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Old 12-16-10, 05:56 AM   #1
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Cycling after a TKR (Total Knee Replacement)

Yes, I already searched this topic, but wanted to start a fresh thread on it. My cranky ass right knee has been sustained with stretching, ice, and Synvisc (today I'm having the third shot of the latest round of shots) but osteoarthritis is a degenerative condition and I fear I am sailing towards a knee replacement. My knee surgeon, Larry Livingston (Montvale, NJ) is the best, he's operated on my right knee twice (in the 1980's). He says his TKR's can get 130+ range of motion. I believe what he tells me, I've known him for almost 25 years.

What's it like cycling after this? Could I ride 10K+ miles annually? Could I ride hard (i.e., TT's, races, etc.)? He seems to think so, I am skeptical.

In any case I hope to put this off for another couple of years, and hoping the Synvisc will kick in, it probably will. Larry seems to think I can be sustained with what I'm doing now until age 60+ (I just turned 53), or that I may never need a TKR. My knee is starting to hurt at times, in addition to the stiffness, so that's not a great sign.

I do know that TKR success is highly dependent on the rehab phase and how aggressively you approach physical therapy. My guess is that I'm considerably more athletic than 95+% of TKR subjects, and my motivation to get this knee working would be much higher than most of those patients.
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Old 12-16-10, 06:15 AM   #2
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Sorry to hear bout the knee pcaddy, I have a knee that gives me some fits as well - had surgery some 15 years ago. All I can tell you is a story about I guy I met a Killington about 8 years ago. He was about 85 then, had both knees replaced. He was skiing and we were ridding the Gondola to the top.When we got to the top I asked him where he wanted to go, thinking some easy way down would be his choice. As I turned to face him he already had snapped in and was pushing off down a steep expert trail, as he started rolling his response to my question was "DOWN", we spent the day skiing harder than I usually do. Being of the older ski generation, I asked him if he could still do a royal christie - he popped off a few as he bombed down the hill, amazing fellow, all on two artificial knees.

So I hope that helps you at least realize that an active life doesn't end with a TKR.
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Old 12-16-10, 06:24 AM   #3
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Killington is the only place I've ever ridden a chairlift in the hammering rain when it was 20F.
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Old 12-16-10, 07:37 AM   #4
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Skied with an 84 year old who had one knee replacement. He said he skiied fewer moguls because of the knee replacement. He skied them very well on telemark skis.
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Old 12-16-10, 07:47 AM   #5
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Skied with an 84 year old who had one knee replacement. He said he skiied fewer moguls because of the knee replacement. He skied them very well on telemark skis.
That's encouraging.
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Old 12-16-10, 08:23 AM   #6
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A couple of thoughts.

1) TKR should be done with a "minimally invasive surgery" (MIS) technique. Sometimes older surgeons are not clued into the newer technologies, as I discovered with my recent L4-L5 fusion and discectomy - where, with MIS, I was walking the evening of surgery, walked a mile the next day, was swimming in 2 weeks and bicycling in 17 days. This while others with the non-minimally-invasive technique were still using walkers at 6 weeks.

2) My wife (now 73) had a MIS TKR about 3 years ago. She worked hard - as you do - to be in the greatest shape possible prior to the surgery, and followed the rehab regimen exactly. You would never, ever know she has had a knee replacement. Synvisc did not help her. She bicycles, wlaks, etc. all the time.

I don't know about the hard bicycling, but I sure don't know of any reason why you could not. Also, I have read recently about TKR appliances designed to last 30 years. I know nothing more, but be sure to check it out. New techniques and appliances are being perfected all the time.
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Old 12-16-10, 08:30 AM   #7
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A couple of thoughts.

1) TKR should be done with a "minimally invasive surgery" (MIS) technique. Sometimes older surgeons are not clued into the newer technologies, as I discovered with my recent L4-L5 fusion and discectomy - where, with MIS, I was walking the evening of surgery, walked a mile the next day, was swimming in 2 weeks and bicycling in 17 days. This while others with the non-minimally-invasive technique were still using walkers at 6 weeks.

2) My wife (now 73) had a MIS TKR about 3 years ago. She worked hard - as you do - to be in the greatest shape possible prior to the surgery, and followed the rehab regimen exactly. You would never, ever know she has had a knee replacement. Synvisc did not help her. She bicycles, wlaks, etc. all the time.

I don't know about the hard bicycling, but I sure don't know of any reason why you could not. Also, I have read recently about TKR appliances designed to last 30 years. I know nothing more, but be sure to check it out. New techniques and appliances are being perfected all the time.
Valuable info, and thanks.
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Old 12-16-10, 08:34 AM   #8
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I know an older guy that kept putting his knee surgery off, because it was going to be the end of his sports life. He did a lot of golfing and a little running. At the age of 80 he couldn't take the pain anymore and decided to get it done. After he got it done, he said he's kicking himself in the ass for not having it done sooner. About 6 months later he had the other one done. He was back to his old self again and very happy. He died at the age of 85. Personally, I don't know if I want to live that long.
He had all this done about 15 years ago and I know they've come a long way with the procedure since then. I do know a few others that had knee surgery, but I don't know if it was complete knee replacement or not, but they said it was a piece of cake as well.
Good luck with the Synvisc, but I don't know if I would be to worried about the surgery either.
By the way do you still squat 400#. If so I think I would forget about that for a while. Have a nice Christmas.
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Old 12-16-10, 08:52 AM   #9
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I have two stories - one very good and one not so good.

A 67 year old team mate, who races track, had a knew replacement a couple of years ago. He was back to riding in a few weeks and set a new World record in the flying 200 meter last year in Masters Track Natz that he held for two minutes until another guy beat him by .1 seconds. This year he was best all around rider at Masters Track Natz in Frisco, Tx and was 6th in the 500 meters at track worlds. His knee does not seem to bother him.

A younger guy in his fifties and a trainer at our gym had his done and it did not turn out well. I was talking with him last night and he had to have it redone.

I have yet to talk with someone that has had a bad doc per se. It appears the outcome depends a lot on the individual but having a doc with a great track record of success is mandatory.

Good luck and hope your knee feels better.
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Old 12-16-10, 08:57 AM   #10
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A guy I know had knee and hip replacement after a bout with MRSA. He's in his 50s and has started riding again. He's not yet up to his former speed or distance but the last time I saw him he was very happy to be on the bike again.
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Old 12-16-10, 08:59 AM   #11
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One of my riding buddies is 58 yrs old and has had both knees replaced. He says that cycling is easier now than before since he does not have to deal with any pain before or after the ride.

Last March at the start of the first Master's 50+ race I was talking to some of the racers, including my buddy with the new knees. I was telling them about the ankle fusion surgery I had done on December 1st. One of the other racers then stated that on Jan 13th he had a hip replaced. He had also won the State Masters 45+ cyclocross championship in Dec. The three of us all laughed at our cobbled up bodies and racing at our advanced ages. A 4th rider laughed and said that he was feeling macho riding with a broken finger but would not mention it to any others.
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Old 12-16-10, 09:40 AM   #12
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Sorry to hear PCad. Sorry I can't offer any additional information but just wanted to be supportive. I am avoiding getting my knee scoped but it's only a torn meniscus and hasn't been affecting my riding.
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Old 12-16-10, 11:18 AM   #13
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Why don't you post this question over on the road forum? I'm sure you'll a lot of good, helpful, and sincere suggestions over there.
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Old 12-16-10, 11:20 AM   #14
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Why don't you post this question over on the road forum? I'm sure you'll a lot of good, helpful, and sincere suggestions over there.
I figure there are older farts over here, and if anything it's even more Fredly.
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Old 12-16-10, 11:22 AM   #15
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I have two stories - one very good and one not so good.
Very encouraging. I'm not worried about finding a guy who won't eff up the knee surgery. The guy I have now is the best and if he retires or moves to Florida, I'll find the current guy who's the best. That I know how to do. In going through rehab for this knee twice I kept meeting people who had one surgeon eff up their knee procedures, including TKR's - and my guy Larry fixed them. Finding the right guy is easy, you ask around, particularly ask the physical therapists. They are the ones who really know which surgeons get it right.
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Old 12-16-10, 11:57 AM   #16
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My knee's not toast yet however. I look forward to Synvisc shot #3 tonight. Oddly, I'm actually starting to enjoy the pain of the injections. I am utterly insane.
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Old 12-16-10, 12:13 PM   #17
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My Mom had it done a few weeks ago, she's 76. This was her second one, her first around Thanksgiving last year. About 3 weeks after the surgery her therapist put her on a stationary bike. This last surgery she was more prepared, she borrowed a Airdyne from a friend. After the initial pain goes away its probably gonna make your bike riding a lot better.
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Old 12-16-10, 12:17 PM   #18
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I figure there are older farts over here, and if anything it's even more Fredly.
I have more good news and bad news.... Your knee is going to be fine with or without replacement but you will always be a Fred. I used two coaches who formerly coached the Belarus National team. They divided cyclists into pros and touristas (Freds). The P/1/2s were pros and the rest of us touristas. You and I will always be a tourista.
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Old 12-16-10, 12:36 PM   #19
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My knee's not toast yet however. I look forward to Synvisc shot #3 tonight. Oddly, I'm actually starting to enjoy the pain of the injections. I am utterly insane.
I wonder if I could use those shots in my elbows.
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Old 12-16-10, 01:06 PM   #20
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My Mom had it done a few weeks ago, she's 76.
Is she racing yet?
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Old 12-16-10, 01:07 PM   #21
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I wonder if I could use those shots in my elbows.
Good question. Synvisc will work on other joint capsules. It has been approved for such use in Europe, currently undergoing FDA trials for likely approval for shoulders, elbows, ankles, etc. here in the USA. So probably within a couple of years. Or go to France on vacation and get a shot there.
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Old 12-16-10, 01:22 PM   #22
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Good question. Synvisc will work on other joint capsules. It has been approved for such use in Europe, currently undergoing FDA trials for likely approval for shoulders, elbows, ankles, etc. here in the USA. So probably within a couple of years. Or go to France on vacation and get a shot there.
Docs have a lot of latitude in using drugs for off label purposes. Drug companies cannot advertise a drug and label it for a particular purpose until it passes FDA approval. George, do some research on the subject and you may find a doc that is using Synvisc for elbows.
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Old 12-16-10, 01:39 PM   #23
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I just checked it out. $1000 to $1500 per injection and you have to get 3. Some say cortisone works just as well, but you can only get 3 shots of cortisone a year. For some people the Synvisc doe's not work at all. I guess it's just like anything else, you have to keep trying until you find out what works for you. They say it's best used with Depo-Medrol and Synvisc
together.
http://www.ehow.com/about_6472436_de...-synvisc_.html
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Old 12-16-10, 02:00 PM   #24
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I just checked it out. $1000 to $1500 per injection and you have to get 3. Some say cortisone works just as well, but you can only get 3 shots of cortisone a year. For some people the Synvisc doe's not work at all. I guess it's just like anything else, you have to keep trying until you find out what works for you. They say it's best used with Depo-Medrol and Synvisc
together.
http://www.ehow.com/about_6472436_de...-synvisc_.html
I pay $1350 for three Synvisc injections in my knee (not guided by radiology, he just tries to hit the spot) and this is in pricey North Jersey. Insurance usually pays about $900 for them, unless they can weasel out of paying with their unfathomable deductible co-pay scam formula, which they love to employ to fark us.
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Old 12-16-10, 02:14 PM   #25
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I figure there are older farts over here, and if anything it's even more Friendly.
Fixed it for you!
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