nutcase

Hi all, I don't know if any of you riders have had a total knee replacement, but I have one scheduled for the 31st of July,and I'm kinda freaking out over it. The ACL was torn in half 24 years ago playing beach volleyball while I was in the Coast Guard. It's really been hurting the past 5 years so I made the decision to get the new knee. Will I be able to ride afterwords? Can Anybody give me some real life stories? I hope I can bike after this. I'm currently training like a mad man to get the leg and muscles in top shape prior to the surgery.

IAmCosmo

My mother in law could just barely walk a couple years ago. She had both knees replaced in the same year, and now she regularly rides 30-40 mile rides most every weekend. She couldn't ride more than 5 miles or so before having them replaced.

nutcase

Thats awesome.

Neil_B

See Peter C's thread about his knee surgery.

canopus 

My wife had both of them replaced. She would freak out when we would start talking about what they do to the bone to get the replacement on and aligned (I am still in awe over this procedure) But after it was done, She was like, "Why didn't I get this done sooner?"


But As Jesse states below and some others might say, THERAPY is everything for a knee replacement. You need to go through the pain of therapy. To help prevent the scar tissue from limiting the joint. Whether you use someone or not be sure to do your therapy.

Jesse143

Ok, I had a motorcycle accident May 7th 2009. As I was flying across the dirt to my finally resting spot that the car sent me to I tore my ACL, MCL and turned my meniscus into mush. I didn't have the total knee replacement but I had my ACL reconstructed from a tendon sample pulled from my thigh and my MCL stapled back into place. I being a stubborn male did not go through physical therapy. After the first month I started riding my exercise bike and have since moved back onto my road bike. I regularly do 40+ mile club rides and 20 - 30 solo throughout the week.

If you get a good doctor and you don't have complications there should be no issue at all with riding again. My surgery was June 2nd of '09 so I am not 100% healed but I have no issues riding. The only time I still feel it is when I get out of saddle for more than a minute or so. It seems like the pressure on the knee just makes it a little sore but not actually aching. I am young though so your results may vary. I am 25 now, and I am a lineman for a living. My doctor sent me back to work after 4 months. So I am back climbing telephone poles.

Biking is a big part of PT, I just chose not to pay for someone to watch me do it. Take it slow and start on your trainer or exercise bike and you should be fine.

Ohh... I am 6'6' 235. So I am a pretty big guy. If you are smaller than me expect out of saddle to be that much easier for you!


Jesse

Frosty861

One of the fellows I ride with had a knee replaced. +1 to the comment above regarding therapy. He went to therapy regularly, rode his stationary bike at home and we've been riding a 6 mile loop at lunch, and will be on a 12-14 mile lunch ride starting next week. His knee is in great shape, no pain at all, good flexibility but it is taking a while for the leg strength to return. We will be riding the MS ride from Quincy to Provincetown this summer with 18 others, and I expect he will lead us out. Long story short, get the surgery, go to therapy, exercise and "ride lots".

adam_mac84

you will be fine, and you will be glad that you had the surgery... you will be able to do things pain free that you haven't done in years. now you will have the biggest 'ACL' on the entire group ride

i routinely treat 4-5 total knees daily, and the first week you will say... why did i do this... after 3-4 weeks you will start moving around like a 60-70 year old with a bum leg... 6-8 weeks you will feel good except for during your PT sessions or high level activities... and 3-6 months you will really start to feel good... a year later you will never believe you didn't do it earlier

deep_sky

Do your therapy, and listen to your therapist. It will take at least 4-6 weeks to complete therapy, and the most painful thing will be getting your range of motion back. We rehab'd many knee replacements at my old clinic, and the worst pain was when they started work on the recumbent stationary bike and had to get a full pedalstroke in. In successive weeks we would lower and lower the seat to push the range of motion (not so low that the tendons would adversely affected) as well as other exercises to improve strength and mobility.
Make sure you do your stretching, and working on the scar every day to remove the adhesions that form as a result of healing from the incision. It ain't worth it to push harder than your therapist thinks you should be going, or your recovery is in danger. We had one guy not listen, and he had to have second surgery because he thought he would be macho and try to run after a couple of weeks. Don't be that guy.

nutcase

I read it. I hope that wasn't supposed to inspire me about the surgery.

Neil_B

Well, better to realize rehab is going to be work.

nutcase

Oh I get it! I've already had 5 arthroscopic knee surgeries, and in 08 I broke off the right knee Tibia plateau (motorcycle), and have a nice L shaped plate and 6 large screws in that knee. I know about rehab and pain. I have 1mm of meniscus left on both knees and advanced arthritis in my left knee. It took me a year to be able to stand up on the pedals of my bicycle. I still have real problem positioning my right foot inside the toe clip. It hurts like hell. That was two years ago. I just don't know if I want to go through this again. The knee pain might be better (or not), and the after math of all that cutting, I know will leave nerve damage that also hurts like hell. I can tell you half of my right leg is numb, and parts of my leg not even near the insission area has nerve damage and pain. I can ride hilly terrain for 27 miles now. I rode thousands of staionary bike miles to get to this point. I'm pretty sure I need the TKR, but I'm not sure I want to give up what took me so long to get back. From what I've read you can eventually bike again, but just on level ground. That doesn't exist hear. It's a climb uphill right out of my driveway for a half mile.

Neil_B

Sorry if I touched a nerve. I meant well.

You can ride on hills with a knee replacement. You might need to do it seated, and get low gearing, but I understand it can be done.

nutcase

It's all good. Yeah I do try to stay in the saddle as much as possible. I ride a SS , so I may have to go up a couple of teeth on the rear cog. I hope that's true about riding hills after the TKR. I read a story of a guy who did a 1600 mile trip on a tandem with his wife after such a surgery. Mostly in flat terrain, but dang that's testing the knee. I'm 53 and the artificial knee's are only supposed to last 10-15 years. That would mean I would have to get another one in my sixty's.

canopus 

Knee replacement is so much better than arthroscopy knee surgery according to my wife. She hurt for 12 months after her orthoscopy, 3 months on the knee replacement. (2 weeks after surgery whe was down here house hunting with me, admittedly on drugs but still she was mobile) The only reason a TKR should hurt you worse is if the doctor screws up the alignment (Always check out your doctor in the area) or puts the wrong joint in, or you don't do all of your therapy afterwords. I don't know of any reason why having a TK would limit you to only flat ground. You should have more mobility after a TKR than you do before. The real limiting factor would be the Quad muscles, that is a problem for my wife because she could never develop hers with her bad real knees. The new knees are supposed to have replaceable inserts on them now so as long as you never go metal to metal in the join itself that should be an easy procedure for you in 10 to 15 years (if you need it).

Now one thing here doctor recommended (she had both done) is to stagger the replacements (i.e. don't do them both at the same time) It is harder to accomplish therapy with two recovering knees and no strength to move around, it increases time on the table and increases your infection possibilities on the table since the procedure usually takes 2 to 3 hours for one knee.

Daspydyr 

KNEES are a serious surgery! The success rate is very good and the results very encouraging. I had both hips replaced in 2008. Biking has been a huge rehab and rediscovered joy in life. A good Physical Therapist can get you in shape to ride hard within 6 months. You are going to enjoy the new parts. Its good to be scared going in, means you will do all the good things the right way.

TrojanHorse

Hey nutcase - please keep updating this thread (or a new one) with your thoughts, impressions, findings etc... I was hit by a car pretty severely 13 years ago or so and I'm on a 5 year arthroscopic surgery cycle (I'm due again next year I guess)... my knee doc says I have the knee of an 85 year old man and TKR is in my future BUT... they prefer to do it on older people, 65+, because apparently the knee only lasts 15 years or so and they don't like doing 2 of them. I'm 42 now.

For me it's just cartilage & bad Osteo... so it hurts a lot of the damn time, hill in low gears suck etc. etc... I have a brace that I wear (not when cycling) that unloads the side of my knee with no cartilage, but it just sucks in general. Fortunately, I had a lisfranc injury in my OTHER foot that required 3 surgeries, a plate and 4 screws so I'm a gimp on both sides now. LOL. I injured it right after the therapy for a knee surgery was done and I was feeling good again. Ooops.

Anyway, best of luck and please keep the info flowing.

CPFITNESS

yes, the knees wear out, i have family members that had to get them redone because after 20 years it was worn out, I can't even fathom that.

If you think about it, the total knee clear out all the damaged parts of the knee and replaces it with a well f unctinoning machine, you just have to get everything around that knee to heal back up fully and it takes time but like everyone says, once it's done, you'll be much better off

Peter_C

A few rather big differences. My TKR has changed my life completely (for the better). I know nothing about your general health overall, your knee history, your pain level (currently) or your weight.

I suspect since you are talking about continuing to ride, that to some degree you can ride now. My last day of riding prior to my TKR was June of 1979, after my 12th dislocation, and just befor my "left patella re-alignment".

I am NOT the "poster child" for TKR...I am not under 200LBS, I am not over 55yrs old, I am in very poor phyical shape (was, still am?) heart issues, blah, blah ,blah...

The point is, the TKR got me BACK ON A BIKE! Got me out of Pain MGNT! Got me off the 180mg of Morphine I had been on the last 18 or so months. Started my weight loss, got me off many of the meds the doctors had put me on to keep me alive.

Some people go back to work 3 weeks after their TKR, some only need 2-4 weeks of PT. I believe I ended up with like 13-14 weeks of PT - not fun, but would do it all again in a heartbeat!

Last week I removed my cane from my car - my wife has never, EVER seen me do that. I had 30+ years of severe life changing pain. I do not have this now!

But do not use me as a *normal* example of a TKR recovery - My knee doctor sent me to a specialist - huh??? Thought a knee Doc *WAS* a specialist - I had a TKR with full bone resission - top and bottom - doesn't get any worse. 26" long scar - up from 20".

If you actually choose to read the entire Thread - that's scary - you will see me trying to decide, trying to figure out if I could get on a bike, everything - good and or bad.

Prior to the TKR half the 'quad' (inner half) was completely dead - no flex of any kind - because I had so much damage over so many years - 25 minutes of muscle stim every PT visit brought it back - you SEE muscle there now, and it bunches, and flexes - oh, and the TKR knee is now better of the two - FYI

2 statements...

Quality of life - where is yours right now? If it will be better after - do it.

No matter what shape you are in - plan for PT, plan for work, plan for pain, and plan for the return you will see in 12-20 weeks at the most.

Peter_C

I'm not great on dates - this is week 19? I think since my TKR - I can do hills, my heart and lungs lose it long before my knee. I can not yet stand on the pedals at all, nor can I do a "squat" either...

But I can crank harder with the new knee than the old one already with ZERO pain caused by cranking. I only have bout 30 total miles on my Bike, and never (yet) more than 3 miles at once (I do 30 minutes on a stationary every day at work)

But I am in and was, in far worse shape than you are right now Sir. With respect, a healthy fear of major surgery makes you normal, but unless you, or your DR blow it, you will be far and away better (in a time) than you are now.

Talk about pain meds? Are you on something? And you *can* ride now? How far can you walk now? Can you run at all now? Can you go up a staircase like a normal person, how much and how many years have you been limping? Is your pain so bad it is changing your life? Do you refuse to go somewhere, or do something because you know it will make you hurt more?

My point is - you and your DR decide if you want/need the TKR - but if you read about me, do not think it will be anywhere like that for you. I could not walk and talk at the same time! Leaving work, going down one flight of stairs, walking out to my handicap parking space, getting into my car, putting on my seatbelt, then pause and breathe for 30-45 seconds to get the stars out of my vision.

I have limped for so many years, they had me walking backwards for 500 yards daily simply to retrain how I walked - I do NOT need to limp - I do not realize I am - after all these years.

Whole point here - My TKR was 11/09 and I am riding now, not real fast, not real far - but for me, HUGE progress! So, you go into the TKR at a better starting point, and you will come out of it better than i did, and will rehab faster than i did - Peter

nutcase

That's great to hear Peter. I did read your entire thread. You are no doubt to be commened on your accomplishments and all the hurdles you overcame. I'm a big strong guy. I'm not bragging, but if you seen me you'd say that guy play's for the NFL. I'm 259 right now, down from 270 2 month's ago. I can bench press 329 lbs, and leg press 750 lbs, but I can't walk more than a mile without much pain and limping. When I complain about ny disability's people look at me and say yeah right look at this guy he can't be disabled. It's hard to deal with. I was in the Coast Guard for 20 years. I was on ships at sea for 14 of those years on steel deck plates 15 hrs a day. My knees are totally gone. Then after I retired I went to work as a heavy equip mechanic, which further destroyed my knees and elbows. In May 2009, I went into work at my normal time of 6am, and was looking at the front end loader I was supposed to do a complete service on, and while I was staring at it it, I said to myself how many Norco's(pain pills) Am I going to have to take to complete this job. At that moment I locked up my tool boxes and went home never to return. It was the hardest thing I've ever done. It was my dream job. 1 man 1 shop a good radio and a heater. It was the job I longed for my whole life. I loved being a Mechanic, and it's all I know. When I went to the Ortho doc ,He confirmed it. I was done working as a mechanic forever. I went on disability retirement, and now on total social security retirement. I would much rather be working ,but I can't. The bicycle has been the best thing I 've ever done for my health. I am totally freaked out about losing the ability to do the thing that brings me this joy. Through all of this I have become depressed, almost addicted to pain killers. By riding I have built my muscles up enough that I rarely need any type of pain meds. I had a serious mishap while on duty in the Coast Guard during the Panama conflict, which almost killed me. Resulting in a paralyzed left lung diaphragm (50%) lung capacity, a broken pelvis, and many internal injuries that I won't go into detail about. I really can't say any more about it. It left me with PTSD, and a life of pain since 1982. I made it through the military, and now I am an 80% disabled Vet, and proud of it. I would do it again if they called me up. I've been through a lot ,as you have, I know I should get the TKR, but I just can't stand the thought of going through with this **** again. The surgery is going to be at Ft Miley in San Francisco . I had my doubts about The VA, but they assured me it won't be like the hospital in the jungle of Panama with wild animals roaming the corridors. (ha ha). I guess I'm rambling, so thanks for the concern, and I hope you continue to get stronger.

nutcase

This is good news, thanks.

deep_sky

In the time I worked as a receptionist at my previous job at a PT clinic, every single person had the same doubts you are, because most of them, like you, had chronic pain and disability, but yet were afraid that they would lose what little mobility they had left by doing a TKR. It's natural to have such doubts, as you have gotten used to what you have, and dealing with it however you can, and it's not easy to give up those habits in the face of the unknown. Without fail, every single one of them told me they wish they had done this years earlier and not lost those years to extreme pain and very limited mobility. If you do your research, visit several ortho surgeons to get multiple opinions, and do your therapy, there is very little chance that you won't come out the other end happy that you did it.

I really would recommend that you look into getting a geared drivetrain. While I do not have near the same difficulties you do, I too struggle with knee issues. I was born with tibial torsion, a condition in which one or both tibias in your lower leg twist. Normally it corrects itself as a child grows; with me it did not. As a result, my patella does not track properly because the entire joint is shaped differently. I tried to ride the same gears as other people did, and suffered terribly with it. After one hilly ride, I was in a great degree of pain, and after a week I could barely walk even though I was staying off my feet, resting, icing, all that bit.
I went to go see a chiro who is in my club, and is also a long distance cyclist (turns out she has the same problem i do, only in one leg) to see if there was something I could do that would allow me to ride again. She identified several issues I had(and accurately diagnosed my condition after one look at my legs and how i stood), and after upgrading my drivetrain to have a large cassette in the back, spacers on my left pedal, corrected cleat position, and adjusted the saddle height, I slowly recovered. Probably took me 3 months to get back to climbing without pain, although I still ice after every hilly ride. My smallest gear is 30-32, and believe you me, I use it when I do a long climb. Switching over to a spinner instead of a masher methodology has made a crucial difference for me. I won't ever be as fast as my peers, but I won't end up being crippled, either. A smaller gear at a higher cadence puts a lot less stress on the knee, and I truly believe that it would be something that would allow you to get back to climbing after you heal from the surgery. We don't have wussy hills around here either, so when I mean hill, I mean HILL (think a climb thats over 4 miles long and averaging at nearly 8%). To me that is a respectable climb

nutcase

Thanks for the real life information. I have been reading doctor and patient's stories or reviews on the subject of a TKR. I find more horror stories than good. But that's the internet! My doctor of course had to explain to me all of the things that could go bad also. There is quite a bit. Yesterday It was a beautiful sunny day,so I thought I would compartmentalize the day ,and do several things. It was supposed to be my long ride day, but dog looked like he needed a long walk. ,So I ran some quick errands on the bicycle (12 miles),Then took my pal to the beach. While we were waliking my knee in question was clicking in back and there was pain all across the front. I kind of succumbed to my fears and think I should get the TKR. When I buy something I do massive research prior to the purchase.and I guess I'm doing the same about my knee. For 20 years the Military got to make those decisions for me,and they weren't always the right one's or for my best interest. I now can make those decisions myself. This forum is a good tool for research, and the info has been good. Thanks.

Tom

CPFITNESS

Nutcase, because you are otherwise fairly strong and of decent health, put your efforts at the present time into just getting your weight down. For one, it may make the knee feel a lot better and 2, if you do elect to do the surgery, recovery will always be easier if you have less weight on your frame. I'm 6'3, 240lbs and a personal trainer, so it goes without saying that I'm pretty fit. But I blew out one knee and had ACL Reconstruction in 2005 and I blew out my other one this past january which was part of what got me on a bike and I'm glad I did. I'm putting off ACL reconstructoin on the knee until the fall so I can get through another golf season, but I'm completely changing my workout routines to remake my body. I've always been a baseball player and I used to do a lot of work as a Bouncer here in NYC so in my mid 20's I worked out to build mass and strentgth. I HATE training for endurance, its never been a big part of the sports I play, but I'm forcing myself to do it and to just reduce my body size. There is really no need for me to be above 230lbs even if my frame can handle it. Ideally, I'll get myself down to about 220 and have the knee done in October and be laid up for a couple of months and back to full normal activiites by June of next year.