ok, so why am I on this forum, if I have a clinic 2 miles away that offers the proceedure I am curious about? Well, because we come to these forums, to find out if someone has unbiaased, first hand experience with something, whether it is a medical proceedure, or a particular brand/model of mountain bike equipment like a shock or shifter, or bike shorts.... right???? we are looking to check things out... right? To get a consensus... right? that is all I am trying to do. I don't understand why I am getting so much attititude. I have had OA for 10 years. It hasn't stopped me from riding Fruita, or Phils World, hiking in the Canyonlands, or teaching thousands of people how to mountain bike. I am a self employed commercial photographer. I am planning on going hiking in Glacier National Park this August. I have clients i need to service. I am trying to get my rides and exercise in. Trying to stay in shape. But my knees are getting worse, and a major impediment. I can't afford the down time. I have given up on the stem cell injections, (4), that I have spent a lot of money on. I dread getting my knees replaced, but it is looking inevitable. I want to make the best decision. Just trying to get all the info I want, to make the best decision. When I was looking for the opthamalogist to do my cataract surgery, I was anal about my search for the best guy, and guess what? It paid off. I found a boutique guy who shot straight with me. Didn't try to sell me on the lastes lens that so many people I know are now regretting. Too many people don't educate themselves about elective surgery. I am just trying my best. And I don't need any attitude about it here on MTBR.com Thanks! Chris



cyclopath1000 said:


> My uni was basically directed by a computer. The bone wasn't cut in jigs. It was basically a CNC mill that the surgeon followed on a screen. It's all on YouTube I bet. If you have a decent surgeon 2 miles away why are you posting?


----------



## cyclopath1000 (Feb 22, 2009)

Do you have a reading comprehension problem. If u read my replies carefully you might gain something. I will try once more. If you are using a very short incision then the traditional jigs ( please watch YouTubes what that is ) aren't going g to be used. If the usual jigs aren't used and very little of the joint is exposed then the specifics of what to exactly resect require other methods. Makoplasty is one specific minimally invasive method. The makoplasty method which uses a detailed ct scan of your knee to quide the resection may be now out there for total.knee replacent. 

Now if this is insulting you somehow then a) I give up and b) I apologise.


----------



## rockman (Jun 18, 2004)

Silly pissing match here boys. We all want what's best for our knees and our quality of life. More information is good. 

I checked with my orthopaedic surgeon today regarding the minimally invasive technique. I'm not going to have him do the surgery since he's a family friend (our daughters are in the same class here in Flagstaff) but he's a big skier and often travels with the US Olympic ski team as the team ortho so I value his opinion. His take was the jury is still out on true minimally invasive or quad sparing. He also thought it was marketed heavily and that it may result in earlier leg extension but the overall outcome was likely no different.

Having the knowledge when interviewing orthos and trying to decide the best course of action is power. So thanks for sharing your experiences.


----------



## chris7777 (Mar 17, 2006)

Thanks Rockman, finally I get an answer to my question. The minimally invasive approach might be good, but might be risky, since it is still unproven. thanks.


----------



## 504avro (Jul 10, 2017)

*Cycling best after TKR*

I started marathons late in life at 55 and ran 7 before quitting at 65 with totally abused and ruined knees. Earlier, cycling had been my primary recreation. There are no knee problems on the bike. I therefore returned to serious bicycle touring at 65 ending those ruinous days of competitive running. As an aside it turns out that the more cycle miles you do the better the knees hold up when you are off the bike. But the therapeutic effect (on walking and stair descending) is never long lasting and I had a left knee TKR on 7 March 2017, at age 81. After about 3 weeks of the usual rehab therapy I returned to the bike. Started with the seat in the highest practical position to minimize the initial range of motion required for a complete 360 degree rotation. But even then suffered mildly for a minute or two at the top of the left hand pedal stroke as I passed quickly through the mandated bend angle of about 105 degrees. Keep going however and the stiffness will soon dissipate. To give some idea of the difficulty of reestablishing full range of motion, i think it helps to watch a video available on YouTube showing how, after the two neatly sliced halves of the primary incision are held apart, a copious amount of internal tissue is literally scooped to the sides to create an open space for the TKR. That's an awful lot of displaced scar tissue to force a way through during rehab. Through April daily miles went from about 2 to 5 with seat position coming down progressively to increase bend angle to about 120 degrees and stretch angle to almost zero. Through March (now 7 weeks post op) l rode about 500 miles with 65 mile max. Interesting by the way is that while there were no problems riding with the TKR knee there were also no problems with the other knee which is a confirmed bone on bone knee. As already said nothing seems to bother even the worst arthritic knee whilst on the bike. Had 3 month check up on the 14th June and left for Georgia on the 15th riding 700 miles in 11 days from Fredericksburg in Virginia down to Sea island in GA. More sensibly my wife with our two Golden Retrievers motored down Interstate 95 stating 9 days later. While not everyone will have the desire to cycle the open road to the extent mentioned here neither is that necessary and my main message here is to cycle cycle cycle, ride that old basement bike as much as possible in whatever you consider to be your safe cycling environment. You will considerably hasten the TKR rehab and you might even get to enjoy the exercise. The right knee is scheduled for August 8th. Oh and by the way I have on several occasions become too cocky and hammered the pedals with mildly painful results so no off the seat riding and no ridiculously steep hills, at least for the near term!!


----------



## 504avro (Jul 10, 2017)

I started marathons late in life at 55 and ran 7 before quitting at 65 with totally abused and ruined knees. Earlier, cycling had been my primary recreation. There are no knee problems on the bike. I therefore returned to serious bicycle touring at 65 ending those ruinous days of competitive running. As an aside it turns out that the more cycle miles you do the better the knees hold up when you are off the bike. But the therapeutic effect (on walking and stair descending) is never long lasting and I had a left knee TKR on 7 March 2017, at age 81. After about 3 weeks of the usual rehab therapy I returned to the bike. Started with the seat in the highest practical position to minimize the initial range of motion required for a complete 360 degree rotation. But even then suffered mildly for a minute or two at the top of the left hand pedal stroke as I passed quickly through the mandated bend angle of about 105 degrees. Keep going however and the stiffness will soon dissipate. To give some idea of the difficulty of reestablishing full range of motion, i think it helps to watch a video available on YouTube showing how, after the two neatly sliced halves of the primary incision are held apart, a copious amount of internal tissue is literally scooped to the sides to create an open space for the TKR. That's an awful lot of displaced scar tissue to force a way through during rehab. Through April daily miles went from about 2 to 5 with seat position coming down progressively to increase bend angle to about 120 degrees and stretch angle to almost zero. Through March (now 7 weeks post op) l rode about 500 miles with 65 mile max. Interesting by the way is that while there were no problems riding with the TKR knee there were also no problems with the other knee which is a confirmed bone on bone knee. As already said nothing seems to bother even the worst arthritic knee whilst on the bike. Had 3 month check up on the 14th June and left for Georgia on the 15th riding 700 miles in 11 days from Fredericksburg in Virginia down to Sea island in GA. More sensibly my wife with our two Golden Retrievers motored down Interstate 95 stating 9 days later. While not everyone will have the desire to cycle the open road to the extent mentioned here neither is that necessary and my main message here is to cycle cycle cycle, ride that old basement bike as much as possible in whatever you consider to be your safe cycling environment. You will considerably hasten the TKR rehab and you might even get to enjoy the exercise. The right knee is scheduled for August 8th. Oh and by the way I have on several occasions become too cocky and hammered the pedals with mildly painful results so no off the seat riding and no ridiculously steep hills, at least for the near term!!


----------



## cyclopath1000 (Feb 22, 2009)

Great recovery. Yea u went as far as u could with the oem equipment. I'm the right medial uni by makoplasty. I love serious climbing Enduro type riding. It took a bit to get back and even longer to actually buy next seasons pass at heavenly after finishing the season on July 4 at squaw with my new bramas.


----------



## chris7777 (Mar 17, 2006)

thanks for the report Avro. Very interesting read. I love hearing about a man who rides 700 miles in 11 days at age 81 after TKR! Bravo!

Does it matter if you rehab at home with a tradtional stationary bike, or a recumbent stationary bike? I ride mountain bikes on the trails and recumbents on the road. 

Since it is so important to stand up when peddaling on a mountain bike, looks like I might not be able to ride trails for quite awhile after surgery. I have my surgery scheculed for November with one of the preminent TKR surgeons. I have decided to go with minimally invasive surgery, but decided not to go with Makoplasty because it is too new.

I agree, cycling, swimming, even pushing weights, make my kees feel better. But I can't stand in line for more than a very few minutes.


----------



## Cuyuna (May 14, 2017)

I'm 66 years old too. I'm also a minimally invasive surgeon (not orthopedic). I agree that the "minimally invasive" TKR is mostly marketing....marketing on the part of the surgeon, and marketing on the part of the company that makes the tools. The guiding principle to TKR is to minimize soft tissue damage. This mainly involves how the incision is made. That in turn plays a big role in the length and magnitude of the recovery.

I had bilateral unicompartmental knees at the Mayo Clinic - Rochester several years ago. Very little pain, very quick recovery. I went in with good quadriceps and worked hard on a stationary bike post-op which helped to maintain quad strength and range of motion. Two years ago, those knees got infected and had to be explanted. I presented in full-blown sepsis. The knees were replaced with mobile spacers because of the infection. Those spacers were supposed to be temporary. That was a tough recovery and I was off work for three months getting to the point where I was mobile enough. 

I still have the mobile spacers. Normally they'd be replaced with real knees, but Mayo's current paradigm is.."replace the spacers when they fail". It's a new concept that only the Mayo Clinic could get away with, but these things have been working great for the last two years. Nobody really knows how long they're going to last. These days, I'm road-biking about 80 miles/week and hitting the local MTB trails once or twice a week.

Marketing is a big component of Surgery these days, including Orthopedics. The whole "Minimally Invasive TKR" concept is just a version of that.


----------



## cyclopath1000 (Feb 22, 2009)

Every orthopedist who isn't adept at makoplasty claims non computer aided unis are equivalent. I don't agree. But if u add in the orthopedists who do makoplasties but with low volume case historues, I'm sure they are correct. This is the same I've observed with davinchi cases intra peritoneall. I used to agree until I finally worked with people who mastered davinchi.


----------



## Cuyuna (May 14, 2017)

Like DaVinci robotic surgery for MIS, makoplasty is mostly a marketing ploy, and one that is really only suitable for the portion of end-stage arthritis patients that are suitable for a uni-compartmental knee, including those who are willing to accept the higher failure rates. Most of the joint fellowships have abandoned makoplasty except for those who suffer a marketing disadvantage. Like robotic abdominal surgery, it adds significant expense with little or no peer-reviewed advantage in outcomes. To be sure...robotic surgery is very cool...it's just unnecessary. A "solution in search of a problem", generally speaking.


----------



## cyclopath1000 (Feb 22, 2009)

You should see my post op pics of the implant orientation. But carry on. As I said this guy has done greater than 400. Most surgeons have a very limited uni practice. And yes it is only suitable for a small subset. I had only medial compartment disease from a buckle handle tear so even my patello femoral area wasn't touched. It's definitely a subset that I luckily fit.


----------



## Cuyuna (May 14, 2017)

That opinion comes from both University of Utah and Mayo Rochester. Neither place even comes close to a "limited uni practice". In fact, Mark Pagnano, the surgeon that did my uni-compartmental knees at Mayo, pretty much wrote the book on the subject. His Fellow at the time is now one of my partners and a close friend.

Uni-compartmental knee replacement is a truly great thing for those who have arthritis pretty much limited to the medial compartment. Quicker recovery for sure, and when they fail in 8 years or so, revision to a total knee is very straightforward, unlike revision of a TKR, which is very hard.

Uni-compartmental knee replacement is good. Makoplasty is pretty much marketing. IMHO.


----------



## cyclopath1000 (Feb 22, 2009)

Thanks for the reply cayuna. From my simplistic anesthesia /internal medicine vantage point plus my love of wrenching , the advantage of makoplasty vs the few other uni s I personally provided anesthesia care to is the fact that the orientation of the implant doesn't require physical comparison to the native side if the sighting devices are deployed correctly. Yes my patellar had to be retracted laterally and you know that takes a while to recover from as well as the obvious atrophy of the distal quads etc. So yea I too had a hell of a time getting my knee / foot over the top of the pedal. And we are all susceptible to late occuring hematogenous seeding and sepsis. But it's a pretty ingenuous method of using basically a rotating abrasive ball guided by a computer akin to a CNC mill to create the 3d shaped repository of the implant. Its a bit like a old school machinist with his old school rotary Mill vs a modern cnc mill. 

The reality is that we are just at the first gen of computer guided surgery. When davinchi or whatever company add computer knot tying etc a come operation will take increasingly short and short times. It's the future.


----------



## Cuyuna (May 14, 2017)

cyclopath1000 said:


> .
> 
> The reality is that we are just at the first gen of computer guided surgery. When davinchi or whatever company add computer knot tying etc a come operation will take increasingly short and short times. It's the future.


I completely agree. Computer-aided imaging and computer-guided surgery are indeed the future, especially as a combination. Right now we're at the point where it's more gimmicky than it is clinically useful, but the current generation of surgical robots is providing an excellent test-bed and platform for the advances necessary to realize its future.


----------



## rockman (Jun 18, 2004)

T-10 days to surgery. Still no pain mtn biking and in fact just came in 2nd in 50+ age class in the Flagstaff Enduro race. But I want to ski again. Game on!


----------



## LadyDi (Apr 17, 2005)

rockman said:


> T-10 days to surgery. Still no pain mtn biking and in fact just came in 2nd in 50+ age class in the Flagstaff Enduro race. But I want to ski again. Game on!


Best wishes on your upcoming surgery!


----------



## rockman (Jun 18, 2004)

7 weeks post-op. 110-115 deg flexion and 0 extension. Got out for my first mountain bike ride yesterday, albeit mostly flat with little climbing but it was good to be out in the woods on singletrack.


----------



## cyclopath1000 (Feb 22, 2009)

Congrats. I'll be at McDowell mountain park camping 1/6 for two weeks. If u r for some reason near stop by.


----------



## rockman (Jun 18, 2004)

cyclopath1000 said:


> Congrats. I'll be at McDowell mountain park camping 1/6 for two weeks. If u r for some reason near stop by.


Thanks. Browns Ranch would make for some nice recovery riding. Haven't been to Pemberton and McDowells in a long time. All trails are open here in Flagstaff at 7000'. Fire season is not going to be pretty if some semblance of winter doesn't kick in.


----------



## cyclopath1000 (Feb 22, 2009)

If u r a local then maybe u know my buddy Marty glinsky who is major in Sedona trail issues. I def will be up to ride with Marty a few times. If u are up to brawn's ranch I will be happy to meet u there . I'm not sure how to get u my phone # or me yours. If u call Marty he will give it to u. I've never seen any body post a phone number here. .


----------



## rockman (Jun 18, 2004)

cyclopath1000 said:


> If u r a local then maybe u know my buddy Marty glinsky who is major in Sedona trail issues. I def will be up to ride with Marty a few times. If u are up to brawn's ranch I will be happy to meet u there . I'm not sure how to get u my phone # or me yours. If u call Marty he will give it to u. I've never seen any body post a phone number here. .


I don't know Marty personally but he's on the board at Verde Valley Cyclist Coalition. They're doing a lot of good things down there in a rather contentious environment.

To be honest I'm still taking baby steps. ~4 miles of mostly flat pedaling. Maybe in another month I can tackle a real ride. I still can't stand and mash yet, it hurts too much where the tourniquet was.

I miss Sedona riding but I'm definitely not ready for that and it's blown out and super dusty anyway. Might be down in Cave Creek toward the end of the month when wife's mom heads down to her winter haunt. In which case, Browns is 10 min away. I can send a PM with my contact info.


----------



## cyclopath1000 (Feb 22, 2009)

Great be are also going to be at dead horse ranch for two weeks at beginning of March. But honestly I think u will want at most something like McDowell. If u check my earlier posts it was a pretty long time before I could get power over the top of the pedal. Please be super careful over using your good leg because if u double up on that side u can irritate or ever tear the labrum of ur hip. Anyway we will meet and ride at some point. Another guy I met this fall in Moab is going to get his knee done up at flag. I briefly considered maybe joing that anesthesia group but I'm quite set down here . I'm at least going to look at houses in cornville for a possible second home.


----------



## rockman (Jun 18, 2004)

cyclopath1000 said:


> Great be are also going to be at dead horse ranch for two weeks at beginning of March. But honestly I think u will want at most something like McDowell. If u check my earlier posts it was a pretty long time before I could get power over the top of the pedal. Please be super careful over using your good leg because if u double up on that side u can irritate or ever tear the labrum of ur hip. Anyway we will meet and ride at some point. Another guy I met this fall in Moab is going to get his knee done up at flag. I briefly considered maybe joing that anesthesia group but I'm quite set down here . I'm at least going to look at houses in cornville for a possible second home.


Who's doing his knee? I went with Randall. She does an Omni which is computer guided or assisted but she's probably the best in Flag although there's another 3 or 4 orthos that do them. I know quite a few of the anesthesiologists in town. Most of them mtn bike. Anyhow, thanks for the advice. I'm just spinning but still need a bit more flexion to feel comfortable on the pedals so it's mostly PT for me for the time being. But it's so nice out I may try and get out for a longer ride today. Anyhow, it sounds like you ride Sedona a lot so we'll have to get one in. Dry Creek area is about the least technical. I suppose I'll always be wearing knee pads from here on out.


----------



## cyclopath1000 (Feb 22, 2009)

Yea always wear knee pads. I use the 661s Velcro around thigh but not too much surface contact with skin. The one time I did t wear knee pads I rode one of my kitted moped on a landsquids rally in Sacramento and the bike got away from me and flipped at a green light. Lacerated that knee. Very unsettling.


----------



## rockman (Jun 18, 2004)

cyclopath1000 said:


> Yea always wear knee pads. I use the 661s Velcro around thigh but not too much surface contact with skin. The one time I did t wear knee pads I rode one of my kitted moped on a landsquids rally in Sacramento and the bike got away from me and flipped at a green light. Lacerated that knee. Very unsettling.


I might be wrong but I believe the biggest risk biking is a direct blow to the knee cap, thus shattering the bone as it lies directly over the implant. I wear 7iDP Flex Knee pads which have a hard shell for tech riding. But not that big a deal to just wear them all the time.


----------



## just4thefunofit (Jul 16, 2017)

Wow this thread has some history to it and a lot of advice so I'll seek some advice too. 68 years old avid cyclist in very good shape with degenerative joint disease I've had for 20 years. Pops frequently in a seated position (thankfully not on a bike). So I'm still riding hard right up until the knife. It's time to go for total new. Scheduled for that Jan. 22. I tend to deal with pain and heal well so we'll see. In addition to lots of mountain biking I do 2-3 road centuries per year. Not the fastest but I finish. So my favorite century, the Wildflower in Creston, CA is on April 7. I really want to do this because it will make 20 consecutive years. Yes, it is that good. That's 74 days of recovery. What do you guys think, should I sign up? I'd be satisfied even if showing up and doing 50 miles. If I heal fast that's probably pretty good considering I will not get much training in before hand. Thanks for the advice.


----------



## cyclopath1000 (Feb 22, 2009)

Well baring some problem I would say u will be riding some distance but I suspect the ride has significant serious climbing for serious distances which is asking a bit too much of yourself. But to be there and ride a portion of course. If u go back and read that I did two runs at heavenly three months post op ,plus I was def riding u would say I was being negative about you in particular, but a serious century is quite a stressor . Personally I recommend kindness to ur new knee.


----------



## just4thefunofit (Jul 16, 2017)

Surgery is now four days behind me. I'm getting around the house and yard pretty good on a walker. Worst experience was a monster constipation last night. Good now and keeping my goal. All physical therapy people say I'm doing excellent.


----------



## woody.1 (Jun 10, 2008)

just4thefunofit said:


> Surgery is now four days behind me. I'm getting around the house and yard pretty good on a walker. Worst experience was a monster constipation last night. Good now and keeping my goal. All physical therapy people say I'm doing excellent.


Yep those pain pills plug you up quickly.
Get some Smooth Move tea. Drink at night and takes overnight to work, but it works pretty darn good.


----------



## rockman (Jun 18, 2004)

Just checking back in. Went skiing yesterday. Week 12. Mtn biking is getting easier and easier but still a little pain when mashing.


----------



## just4thefunofit (Jul 16, 2017)

That's encouraging. Coming up on 3 weeks now and I hope to ditch the walker for a cane soon. Whole leg down to the toes still very swollen and seems to make recovery slower than I'd like.


----------



## mojorules (Dec 23, 2005)

I'm 57 and had left tkr on 8-22,I still have a bit of swelling and some numbness in my toes,but the Doctor isn't worried and really happy how its progressing.Even with the swelling there is no pain so Im pretty happy.I'm slowly getting the hrs back on the bike,on the bike trail and the trainer.Hopefully I'll get back on the trail when it dries up even though he frowned when i mentioned the mtb.


----------



## rockman (Jun 18, 2004)

mojorules said:


> I'm 57 and had left tkr on 8-22,I still have a bit of swelling and some numbness in my toes,but the Doctor isn't worried and really happy how its progressing.Even with the swelling there is no pain so Im pretty happy.I'm slowly getting the hrs back on the bike,on the bike trail and the trainer.Hopefully I'll get back on the trail when it dries up even though he frowned when i mentioned the mtb.


At this point I'd be more worried about what your PT thinks than your surgeon.


----------



## woody.1 (Jun 10, 2008)

rockman said:


> At this point I'd be more worried about what your PT thinks than your surgeon.


+1:thumbsup:


----------



## chris7777 (Mar 17, 2006)

I had total knee replacement on 10/29/17. I was on my stationary bike after 2 weeks. Riding my road bike at week 4. And started mountain biking on the 6th week. I get up out of the saddle, and ride anywhere I want. No issues. I am about to teach my 220+ beginner clinic. I push and lift weights at the gym. Swelling was completely gone at week 8. I can bring my heel to withing one finger widith of my buttocks. I am 67 years old. I will have my left knee replaced in 2 weeks. Doctors need to be told that most mountain biking does not look like a mountain bike video on you tube. They are concerned about collisions with obstacles. Or landing huge jumps. Nowadays, when ride, I am a lot more cautious and pull my punches. I have nothing more to prove to myself or anyone else. But I can still get in some very exhilirating rides that get my heart rate up. I have never had numbness in my toes, rockman. INMHO, I think it is odd that your doctor is not concerned about that, or your swelling, but is concerned about mountain biking.


----------



## rockman (Jun 18, 2004)

chris7777 said:


> I I have never had numbness in my toes, rockman. INMHO, I think it is odd that your doctor is not concerned about that, or your swelling, but is concerned about mountain biking.


No numbness here. My knee feels surprisingly like...a knee. Hard to believe there is an implant in there. Still some minor swelling and flexion is ~125. I'm at 15 weeks and haven't talked to my surgeon in 2 months. Might try the telemark skis tomorrow.


----------



## just4thefunofit (Jul 16, 2017)

I'm happy for you Chris. After talking with many doctors, physical therapists and reading here about other's recoveries I'd say you are the recipient of a serious miracle. You have good reason to believe in God. May your second knee be as good as the first.


----------



## mojorules (Dec 23, 2005)

He told me before surgery it could be 3 to 6 months and up to a yr for swelling and numbness to go away,and the fact I'm a lettercarrier with a walking route so he said it could take the longer amount.


----------



## rockman (Jun 18, 2004)

Just an update but I finally got 130 deg flexion at the 5 month mark. Back to mtn biking technical trails and alpine skiing. Stoked!


----------



## JDHutch (Sep 29, 2017)

Chris - do you happen to know what brand implant you got? Stryker, Zimmer, Smith & Nephew, etc?


----------



## wmbeverleyblanco (Sep 7, 2016)

*TKR Preparation...Any wisdom at all!!*

Greetings
Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...

57 yo lifelong athlete
I ride off and on road and swim. 
Thanks 
Bicycle Bill


----------



## rockman (Jun 18, 2004)

wmbeverleyblanco said:


> Greetings
> Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...
> 
> 57 yo lifelong athlete
> ...


Go into it in the best shape you can. Seems obvious but I was also hitting the weights pretty hard. Who cares if it hurts. That diseased knee is going bye bye.


----------



## woody.1 (Jun 10, 2008)

wmbeverleyblanco said:


> Greetings
> Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...
> 
> 57 yo lifelong athlete
> ...


Work on your core. You'll rely on your stomach muscles a lot.
Keep us posted.


----------



## MichaelVem (Jun 3, 2018)

I had my total knee replacement FIVE years ago and I have a baker's cyst right now. The knee swells up in bad weather and is full of scar tissue despite 3 surgeries to remove scarring. Don't really know how at this point to treat the baker's cyst. I suppose some ice?


----------



## Cuyuna (May 14, 2017)

wmbeverleyblanco said:


> Greetings
> Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...
> 
> 57 yo lifelong athlete
> ...


Quadriceps, quadriceps, quadriceps.

And buy a stationary bike for postop rehab re:range of motion and maintaining the quadriceps.


----------



## pat shanks (Apr 12, 2010)

Hey all, just read this whole post.
Hows everyone doing? any updates?

I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR. 
I'm worried life will just be revisions every few years for the rest of my life


----------



## cyclopath1000 (Feb 22, 2009)

Well I'm two years out from the makoplasty which just was my medial compartment not the whole knee. I actually just had semi emergency c3&4 neck surgery because hmmm one too many head vs tree or log etc. So I'm forced to take three months off from hurtling off things. But this past year I be ridden often and ridden hard. Because I'm meshing my native knee cap with metal medially and I have all my ligaments such as my stretched acl , my knee let's me know it's there. I also did a five hell ride day April 3 of this year at revelstoke. So whatever you decide to do just realize it's not oem. And it's probably not a good idea to run, jump or otherwise overload the materials. As in don't jump off that rock. Good luck. If u r in misery go for it.


----------



## Cuyuna (May 14, 2017)

pat shanks said:


> Hey all, just read this whole post.
> Hows everyone doing? any updates?
> 
> I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR.
> I'm worried life will just be revisions every few years for the rest of my life


The unicompartmental knee will have good longevity, but the arthritis process that created the need for it may well be progressive, so yes, if you have a PKR it may well need to be revised. Statistically, the 7 year cumulative risk of need for revision of a unicompartmental knee replacement is about 20% for patients younger than 55. On the positive side, revision of a unicompartmental knee to a total knee replacement is a relatively straightforward operation in the hands of a Fellowship-trained joint-replacement specialist, and that revision to the total will have the usual expected 20+ year longevity. On the downside, that only gets you into your 60's before you might need revision of the TKR, and (at least currently), that operation is kind of a big one.

OTOH, your options are limited. The alternative is just continue to limp around and have your activities limited. Sucks to be in that position at age 33, but I suspect that you'll be glad you had it done, if you do.


----------



## JDHutch (Sep 29, 2017)

pat shanks said:


> Hey all, just read this whole post.
> Hows everyone doing? any updates?
> 
> I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR.
> I'm worried life will just be revisions every few years for the rest of my life


Look into amniotic stem cell therapy. It's a knee injection that will reduce pain and swelling and possibly rejuvenate damaged tissue and cartilage. It's relatively new to orthopedics but has been used in other areas of the body with tremendous success. My buddy had both knees injected a year ago and said he forgot he has bad knees. I had mine injected a month ago so too soon for me to give an opinion. We both rode 18 miles with 1700 feet of elevation yesterday. Insurance doesn't cover yet so you'll pay several thousand out of pocket depending on where you go....but if you have your knee replaced you'll pay several thousand out of pocket anyway. You're too young for a knee replacement.


----------



## Cuyuna (May 14, 2017)

There is no good evidence that stem cell therapy is beneficial. It may be, but there isn't anything that proves it. Yet.

In the meantime, there are a variety of "alternative medicine" clinics that are hawking some version of "amniotic stem cells". If you're going to go with this treatment, which may have benefit but is totally unproven, make sure you understand where you're getting it from. There are a variety of chiropractic "wellness" clinics that are perpetrating a hoax. Be careful who you get such treatments from.

https://www.fda.gov/forconsumers/consumerupdates/ucm286155.htm
https://www.regenexx.com/amniotic-stem-cell-therapy-review/
https://www.thedenverchannel.com/ne...unproven-treatments-and-wild-marketing-claims


----------



## cyclopath1000 (Feb 22, 2009)

Cuyana speaks the truth! If u have loss of joint.space either medially or laterally and the other half is good ( yes that's what I had from various ski injuries a uni is such an excellent solution. Yes u are so much a youngster but nevertheless if you have one good and one bad half +/- your patellofemoral joint area , it can be a pretty sweet solution. Now as I've said I'm an anesthesiologist but I've never worked in a place that does makoplasty. In fact I never heard about "makoplasty" before a rep in a spine room mentioned another guy who services makoplasty. Now I've gotten into all sorts of things on this post about the specific testimony plus one of the excellent academic surgeons claims he can do a uni better. Ok !! But I was quite impressed with both the theory and it's execution on me. If u do for a uni by whatever means, I suggest u find a person who has done at least 200 unis and totals really don't count in my book. It's a different operation.


----------



## Cuyuna (May 14, 2017)

cyclopath1000 said:


> If u do for a uni by whatever means, I suggest u find a person who has done at least 200 unis and totals really don't count in my book. It's a different operation.


Yes. Not your local general orthopedist. An orthopedist who has specific Fellowship training in joint replacement (Adult Lower Reconstruction). For something that you will be relying on for 20+years, you want your knee replaced by someone for whom total joint replacement is more than a hobby. You want it to be the focus of his/her practice.


----------



## cyclopath1000 (Feb 22, 2009)

Even fellowship training in total joints in my experience is not sufficient to pick a person to do a uni. I really an only aware of one guy in my area ( major metropolitan area ) who has the volume of uni s to get me excited. Lots of advertising by hospitals etc of what they have to offer , unfortunately for most people it's impossible to get the accurate numbers on case volume for specific proceedures. But if the 33 yo wants to contact me , I might get specific as to who and where I got mine done. It's unethical for me to publicly post it. So I have to get to know u. 

There are a few newer operations that the variance of operator skill is extremely great, for example arthroscopic repair of labral hip tears. When I finally got to work with a master it was one of those moments of wow ! But that's basically the only operation the guy even bothers doing these days. Leaves all the rest for mere mortals.


----------



## Cuyuna (May 14, 2017)

cyclopath1000 said:


> It's unethical for me to publicly post it. So I have to get to know u.


Not clear on what the ethical breach might be.

I had bilateral unicompartmental knee replacement at the Mayo Clinic in Rochester.


----------



## cyclopath1000 (Feb 22, 2009)

I disagree. I think a aggrieved surgeon could make it a med board issue. I'm certainly not in the mood to find out. So if anyone wants specifics they have to contact me.


----------



## Martinb46 (Nov 16, 2016)

Comment on stem cell therapy.......i had 2 stem cells. After the first one, my knee felt better than it had in 2-3 years. Second one didn’t help at all.....i think my knee was too far gone. 

I’m 48. Had TKR 2 years ago in December. Wish i had done it a couple of years sooner. Absolutely zero limitations on what i can do now vs previous. Zero loss in mobility. That being said i had good mobility before.


----------



## rockman (Jun 18, 2004)

pat shanks said:


> Hey all, just read this whole post.
> Hows everyone doing? any updates?
> 
> I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR.
> I'm worried life will just be revisions every few years for the rest of my life


I'm now 11 months post-TKR. I've done two Grand Canyon river trips and competed in two Enduros. 2nd Amateur 50+ in the recent Flagstaff Enduro (37th overall). I was skiing at 4 months. Not much pain if at all anymore. 130 deg flexion although I tested that pretty good on a wet log rollover and slid out to the side with my foot underneath me. Not sure what foot to butt is but at least 150 deg and it hurt like crap. Some soft tissue damage but my ortho just said I got a "flexion manipulation" for free and not to worry about it.

As for revisions or the joint wearing out I'm not worried about it. Staying in the moment and if I wear it before I'm 70 so be it. Good luck with your decision. At age 33 I'd stick with the natural joint for as long as possible, maybe even trying another ACL graft. I got nearly 30 years out of a patella tendon graft. But osteoarthritis killed the joint.


----------



## 4slomo (Jul 4, 2006)

I'm about a month from my first TKR. What is your experience in mtb trail riding with knee pads: recommended/required or doesn't matter?


----------



## rockman (Jun 18, 2004)

4slomo said:


> I'm about a month from my first TKR. What is your experience in mtb trail riding with knee pads: recommended/required or doesn't matter?


I used knee pads on advanced trails before my surgery but I still hang it out there a bit. After the TKR I generally wear knee pads all the time. You really don't want to take a direct hit to the kneecap for obvious reasons. I run these: https://7protection.com/us/product/flex-knee/


----------



## 4slomo (Jul 4, 2006)

I came across some exercises, best advice is to start with a Physical Therapist, which is what I will be doing tomorrow morning:
https://www.verywellhealth.com/total-knee-replacement-preop-exercises-2696473
https://www.healthline.com/health/total-knee-replacement-surgery/exercises
https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/preparing-for-surgery/before-surgery-knee-exercises/



wmbeverleyblanco said:


> Greetings
> Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...
> 
> 57 yo lifelong athlete
> ...


----------



## cyclopath1000 (Feb 22, 2009)

I've only fell once on my knee without wearing knee pads and lacerated the skin. The implant is just too Damm close to your skin anteriorly to chance it. I always wear them mountain biking. I was riding a moped in a rally when I fell. So for me the answer is I never ever ride serious stuff without knee and elbow pads. The usual course of lacerations over knees and elbows is staph infection of skin and bursae. At least for me. Multiple times. There are some great pads out there now.


----------



## 4slomo (Jul 4, 2006)

Thanks for both confirmations!


----------



## Jayem (Jul 16, 2005)

Martinb46 said:


> Comment on stem cell therapy.......i had 2 stem cells. After the first one, my knee felt better than it had in 2-3 years. Second one didn't help at all.....i think my knee was too far gone.
> 
> I'm 48. Had TKR 2 years ago in December. Wish i had done it a couple of years sooner. Absolutely zero limitations on what i can do now vs previous. Zero loss in mobility. That being said i had good mobility before.


I just had some arthroscopic surgery on my foot with microfracture and the surgeon said it's available and some people have them injected to "aid" in recovery, but the efficacy is not proven. Studies aren't showing any definitive difference at this time, or not enough studies, something like that. It's intriguing of course.


----------



## Emtbiker (Jan 4, 2019)

Hi There, I was wondering if anyone in this forum had a TKR surgery made recently with the Mako robotic technology and what the result and recovery timing for coming back to good mountain biking (all mountain/Enduro style), Thanks


----------



## Cuyuna (May 14, 2017)

The value of Makoplasty is largely that it shoulders some of the decision-making regarding prosthetic fit and alignment from the surgeon. It's useful especially for surgeons not trained in or particularly skilled in unicompartmental knee replacement. That can be a tricky procedure. It has good results in the hands of an experienced surgeon, but in many ways its downfall has been inconsistent results when done by surgeons with less training or experience in the procedure. The Mako robot can make up for some of those deficiencies.


----------



## cyclopath1000 (Feb 22, 2009)

Ya gotta know how to use the equipment with any of these computer assisted medical therapies. If the spacial location devices aren't set up correctly so the stored ct scan is accurately alligned with your actual body, all hell breaks lose. But yeah that's what my surgeon so loved about my post op visit : just how perfectly the axis and orientation of the implant side is in perfect plane to the native tibial plateau and femoral condyle. And remember the native side wasn't opened for comparison as it would need to be with a freehand uni. That's what makes the results so astonishing.


----------



## rockman (Jun 18, 2004)

Emtbiker said:


> Hi There, I was wondering if anyone in this forum had a TKR surgery made recently with the Mako robotic technology and what the result and recovery timing for coming back to good mountain biking (all mountain/Enduro style), Thanks


Not sure if it was a Mako but my TKR was computer controlled, robotic-assisted. I was riding gingerly at 2 months and full-on at 4 months. Did an enduro race at 9 months and 10 months, respectively.


----------



## Cuyuna (May 14, 2017)

rockman said:


> Not sure if it was a Mako but my TKR was computer controlled, robotic-assisted. I was riding gingerly at 2 months and full-on at 4 months. Did an enduro race at 9 months and 10 months, respectively.


Those would be the expected results for any unicompartmental knee, robotic or otherwise.



cyclopath1000 said:


> Ya gotta know how to use the equipment with any of these computer assisted medical therapies. If the spacial location devices aren't set up correctly so the stored ct scan is accurately alligned with your actual body, all hell breaks lose. But yeah that's what my surgeon so loved about my post op visit : just how perfectly the axis and orientation of the implant side is in perfect plane to the native tibial plateau and femoral condyle. And remember the native side wasn't opened for comparison as it would need to be with a freehand uni. That's what makes the results so astonishing.


Those would be the expected results in the hands of any experienced joint surgeon, robotic or otherwise.


----------



## rockman (Jun 18, 2004)

Damn and here I thought I was special but just an average TKR Joe. Guess the point is I got to pretty much where I left off. I finished 2nd in 50+ in the Flag Enduro. Riding at race pace is not anything close to recreational riding. I was quite pleased with that and my decision to go ahead with the surgery. However, I'm extremely paranoid about crashing or hitting the knee. I wear knee pads on pretty much every ride even if it's a cruiser.

I think my surgeon did 8 or 9 TKRs that day. I made sure I was #2 or #3 and not #9!


----------



## Emtbiker (Jan 4, 2019)

Mako total knee robotic has been introduced only on early 2017, could you tell me about your post surgery and recovery? , Pain, timing for walking, driving, etc. Problems?
I should get the Mako TKR in a week but I am very scared about that. I am 60yo and although my knee is in advanced OA I still ride very aggressively and use to do some enduro race on E-bike. My pain so far has been accetable but my real problem is walking (only 500mt,max), no more hiking, no more skiing. My surgeon is not very familiar with enduro MtB, he just told me that biking is an allowed sport after TKR but we know that riding on enduro trails it is not exactly "biking". I still don't know if it is really the time for this surgery or i shoul still wait for it. Thanks for your help.


----------



## Emtbiker (Jan 4, 2019)

Also, do you know the name of your implant ? Is it the triathlon from Stryker?


----------



## Emtbiker (Jan 4, 2019)

Mako total knee robotic has been introduced only on early 2017, could you tell me about your post surgery and recovery? , Pain, timing for walking, driving, etc. Problems?
I should get the Mako TKR in a week but I am very scared about that. I am 60yo and although my knee is in advanced OA I still ride very aggressively and use to do some enduro race on E-bike. My pain so far has been accetable but my real problem is walking (only 500mt,max), no more hiking, no more skiing. My surgeon is not very familiar with enduro MtB, he just told me that biking is an allowed sport after TKR but we know that riding on enduro trails it is not exactly "biking". I still don't know if it is really the time for this surgery or i shoul still wait for it. Also Do you know the name of your implant. Is it the Triathlon by Stryker co.Thanks for your help.

QUOTE=rockman;13937789]Damn and here I thought I was special but just an average TKR Joe. Guess the point is I got to pretty much where I left off. I finished 2nd in 50+ in the Flag Enduro. Riding at race pace is not anything close to recreational riding. I was quite pleased with that and my decision to go ahead with the surgery. However, I'm extremely paranoid about crashing or hitting the knee. I wear knee pads on pretty much every ride even if it's a cruiser.

I think my surgeon did 8 or 9 TKRs that day. I made sure I was #2 or #3 and not #9![/QUOTE]


----------



## rockman (Jun 18, 2004)

Emtbiker said:


> Mako total knee robotic has been introduced only on early 2017, could you tell me about your post surgery and recovery? , Pain, timing for walking, driving, etc. Problems?
> I should get the Mako TKR in a week but I am very scared about that. I am 60yo and although my knee is in advanced OA I still ride very aggressively and use to do some enduro race on E-bike. My pain so far has been accetable but my real problem is walking (only 500mt,max), no more hiking, no more skiing. My surgeon is not very familiar with enduro MtB, he just told me that biking is an allowed sport after TKR but we know that riding on enduro trails it is not exactly "biking". I still don't know if it is really the time for this surgery or i shoul still wait for it. Thanks for your help.


Well I guess we're somewhat similar in that I really had no issues with my bone on bone knee riding and racing mtb. Anything load bearing, however, had become painful and I had given up skiing and hiking. So, it's a quality of life decision. If you can live with just biking then put it off for awhile. Like most others, now that I have had it done I echo the refrain of "why didn't I do it sooner"? I'm back to skiing and could even run if I wanted. Enduro racing is very aggressive riding so that's a risk-reward dealio. Good luck with your decision but I suspect you won't regret it.

With regard to your other questions, your pretty much walking that same day albeit with a walker. It's the first two weeks that suck and then after that hopefully weaned off the painkillers and hitting PT hard to get the flexion back. I was driving my TDI Golf with a stick shift and operating the clutch with my leg at 4 weeks I think. The whole thing is really amazing actually. Far easier than my previous ACL reconstruction.


----------



## Emtbiker (Jan 4, 2019)

Sorry to bother you but I have finally found someone can tell me what i was wondering.
Could you please answer a few more questions:
Do you know if your implant is the Triathlon by Stryker?
How long have you had the surgery right now?
How long have you been in the hospital? did you do PT at the hospital too?
Can you hear any mechanical noise or click in your new knee when you pedal?
Doing your Enduro riding after surgery, have you had the chance to point your prosthesis leg to the ground for avoiding a fall? Any problems?
Can you go downhill standing up on the pedals for a long time ?
Thanks a lot for answering me.



rockman said:


> Well I guess we're somewhat similar in that I really had no issues with my bone on bone knee riding and racing mtb. Anything load bearing, however, had become painful and I had given up skiing and hiking. So, it's a quality of life decision. If you can live with just biking then put it off for awhile. Like most others, now that I have had it done I echo the refrain of "why didn't I do it sooner"? I'm back to skiing and could even run if I wanted. Enduro racing is very aggressive riding so that's a risk-reward dealio. Good luck with your decision but I suspect you won't regret it.
> 
> With regard to your other questions, your pretty much walking that same day albeit with a walker. It's the first two weeks that suck and then after that hopefully weaned off the painkillers and hitting PT hard to get the flexion back. I was driving my TDI Golf with a stick shift and operating the clutch with my leg at 4 weeks I think. The whole thing is really amazing actually. Far easier than my previous ACL reconstruction.


----------



## rockman (Jun 18, 2004)

Emtbiker said:


> Sorry to bother you but I have finally found someone can tell me what i was wondering.
> Could you please answer a few more questions:
> Do you know if your implant is the Triathlon by Stryker?
> How long have you had the surgery right now?
> ...


-I have an Omni
-I'm at 14 months post surgery
-2 night hospital stay. Started PT that same day.
-I do get some clicking or minor noise walking around but nothing while I ride.
-I have bailed to the side of my TKR leg several times with no issues. I also crashed and broke my collarbone, 4 ribs, and scapula at 5 months on a black diamond trail. Knee escaped unscathed.
-no issues using a seat dropper and standing while long periods. Which is pretty much any enduro race. Downhill sprinting. Lower back probably limits me there more than anything. The newer bikes with longer reach also help.

Frankly, it's been just what my surgeon said it would be. Now, at a year I don't even think about it. If I was 27 instead of 57 then I might feel differently but I'm still quite competitive and can go as fast as I care to. Really I hold back a bit because I don't want to crash. Bone just don't heal as fast at our age. That risk-reward thing rearing it's ugly head and the pendulum tipping more and more to the side of reason.


----------



## Forest Rider (Oct 29, 2018)

Those people who have resumed normal activity after 4 weeks post-replacement make MY knee hurt!

I think those doctors need to go back to med school (in my opinion).


----------



## rockman (Jun 18, 2004)

Forest Rider said:


> Those people who have resumed normal activity after 4 weeks post-replacement make MY knee hurt!
> 
> I think those doctors need to go back to med school (in my opinion).


Fake News! There was nothing normal about my activity level at 4 weeks except going to PT. Getting back to normal is more like 4 to 6 months.


----------



## Forest Rider (Oct 29, 2018)

I had ACL replacement and no way could I get out and climb mountains and shred downhills at 4 weeks.
Can't imagine the risk involved with the implant shifting a millimeter then volunteering to have surgery again to fix the self-inflicted mistake.

If a broken bone takes 6 weeks to heal before it's said to be safe to ride, how long do we think it takes for a hole drilled into the bone to heal.

Eeks.

Having gone through recover, in no way am I anxious to resume activity too soon.

It might feel great right now but in 5 years, maybe not so much. I'm 9 years or so post-op and have since become a mountain biker, marathon runner, etc....none of which I had done before surgery.


----------



## Cuyuna (May 14, 2017)

The knee prosthesis is cemented to the bone. It can't shift. It's as solid on the first day post-op as it is a year later.

Knee joint replacement has nothing to do with ACL surgery. Except...the knee, of course....

I had bilateral unicompartmental knee replacement about 6 or 8 years ago. I was back at work with a cane two weeks later (I'm a surgeon), threw the cane away at four weeks. Riding the road bike at 6 weeks, riding the mountain bike at 8 weeks. I did OT while I was in the hospital (which was dumb, but I didn't have anything else to do). Didn't really do any PT. They gave me 60 oxycodone tabs at discharge. I used about 8.

(these were _unicompartmental_ protheses. a TKR is a bit of a different ballgame


----------



## rockman (Jun 18, 2004)

The only good thing left in my knee at the time of surgery was my ACL patella tendon graft from 1989. A pity to hack it out of there after going strong for 29 years.

I did have a scare where I slid on a wet log with my foot in daffy position and went down with it directly underneath my weight. So, a forceful flexion to 150+ degrees. It hurt like hell but was mainly surrounding area connective tissue damage. The prosthesis and Cayuna indicated above was unaffected. The cement is space age. Guess in that scenario the risk is tearing the quadricep tendon but my surgeon just shrugged and said I got a mechanical manipulation for free.


----------



## Cuyuna (May 14, 2017)

rockman said:


> The cement is space age.


Yes, although they've been using the same cement (methyl methacrylate) for more than 50 years.


----------



## BEETROOT (Nov 28, 2005)

I am a sales rep/consultant for a company that sells the instruments and implants for these procedures. If anyone is considering surgery and doesn't have a trusted surgeon, if at all possible I recommend talking to a device sales rep in your area. We are in the unique position of being in the OR and watching dozens if not hundreds of these cases with multiple surgeons. We usually have a pretty good idea of who the most skilled surgeons are and who you might want to avoid. 

Just a thought.


----------



## Cuyuna (May 14, 2017)

BEETROOT said:


> I am a sales rep/consultant for a company that sells the instruments and implants for these procedures. If anyone is considering surgery and doesn't have a trusted surgeon, if at all possible I recommend talking to a device sales rep in your area. We are in the unique position of being in the OR and watching dozens if not hundreds of these cases with multiple surgeons. We usually have a pretty good idea of who the most skilled surgeons are and who you might want to avoid.
> 
> Just a thought.


What about the surgeons using the brands of implants you _don't_ sell?


----------



## BEETROOT (Nov 28, 2005)

Cuyuna said:


> What about the surgeons using the brands of implants you _don't_ sell?


Basically a sales reps job is to know the industry and to know the surgeons. We know their reputation and skill level, case volume, issues or complications with their products or techniques, their outcomes. It's our job to know this whether they use our stuff or not. Plus we spend all day every day in hospitals, labs, trainings, industry meetings. I think I know who the best guys around are for any given surgery just by osmosis.

If a friend or family member needed a TKA in Arizona there is a short list of who I would recommend and none of them use the products I sell for that surgery.

Not saying a sales rep should be a primary source of information or anything. Just that if you happen to know anyone in the industry it's worth shooting them an email.


----------



## Cuyuna (May 14, 2017)

BEETROOT said:


> Basically a sales reps job is to know the industry and to know the surgeons. We know their reputation and skill level, case volume, issues or complications with their products or techniques, their outcomes. It's our job to know this whether they use our stuff or not. Plus we spend all day every day in hospitals, labs, trainings, industry meetings. I think I know who the best guys around are for any given surgery just by osmosis.
> 
> If a friend or family member needed a TKA in Arizona there is a short list of who I would recommend and none of them use the products I sell for that surgery.
> 
> Not saying a sales rep should be a primary source of information or anything. Just that if you happen to know anyone in the industry it's worth shooting them an email.


I don't disagree with anything you said. I regularly deal with medical device reps and have for far longer than you've been one. I have great respect for them and their professionalism, agree that they understand the surgeon landscape better than almost everyone (including other surgeons), and that they could be a very useful source of information on surgeon and hospital capabilities. Your recommendation about checking with one is a good one, but their accessibility to the general public is generally poor, and if they are truly professional then they will keep such opinions to themselves. I can't think of anything a device rep could do that would sabotage his/her job or reputation more profoundly than rendering opinons on surgeon qualifications to the general public. I'm surprised that an experienced Ortho rep would make such a recommendation.


----------



## rockman (Jun 18, 2004)

I took a different approach and asked all the PTs in town who they had the least problems with. It was almost unanimous in terms of which surgeon had the best results. I live in a town of 70,000 with perhaps ~6 surgeons to choose from. I talked to 3 before making my decision. 

Not sure if that falls into the same level of professionalism that Cuyuna is referring to but if your active and outdoorsy for any length of time you end up knowing either first hand, or by name and reputation, all the players: surgeons, nurses, PTs, etc. The medical device reps not so much.


----------



## Cuyuna (May 14, 2017)

rockman said:


> I took a different approach and asked all the PTs in town who they had the least problems with. It was almost unanimous in terms of which surgeon had the best results. I live in a town of 70,000 with perhaps ~6 surgeons to choose from. I talked to 3 before making my decision.
> 
> Not sure if that falls into the same level of professionalism that Cuyuna is referring to but if your active and outdoorsy for any length of time you end up knowing either first hand, or by name and reputation, all the players: surgeons, nurses, PTs, etc. The medical device reps not so much.


Surgeons don't generally refer to specific physical therapists, whereas their relationship with device reps is far more personal and interdependent, especially orthopaedists and orthopedic device reps. In the case of device reps, if a surgeon got word that one was recommending patients not see him/her...that would not bode well for that rep's job, even among the surgeons he was recommending. It would be seen as very unprofessional by both the surgeons and the device rep's boss.

In the case of physical therapists, most orthopaedists are very involved in the PT departments they use. A PT shooting his/her mouth off about the qualifications of various surgeons they work with is generally seen as unprofessional and is very likely to be counterproductive to job security.


----------



## rockman (Jun 18, 2004)

Cuyuna said:


> Surgeons don't generally refer to specific physical therapists, whereas their relationship with device reps is far more personal and interdependent, especially orthopaedists and orthopedic device reps. In the case of device reps, if a surgeon got word that one was recommending patients not see him/her...that would not bode well for that rep's job, even among the surgeons he was recommending. It would be seen as very unprofessional by both the surgeons and the device rep's boss.
> 
> In the case of physical therapists, most orthopaedists are very involved in the PT departments they use. A PT shooting his/her mouth off about the qualifications of various surgeons they work with is generally seen as unprofessional and is very likely to be counterproductive to job security.


I suppose so but the feedback I usually got was something along the lines of "don't use that guy for you knee, he's much better with shoulders" or whatever. The PTs are generally independent from the two main orthopaedic offices in town. You have the choice of going to see whomever you want. I don't see how getting a recommendation from a PT is counterproductive to their job security. Facts are facts. If a surgeon is lame you should be able to ascertain that knowledge somehow. Or, put another way how would you recommend going about finding who you want to saw your joint apart? It's a big decision.


----------



## Cuyuna (May 14, 2017)

rockman said:


> I suppose so but the feedback I usually got was something along the lines of "don't use that guy for you knee, he's much better with shoulders" or whatever. The PTs are generally independent from the two main orthopaedic offices in town. You have the choice of going to see whomever you want. I don't see how getting a recommendation from a PT is counterproductive to their job security. Facts are facts. If a surgeon is lame you should be able to ascertain that knowledge somehow. Or, put another way how would you recommend going about finding who you want to saw your joint apart? It's a big decision.


Fact are facts, but more relevant to this situation, opinions are opinions and opinions are not facts.

Sometimes it's unprofessional and unwise to share one's opinions.


----------



## rockman (Jun 18, 2004)

Cuyuna said:


> Fact are facts, but more relevant to this situation, opinions are opinions and opinions are not facts.
> 
> Sometimes it's unprofessional and unwise to share one's opinions.


I understand your POV but as someone about to face a potentially life changing operation you don't bury your head in the sand either.

If a device rep is recommending a surgeon because they use the product he reps then that is indeed unprofessional. No argument there. As for PTs, I would call it an 'educated opinion' and I think they should be able to share that information without fear of reprisal. Apparently you don't which I find a bit disturbing but to each his own. You didn't answer the question either.

I'm a geologist and I have no problem recommending which firm in town to use to drill your well to find water on their property. In your case, you are in the medical field. If you were looking for the best surgeon how do you go about it? So far, we've covered device reps, PTs, or referrals from other surgeons.

Opinion is one end of the spectrum and first hand knowledge at the other end. Guess the answer is somewhere in the middle but I'm sure glad I chose wisely instead of poorly. How do you get to that choice is the question that is relevant to this thread.


----------



## Biohazard74 (Jul 16, 2009)

Wherewolf said:


> Had both replaced five years ago. My 63rd birthday ride:
> 
> View attachment 982391


Hell yeah! You my friend are an inspiration to me.


----------



## rockman (Jun 18, 2004)

Biohazard74 said:


> Hell yeah! You my friend are an inspiration to me.


Well shyte, Wherewolf passed away in a car accident a couple of years ago. I rode a couple of times with him on long epics in Arizona. He lived in continual knee pain even with his TKRs which didn't give me much confidence. But he was out there doing it, living for the long ride. RIP Wherewolf!


----------



## Biohazard74 (Jul 16, 2009)

rockman said:


> Well shyte, Wherewolf passed away in a car accident a couple of years ago. I rode a couple of times with him on long epics in Arizona. He lived in continual knee pain even with his TKRs which didn't give me much confidence. But he was out there doing it, living for the long ride. RIP Wherewolf!


 Oh damn !!! RIP Wherewolf. That post inspires me more now. He's not forgotten.


----------



## Cuyuna (May 14, 2017)

rockman said:


> I understand your POV but as someone about to face a potentially life changing operation you don't bury your head in the sand either.
> 
> If a device rep is recommending a surgeon because they use the product he reps then that is indeed unprofessional. No argument there. As for PTs, I would call it an 'educated opinion' and I think they should be able to share that information without fear of reprisal. Apparently you don't which I find a bit disturbing but to each his own. You didn't answer the question either.
> 
> ...


Facts are indisputable (except by politicians). Opinions can be shaped by many factors that have nothing to do with professional competence.

I have no clue what constitutes professionalism in the geology field, nor do I have a clue about the professional landscape in your town. I'm not making comparisons. I do have a very clear concept of professionalism in the health care field and clearly understand how lack of it can and should affect one's job.

I'm glad you chose wisely too, and certainly wouldn't fault you or anyone for trying to obtain advice from any avenue available to them.


----------



## rockman (Jun 18, 2004)

Cuyuna said:


> Facts are indisputable (except by politicians). Opinions can be shaped by many factors that have nothing to do with professional competence.
> 
> I have no clue what constitutes professionalism in the geology field, nor do I have a clue about the professional landscape in your town. I'm not making comparisons. I do have a very clear concept of professionalism in the health care field and clearly understand how lack of it can and should affect one's job.
> 
> I'm glad you chose wisely too, and certainly wouldn't fault you or anyone for trying to obtain advice from any avenue available to them.


Sounds to me like we need more people like you in your field. Glad we can keep this discussion civil and I appreciate your integrity and professionalism. But you as a surgeon are on the inside looking out. Most of us are on the outside looking in. You obviously had what might be considered privileged insider knowledge as to which surgeon to choose for your bilateral unicompartmental knee replacement. Or, did you simply go with the guy in your practice because it was the right thing to do?

I thought about this more and asked my brother who is a Phizer rep. Actually he is a manager for reps in several states doing mostly medical devices. Device reps are a solid source of information but have a possible conflict of interest like you stated. He thinks what other surgeons have to say is important knowing that it also is unprofessional to throw a colleague under the bus. But more importantly, with relevance to this thread he suggested looking at message boards and also to research lawsuits.

Good luck out there future TKR recipients!


----------



## Cuyuna (May 14, 2017)

In my case, having been advised by an orthopaedist partner of mine that a unicompartmental knee replacement was an option for both knees (I had had no clue that that was an option), I opted to skip him and go to the surgeon who literally wrote the book on uni knees, an orthopedist at one of the premier joint replacement programs in the country, Mayo Clinic in Rochester (about a 3.5 hour drive from here). My orthopaedist partner that I originally saw is an excellent orthopaedic surgeon, a good friend, and does a great joint replacement, but he’s a Fellowship-trained Sports Medicine specialist, not a joint specialist. I picked my joint surgeon not based on any inside information, but by looking for the guy with the best credentials and training in unicompartmental joint replacement. I started by doing a literature search and finding the surgeons with the largest number of publications, then reviewing their training from online sources. The only perk I got from the guy I ultimately chose was that I asked him to replace both knees at the same time and he agreed.

I went through the same process as many here....what kind of prosthesis? Lots of internet research and a review of medical literature, thought I had a well thought-out rationale. It turns out that despite my many resources and my ability to interpret medical literature, I actually had no clue about what was best and why, and having raised the issue with the surgeon, and telling him what I thought was my preference, he patiently explained why I didn’t know WTF I talking about. There’s a lesson in there...pick a surgeon with the best credentials and training you can find and take his/her recommendations. Nothing you read on the internet, even in a mountain biking forum, is going to give you better information that you’ll get from a good, well-trained orthopaedic surgeon that has examined you, and knows your medical history. In that regard, you should looking for someone that has post-graduate Fellowship specialty training in joint replacement, not the guy/gal who, on a typical OR day, has three carpal tunnels, a trigger finger, two ORIFs and one total knee replacement. Pick the surgeon that does 20 joints a week.


----------



## BEETROOT (Nov 28, 2005)

Cuyuna said:


> ...
> 
> Your recommendation about checking with one is a good one, but their accessibility to the general public is generally poor, and if they are truly professional then they will keep such opinions to themselves. I can't think of anything a device rep could do that would sabotage his/her job or reputation more profoundly than rendering opinons on surgeon qualifications to the general public. I'm surprised that an experienced Ortho rep would make such a recommendation.


Re-reading my original post I guess I could have been more clear. I wasn't suggesting calling sales reps out of the blue. We give advice freely to friends and family, but like you said... providing these opinions to the general public would be unprofessional.

The chances of knowing someone in the industry are small, I'm aware of that and probably shouldn't have posted anything about it in the first place. Just saying if you happen to know anyone in the business, they could be helpful.


----------



## BEETROOT (Nov 28, 2005)

Cuyuna said:


> you should looking for someone that has post-graduate Fellowship specialty training in joint replacement, not the guy/gal who, on a typical OR day, has three carpal tunnels, a trigger finger, two ORIFs and one total knee replacement. Pick the surgeon that does 20 joints a week.


This is great advice and something I don't think the general public thinks about. A lot of people seem to think that if they are seeing a surgeon for a procedure, that surgeon probably does those procedures regularly. People don't realize they may be seeing a surgeon for a complicated procedure that the surgeon only does a couple times per year.


----------



## Cuyuna (May 14, 2017)

Joint replacement, _any _joint, is a big deal. The consequences of it being done anything less than perfect are at best annoying and at worst devastating. One should seek out the most qualified surgeon with the best credentials that they can find. There are many general orthopaedists out there that don't have specialty training (Fellowship training) in joint replacement, and doing a few joints a month. Prospective patients should look at their surgeon's credentials, training, and experience very carefully.


----------



## ttwymr (Jan 11, 2019)

two years ago I had both knees replaced three weeks apart. The one thing that I learned is that no matter what anyone says your body heals differently than others. My first surgery went without a hitch. I was walking with one crutch 5 day after and in physical therapy. The second went somewhat ok but staggered a little on the rehab and full range of motion. Three months after the second surgery I developed a leak which required a revision and a much longer rehabilitation time. At this point I am perfect and I could not be any more happier with the out come. I did a lot of research and asked a lot of physical therapiest which Dr had the least amount of patients with complaints and set backs. Thats when I choose the physician to do my surgery. Expect a good year to really feel like your knees are yours. Good luck!!


----------



## 4slomo (Jul 4, 2006)

I'm now eleven days before my first knee replacement! My second will follow in three months. Going through both dread of the rehab, and excitement for being able to ride after recovery without as much pain.


----------



## woody.1 (Jun 10, 2008)

4slomo said:


> I'm now eleven days before my first knee replacement! My second will follow in three months. Going through both dread of the rehab, and excitement for being able to ride after recovery without as much pain.


Good luck and with only 11 days work on your core, which will help after surgery. I think mine were done 6 or 7 weeks apart and rehab gets old the second time around, but is a necessary evil. Keep us posted.


----------



## Cuyuna (May 14, 2017)

After knee replacement surgery, what did your rehab consist of?


----------



## woody.1 (Jun 10, 2008)

Cuyuna said:


> After knee replacement surgery, what did your rehab consist of?


Been awhile, but I know I went to PT 3 days for 6 weeks. Got home on a Thursday with both surgeries and started PT on Monday. I know getting knee motion back was number 1 importantance with therapist and myself. Sat on exercise recumbent bike and would go back and forth as much as I could bend it. Therapist and I would do knee exercises laying on table and over the edge of table. PT would also lay me flat n table and push down on knee to get it to go straight. I know with my first one I had my trainer setup in the garage and I would work it back and forth everyday. Then all of a sudden going back to the top my leg did a full rotation, which I was not expecting and man did that hurt. I did walk a lot as well. I did have a CPM machine at home for both knees, which I think helped me get my motion back. Most surgeons don't use these anymore, I think it's more insurance reasons.

And a little bit of worthwhile information on crutches for all. Once you get down to one crutch put the crutch on the opposite side of the surgery fixed knee. Sounds weird, but makes walking much easier. So if it's your left knee that had surgery use crutch on right side. One more thing is to remember "heel toe" when walking. Tell your spouse and friends to remind you of this as well. When you walk your heel should hit the ground first then over to toe. Sounds easy enough doesn't it? But it will take time to get there.


----------



## Cuyuna (May 14, 2017)

I had bilateral unicompartmental knee replacements 6-7 years ago. On the morning of discharge, after the femoral blocks had worn off, they had me do some OT to show me how to get up and down stairs with a walker, and stuff like that. I asked the surgeon about PT, he shrugged and said "sure, if you want". I went to one PT session when I got back home...they measured my ROM, showed me some exercises, and told me get a stationary bike. I came back a few weeks later (after I was off the walker) and they said.."good to go, come back if you need us". Never did.

After a knee replacement, intensive PT might be helpful but mostly it's to make sure the patient is doing his/her exercises and that knee mobility is moving along nicely. The days of the CPM machine are long gone now in the days of (almost) outpatient TKR.


----------



## Turk1985 (Jan 14, 2019)

I have read through a majority of the thread replies here, all have value to what everyone has stated. Educating yourself on such a life changing event to your body, especially one that you will change your life with till the day you die, is paramount. 

With that said, I did my research, found the best device on the market, matched it with the best surgeon that performs dozens per week. Results have been outstanding. 

I was 45 and had 5 previous cleanlout surgeries, when I was told I had no repairable cartilage left in either knee, prolonged replacement for another 5 years by riding on a regular basis. This mostly by gravel trail and mountain biking. 

Age 50, could not take the burning from simply walking around for any length of time. Asked the questions, researched, then researched again. Found what I considered my best options. Had the bilateral TKR's on the same day. Was on stationary bike one week post. On a gravel bike little over two weeks post. I held off putting any resistance to the joint for three months, but continued to ride almost daily. Started mountain biking earnestly again at the the three month juncture and never looked back. 

I am 55 and almost at the 5 year post surgery point and I have not had one single regret or issue. I am a very strong rider and can ride with those half my age. Riding is a non impact activity, great for leg strength, lubrication of your joints and stretching of your muscles. My surgeon even said to ride over the rehab, just restrain till the muscles healed.

I encourage those that are at that point of needing one or both replaced, do not hesitate. It is a small hurdle that you quickly overcome. Just complete your research and be informed. I will not not knock companies or devices on the market. Most are good, some are better, but all can be crap in the hands of the wrong surgeon. Choose wisely, and ride on!!!


----------



## EatsDirt (Jan 20, 2014)

Hey Turk, say someone who is knocking on the door of 50 and rides at a high level/aggressive descending (Whistler big hits for a month every year) but is in need of a partial KR. Does your advice still hold? What are the stress limits of TKR's?


----------



## rockman (Jun 18, 2004)

EatsDirt said:


> Hey Turk, say someone who is knocking on the door of 50 and rides at a high level/aggressive descending (Whistler big hits for a month every year) but is in need of a partial KR. Does your advice still hold? What are the stress limits of TKR's?


I'm not Turk but at 57 I do still ride aggressively and compete in enduro racing albeit for fun. I don't think the stress limit is mechanical it's more about impact with your kneecap now residing on top of a hard metal and plastic implant. I worry more about shattering my kneecap than anything else. Hopefully others will chime in but it becomes a risk-reward dealio.


----------



## Turk1985 (Jan 14, 2019)

Impact to riding is virtually negligible, unless you want to test them by going over the bars. I ride a single speed rigid, and I can guarantee they have been stressed as much as possible and I've never experienced any discomfort. Total over a partial any day. Longevity of the devices won it over for me. I had the option to a partial, but the devices at the time had half of the lifetime to my total hardware


----------



## EatsDirt (Jan 20, 2014)

Thanks guys, that is encouraging. I'd suspect a rigid SS is prob worse on knee then having full squish at nearly any speed/terrain... and good to see you're still getting after it Rock!


----------



## Tommybees (Dec 25, 2014)

*How to prepare*



Cuyuna said:


> The only perk I got from the guy I ultimately chose was that I asked him to replace both knees at the same time and he agreed.


Cuyuna, thanks for posting your path and details of finding your surgeon and recovery. I am basically in the same boat, probably waited a bit too long and now looking at the same option as you had done. I really want to knock them out at the same time and having problem convincing the Docs to do it. 
I had micro fracture on one and meniscus resection on both at the same my last round 10 years ago and it worked out well for me, was off of pain meds day 2 and fully mobile on crutches day 3 (expect for micro-fracture side). But, this is a lot different and I have no sense how I could get along the first month. Can you comment on how you manged the first few days and weeks? What did you find you were not prepared for and what you had wished you knew if you did it again. I ask the all with respect to recovery, including showers and other nitty grittys. For example, on a separate occasion I had a pretty tough surgery and shaved my head just prior to be able to skip a week of showers. Would be happy to take this to a PM if needed.

Thanks and cheers,


----------



## 4slomo (Jul 4, 2006)

I've had one total knee replacement (1/22/19) and the other one scheduled for 4/16/19. My Surgeon recommended three months apart for me (in my mid-60s), to minimize the possibility of blood clot complications. I had a month of PT, 3 times a week, and found it very helpful to begin to get my range of motion back. My knee is presently at 126 degrees of bending (3/5/19). You can't drive until 1) you're off the narcotic prescription (get off as soon as you can tolerate it), and 2) you have sufficient range of motion to be able drive safely and move between brake pedal and accelerator pedal with your foot (clutch pedal too if a manual transmission). I resumed driving 3 weeks post-surgery. I started out with a walker for several weeks, before graduating to walking unassisted. Couldn't shower for a week, until the compression dressings were removed, but could do sponge baths. It's pretty easy to leave a walker outside of the shower, especially if you have a bar in your shower to grab onto. A Polar cooler is wonderful for controlling the swelling, it pumps ice water through a plastic pad you place over your knee, I think most hospitals are providing them, although I have experience with only one hospital. I'm presently riding my road bike on flat bike trails around my neighborhood, and just about ready to do longer rides. I've found that the consensus is you will want to ride your mtb with knee pads, and know that your femur is most likely to break if you fall on your knee, as the bone is weaker than the joint. I was recommended to dial back my riding style, when I'm eventually ready to mtb ride again late summer/early autumn.


----------



## Cuyuna (May 14, 2017)

Tommybees said:


> Cuyuna, thanks for posting your path and details of finding your surgeon and recovery. I am basically in the same boat, probably waited a bit too long and now looking at the same option as you had done. I really want to knock them out at the same time and having problem convincing the Docs to do it.
> I had micro fracture on one and meniscus resection on both at the same my last round 10 years ago and it worked out well for me, was off of pain meds day 2 and fully mobile on crutches day 3 (expect for micro-fracture side). But, this is a lot different and I have no sense how I could get along the first month. Can you comment on how you manged the first few days and weeks? What did you find you were not prepared for and what you had wished you knew if you did it again. I ask the all with respect to recovery, including showers and other nitty grittys. For example, on a separate occasion I had a pretty tough surgery and shaved my head just prior to be able to skip a week of showers. Would be happy to take this to a PM if needed.
> 
> Thanks and cheers,


I was off work about 3 weeks. I spent a lot of time on a stationary bike in front of the TV. First week or so I used a walker around the house, then used a cane because the walker was a pain. Showering a day or two after surgery. I was driving after about 7-10 days, but I drove my wife's car since my car is a very low sports car (hard to climb down into) and has a manual transmission, and my truck is big and hard to climb up into. Working the clutch on the sports car was no big deal, but I was concerned about working it well in an urgent circumstance. Once back at work, I used a cane until I shortly realized I was carrying it more than walking on it. I didn't really have any pain. They prescribed 120 oxycodone tablets on discharge...I think I used about 6 of them....still have some sitting around in my medicine cabinet. I didn't really do any PT. They showed me some ROM exercises before I left the hospital, and OT showed me how to go up and down stairs with a walker or cane, stuff like that. The surgeon kind of shrugged when I asked about PT at home...said "sure, why not?". I went once, learned some ROM exercises but otherwise didn't really find it helpful, although I did pick up a goniometer while I was there instead of buying one off Amazon.

Bear in mind that my knee replacement was bilateral unicompartmental. That's less intrusive than a TKR. Although I will say that a close friend was able to talk the orthopod into a bilateral TKR. His recovery experience wasn't that much different than mine, although it did take longer...I'd guess his recovery was about 125% of mine. I do recall that he was out on his tractor mowing his lawn on about postop day 10. He was in the hospital 2 1/2 days, but usually unilateral TKR patients here go home on the day after surgery. They're guessing that outpatient TKR will be commonplace for some patients very soon.

It can be hard to judge experiences from one TKR patient to the next. The joint specialist here is a pretty remarkable guy. He did his joint Fellowship at Mayo Rochester, trained by the same guy that did my bilateral Uni's. It takes him about 20 minutes to do a TKR and the staff he has for the Joint Center is remarkable. He does 4-6 joints a day typically. It's a very elaborate and sophisticated system. He sees a lot of patients from other surgeons around the area for TKR complilcations. I review those revisions monthly. It has certainly reinforced for me the importance of having a Fellowship-trained joint replacement specialist do your joint replacement.


----------



## milehi (Nov 2, 1997)

BEETROOT said:


> I am a sales rep/consultant for a company that sells the instruments and implants for these procedures. If anyone is considering surgery and doesn't have a trusted surgeon, if at all possible I recommend talking to a device sales rep in your area. We are in the unique position of being in the OR and watching dozens if not hundreds of these cases with multiple surgeons. We usually have a pretty good idea of who the most skilled surgeons are and who you might want to avoid.
> 
> Just a thought.


I recently retired, but I owned a distributorship and have been in on over 5000 joint cases, along with a couple hundred spine cases in Southern California.


----------



## milehi (Nov 2, 1997)

BEETROOT said:


> This is great advice and something I don't think the general public thinks about. A lot of people seem to think that if they are seeing a surgeon for a procedure, that surgeon probably does those procedures regularly. People don't realize they may be seeing a surgeon for a complicated procedure that the surgeon only does a couple times per year.


Most patients don't have a clue what implant brand the have. I'll also add (to the other posters) that there are industry standards and brands can be used together. An example would be a hip revision where they use my cup and head, but since the femoral component is solid and has the same 12/14 taper as my head, it gets left in.


----------



## Cuyuna (May 14, 2017)

Vader said:


> Most patients don't have a clue what implant brand the have.


I don't know if that's true or not, but probably is. Of course the other side of the coin is the patient, non-medical, who finds out that they need a new hip or knee and then researches brands and models of prostheses all over the internet and bases their surgeon decision on finding one that implants the one that their internet search has told them is best.


----------



## milehi (Nov 2, 1997)

Cuyuna said:


> I don't know if that's true or not, but probably is. Of course the other side of the coin is the patient, non-medical, who finds out that they need a new hip or knee and then researches brands and models of prostheses all over the internet and bases their surgeon decision on finding one that implants the one that their internet search has told them is best.


I always ask people what implant company they went with because I'm genuinely interested. Most never bothered to ask. I worked for three top docs who only used my stuff and were loyal to me, but sometimes a patient had did their research and wanted what they thought was best, or in one instance, saw a commercial for a "womens' specific" system and another rep would step in. That works both ways. Id sometimes travel to a distant hospital for a spacer or liner exchange.


----------



## just4thefunofit (Jul 16, 2017)

Ok Liz I can provide a less than perfect case scenario. First and foremost get this book on Amazon- "Total Knee Replacement & Rehabilitation" by Brugioni and Falkel. I wish I'd had it before surgery instead of 3 months later when things were not going well. Read and prepare now. Get that leg moving immediately after surgery. If possible arrange for a machine that moves your leg in the hospital bed. It hurts like hell but get out of bed and move. Within first few days of surgery If you miss a day poop do everything you can get that thing to drop including an enema or else you will experience pain like you could never imagine. Physical therapy- Make sure you have it set up in advance to occur right out of the hospital. Read that book and follow the advice in it. I hope you don't have as rough a time as i I did. 3 months before I could do stationary bike pedalling. 6 months for a real bike ride. 9 months and 78 miles on the road. 14 months later and I'm mountain and road riding at least 3 time a week. In a few weeks will try for another century ( would be 20 straight years except for missing last year).BTW I'm 70. But in some respects my leg is not better than before surgery.


----------



## Cuyuna (May 14, 2017)

just4thefunofit said:


> Ok Liz I can provide a less than perfect case scenario. First and foremost get this book on Amazon- "Total Knee Replacement & Rehabilitation" by Brugioni and Falkel. I wish I'd had it before surgery instead of 3 months later when things were not going well. Read and prepare now. Get that leg moving immediately after surgery. If possible arrange for a machine that moves your leg in the hospital bed. It hurts like hell but get out of bed and move. Within first few days of surgery If you miss a day poop do everything you can get that thing to drop including an enema or else you will experience pain like you could never imagine. Physical therapy- Make sure you have it set up in advance to occur right out of the hospital. Read that book and follow the advice in it. I hope you don't have as rough a time as i I did. 3 months before I could do stationary bike pedalling. 6 months for a real bike ride. 9 months and 78 miles on the road. 14 months later and I'm mountain and road riding at least 3 time a week. In a few weeks will try for another century ( would be 20 straight years except for missing last year).BTW I'm 70. But in some respects my leg is not better than before surgery.


Wow! In this day of almost-outpatient TKR, you must have had a _terrible_ experience.


----------



## JodiGrab (Jul 19, 2021)

Wherewolf said:


> *Second opinion*
> 
> Get a second opinion. One orthopedist said I wouldn't be able to bike, while the second opinion encouraged me to bike. I took the second opinion and I have biked thousands of miles since!


I'm so glad to see this! I had one surgeon tell me any cycling was fine, but another said I could ride the road, but not MTB. But I know doctors with TKR who got back to riding mtb. I bought knee protectors and just need to get the knee bent a bit more then I'm getting out there


----------



## flipnidaho (Aug 10, 2004)

Sorry to revive this thread but I'm another mtbr OG that is looking at either Partial or TKR. I was diagnosed with bone on bone/end stage osteoarthritis of the left knee. I'm going to try PRP treatments first to see if it buys me some time. Reading the thread gives me encouragement that there is light at the end of the tunnel. If anyone has an update on their experience with PKR or TKR, I'd be glad to hear it.


----------



## milehi (Nov 2, 1997)

flipnidaho said:


> Sorry to revive this thread but I'm another mtbr OG that is looking at either Partial or TKR. I was diagnosed with bone on bone/end stage osteoarthritis of the left knee. I'm going to try PRP treatments first to see if it buys me some time. Reading the thread gives me encouragement that there is light at the end of the tunnel. If anyone has an update on their experience with PKR or TKR, I'd be glad to hear it.


You may already know this. If you're researching a partial, the industry term is unicompartmental and you'll get better search results. Look into MAKO too (robotic). I hope you feel better soon.


----------



## flipnidaho (Aug 10, 2004)

I've been reading about the unicompartmental and Mako! Amazing advances. If I go with the partial, I heard it was way less invasive and also a quicker recovery.


----------



## milehi (Nov 2, 1997)

MAKO is also more of a custom implant rather than a standard uni implant which is perfectly fine for sedentary people.


----------

