# Mountain bikers with knee replacements



## datman (Jul 17, 2005)

Hey guys,

I could not see a better place for this. I'm a 56 year old carpenter and my knees are bad. Slows me down at work as well as on the trails. I may go ahead and get the surgery later this year. I'm concerned to say the least. Both knees will get done over the winter.

I would like to hear other stories of mountain bikers and their experiences. I know of 3 bikers and several carpenters and all but one biker said I should have done this years sooner. So please post your experience good,bad or other.


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## H0WL (Jan 17, 2007)

The Fifty+ Years Old forum has a thread about this.

I've been through this three times with my husband. His first knee replacement became infected and he had to have it redone. That 2nd replacement went well and he just had a partial knee replacement on the other leg last fall -- he was riding again about 6 weeks later. He's 75.

First, find a sports medicine practice with a surgeon who does hip and knee replacements every week. My husband's surgeon does at least 10 hip or knee replacements every week. It's what he does. They used some kind of laser thing to make sure the fitment was absolutely precise.

Ask about the surgeon's protocol to prevent infections.

Timing: apparently, summer is when all teachers schedule their surgeries. My husband had a consult in May and didn't get his surgery until August.

Try to find a physical therapist who understands cycling or at least is involved in some type of sport.

Were it me in this situation (I hope it never is) I'd go to this guy: Richard Berger, MD. He does minimally invasive knee replacements. 
https://outpatienthipandknee.com/


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## datman (Jul 17, 2005)

Thanks for both the links Dr. Berger must be in Chicago so I'm going to have a consultation with him.


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## datman (Jul 17, 2005)

June Bug said:


> The Fifty+ Years Old forum has a thread about this.
> 
> I've been through this three times with my husband. His first knee replacement became infected and he had to have it redone. That 2nd replacement went well and he just had a partial knee replacement on the other leg last fall -- he was riding again about 6 weeks later. He's 75.
> 
> ...


I made an appointment today. He sounds very good in great demand. From reading the other threads and your husbands initial outcome not getting an infection is most of the battle. My history of healing from injuries has been quite good.

Oh and June Bug I really miss Jon Stewart.


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## datman (Jul 17, 2005)

So here is my dilemma, in 2 parts. Dr. Berger looks real good. He uses the Zimmer Mexgen Highflex. It's a 15 year knee. Sounds like replacing the pad after the 15 +/- year is far less evasive.

So the other doctor uses a Smith& Nephew Journey 2. I think this is a 25-30 year knee. This doctor said he doesn't want me working on my knees certainly not 6-7 hours a day. He has no problem signing the disability paperwork and I'm done working.

All the carpenters I know all said the doctors don't want you on your knees. Dr. Berger's position from the person setting up the appointment.
" I completely understand your concern. Dr. Berger typically allows 8 weeks for disability but will sign off on 12 weeks for patients with more labor intensive jobs. At that point you may return to work with restrictions, such as limiting kneeling. 

Overall patients are doing very well by three months and are no longer "disabled". Therefore, additional time off would need to be issued by your primary care provider."

His own website says it can take a year before you can kneel. There is no light duty if I can't keep up I won't work. So it seems like disability is a must for me.


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## matt4x4 (Dec 21, 2013)

"This doctor said he doesn't want me working on my knees certainly not 6-7 hours a day."
Yeah, working on the knees and always bending over is not good for you, but its a 30 year product. What does the 15 year product doctor say about always working on the knees and bending over all the time.


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## H0WL (Jan 17, 2007)

I met a patient of Dr. Bergers who had also become a personal friend of the doctor, so that guy's endorsement is my only experience. 

The patient was a hard core triathlete in his late sixties who'd had Dr. Berger do the minimally invasive total knee replacement several years before. He continued doing triathlons post surgery and was back to running in what seemed like a relatively short period of time. Needless to say, he's a fan. 

Dr. Berger also did two knee surgeries for George W. Bush; he's that good. 

Best wishes for a positive outcome on whatever option you choose.


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## datman (Jul 17, 2005)

I haven't meet with DR Berger ( 15 year product) I talked with the scheduler/assistant and she said the doctor will only sign papers up to 12 weeks more than that it's up to your primary doctor.
I'm sold on Dr Berger being perhaps the better of the 2 doctors but the insecurity of not being able to work and having to go on cobra or ACA for my insurance is a big pill to swallow.

There seems to be a disconnect somewhere. Years ago everyone I talked to said "the doctors won't let you work on your knees" now it's quite a bit different. They don't want the headache of disability many are saying you can work on your knees, it might hurt or feel uncomfortable when you do.

I would like to hear from other TKR patients new and old and could you see yourself working on your knees for hours at a time ?


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## hardtail1416 (Oct 18, 2019)

Just wanted to say my father had a double knee replacement 25 years ago and it was very successful for him. My mother had a single knee replacement and now 7 years later needs the other knee done but due to other factors it won't work for her now.

For myself, just seeing how well it worked for my Dad, If I need one I will do both knee's at once.

Not sure what type of knees he received.


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## Racecar (Oct 10, 2019)

I had one knee joint replacement a few years ago when I was 66. I didn't have much choice, due to swelling and pain. The operation is easy, the recovery is not easy. It takes a few days in the hospital, and a few weeks in bed before you can walk downstairs without taking five minutes. A few more weeks, you are moving around, and driving the car. A year later, you don't even notice it is there. The recovery is long, painful at times, but it is way better than being in pain all of the time.


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## mactweek (Oct 3, 2011)

Whatever knee you choose, you must really work on the Physical Therapy. I had my left knee done 8 years ago, results have been very good. It is imperative that you get your range of motion back asap or you will never get it back. After 3 months of recovery I was back to work driving and delivering food to restaurants, schools and other institutions. It was very demanding work, but I did not have to kneel down onto my repaired knee.
I retired 3 years ago and the knee is happier now. It is fine riding bikes.


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## CHIEF500 (Aug 30, 2012)

I had my right knee replaced after 8 years of putting it off. I had been bone on bone a long time, my knee surgeon told me "you'll tell me when you're ready" and ......... he was right, I sat and didn't want to get up. It was sore to walk. So I finally got the surgery scheduled, there are a lot of clearances to get prior to surgery so be ready for that.
My surgery was April 26 2017, my surgeon and his associates do all their surgeries in space suits and have a very low % of infection. I did very well after the surgery. The rehab is no joke and hurts, they are trying to get you as much flexibility back as possible as quickly as possible so they don't lose the window. I can't my knee flat but the flexibility is good. As a carpenter and working on your knees is over. It's been 3 years and I can finely actually kneel on all fours without any discomfort but it was a struggle. 
I do engineering full time (laid off recently due to Covid) and I'm a volunteer firefighter and used to have to crawl and sit on my knees to work in a fire; that's over with.
Do the work in rehab and it pays off. I ride daily, 10+ miles and have no issues.
That first time on the stationary recumbent cycle in rehab was an adventure. I couldn't wait to get there and once you're there OH MY. Due to the knee not being real flexible and trying to get on the bike at first. Then getting your feet onto the pedals......... you can't spin pedals at first so it's a back and forth motion...... then you want to try it and it's easier pedaling backwards to get the first full rotation. It goes well after that.
Good luck.


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## datman (Jul 17, 2005)

I'm not sure many people research it that far. From what I understand the 15 year knee all that's required is replacing the pads. From reading up a little on it has a better range of motion; from the website

The features of the NexGen LPS-Flex Knee include:

Extended posterior condyles on the femoral component to facilitate tibiofemoral contact to support deep flexion up to 155 degrees
Conforming geometry of the femoral component with its bearing allows minimal loss of contact area in deep flexion
Deep anterior patellar cut-out on the tibial bearing helps reduce patellar tension and provides greater clearance for the extensor mechanism
Modified posterior stabilized cam/spine mechanism increases subluxion resistance at deep flexion angles
Proportionally sized pegs on the femoral component provides additional stability and fit
Fixed bearing articulating surface mates with current NexGen Tibial Base Plates
Available with stem extenstion and tibial augments
Tibial component implantation uses existing NexGen instrumentation


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## datman (Jul 17, 2005)

I meet with Dr Berger July 13th. He is high on my list.


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## datman (Jul 17, 2005)

Trust me I know PT is everything. I was planning on getting a trainer and get it all dialed in prior to the surgery and get the therapist to help me drop it in place when I'm ready for it.


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## datman (Jul 17, 2005)

Well with this Covid-19 that does make me feel a little less concerned.


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## datman (Jul 17, 2005)

Oh I found a pretty good forum. Hes helped.
https://bonesmart.org/forum/categories/knee-area.7/


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## LadyDi (Apr 17, 2005)

How old is this thread? Did you ever get your knees replaced? Mine were done (TKRs) a year apart, 4 and 5 years ago because I had, like, no cartilage. I work 12 hour active shifts, had to take ~16 weeks off each time. My surgeon had no problem signing off on that, considering that I am employed by the same hospital where he does his surgeries, and he knows how hard I work. 

In my opinion complete TKR recovery is a full two years... yes, TWO YEARS. You will be back to your normal activities long before that, but I say two years due to occasional aches, swelling, and the ongoing bone and tissue remodeling that causes it. It is no walk in the park, lol. 

I have a spin bike at home. After my first TKR it took me about 3 weeks of rocking the pedals back and forth to get a full rotation. With my next TKR I was spinning as soon as I got home from the hospital, on day 3. Know-it-all that I am, by the second knee I had a room in my house dedicated to self-PT and only made a few cursory trips to outpatient PT for measurements and feedback. I always did my own dressing changes, wouldn't dream of letting anyone else touch my incision. 

My advice is to choose your surgeon based on excellent reviews/recommendations, and let him (or her!) decide which particular prothesis is best for you. I don't even know what brand of knees I'm walking/riding on, and it doesn't matter as long as they work, right? I don't even think about my knees anymore- they're just my knees. 

Wherever you are in the process, I wish you well.


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## datman (Jul 17, 2005)

LadyDi said:


> How old is this thread? Did you ever get your knees replaced? Mine were done (TKRs) a year apart, 4 and 5 years ago because I had, like, no cartilage. I work 12 hour active shifts, had to take ~16 weeks off each time. My surgeon had no problem signing off on that, considering that I am employed by the same hospital where he does his surgeries, and he knows how hard I work.
> 
> In my opinion complete TKR recovery is a full two years... yes, TWO YEARS. You will be back to your normal activities long before that, but I say two years due to occasional aches, swelling, and the ongoing bone and tissue remodeling that causes it. It is no walk in the park, lol.
> 
> ...


This is a new thread and I am planning the operation for later this year, when I find the right doctor.
My question to you is how soon could you kneel on your knee and can you see yourself crawling around all day constantly getting up and down from your knees and do it as fast as a 25 year old?


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## milehi (Nov 2, 1997)

When and if the polyethelyne insert needs replacing, it's a 20 minute procedure. The old one is replaced with the next thickness. Around 2mm. Any scar tissue inside the joint is also removed.

The doc will contact the implant company who keeps the patient implant records on files which contain the sizes of components used and lot numbers. The hospital also keeps these records.


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