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Old 08-30-03, 10:41 PM   #1
Gene James
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knee replacement

I'll ask this again. Is there anybody out there who has had a partial or total knee replacement and still rides around 150 miles a week. I know cycling is good for bad knees, but I'm beginning to think it's not good for artificial knees.
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Old 12-24-05, 07:33 AM   #2
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I am contemplating knee replacement. I am 56 and used to be a triathlete at 49 until I had an accident. While I know I will never be able to compete again, I would like to know what limitations I can expect when I go back to biking. Does anyone have any experience with this.
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Old 12-24-05, 07:55 AM   #3
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Time for a new bike, either a semi-recumbent [giant revive] or a full recumbent. cycling shoes are definite plus.

Art knees don't take torque well. Any twisting motion will wear them out faster. They are only designed to go forward and back. I would check with your doctor as different makers may have a reputation for shorter or longer life. With only 2 or 3 per lifetime, you don't want to wear out these babies.

If you haven't had the surgery yet, the key is therapy. You have to force the exercises afterwards. If you don't get the full range of motion in that first month, 6 weeks, you probably won't get it. It is so frustrating to almost be able to lift your knee to the top of the crank, but just not quite make it. The therapy hurts like ***ll, but it's the only way to get more lifting ability.

If you're going to ride with art knees, be sure to get a bike with very close gearing, so it is very easy to switch between gears. You don't want a mtn bike wide range cassette, Look for a very close, i.e. training, road set, widest is 12-27, 12-23 or closer would be even better.

Good luck.
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Old 12-24-05, 10:10 AM   #4
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I've had both knees replaced in the last year. I can ride just fine
but....I have to ride in a non stress manner so as not to overload
the implants. NO standing or power runs anymore.

Then there is also the issue of falls. One good spill can really damage
the joint with an implant. So one must ride with greater care and not
take even a small risk while cycling. Sure you can get away with lots
of stuff......for a while. Then the life of the implant (yes, they are limited)
will get MUCH shorter or loosen which is even worse.

So , to me, riding is now a casual activity that I can do for cardio reasons.
"Performance" riding is now a spectator sport. Could I tour? sure, I could
as long as I do so with care and don't push it.
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Old 12-24-05, 02:06 PM   #5
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This is utterly depressing.
I have articular cartilage damage which almost certainly spells a TKR in my NTD future.
I can't fathom the idea of not racing with the Cat 1-2 field. It's bad enough that old age is slowly leaking the speed from my legs.
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Old 12-24-05, 02:12 PM   #6
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Quote:
Originally Posted by EventServices
This is utterly depressing.
I have articular cartilage damage which almost certainly spells a TKR in my NTD future.
I can't fathom the idea of not racing with the Cat 1-2 field. It's bad enough that old age is slowly leaking the speed from my legs.
There are certainly worse things you could be worrying about. Hang in there and good luck!

jw
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Old 12-24-05, 02:17 PM   #7
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Oh, don't I know it!
My cycling buddy is dying of cancer. I've got everything to be thankful for.

But if life were perfect...
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Old 12-24-05, 02:29 PM   #8
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Let me first say, you are in uncharted waters. Doctors are used to dealing with fat, sedentary people. They don't know what to recommend. I had massive amouts of scar tissue form and my doctor gave up. I took matters into my own hands. I bought a Hase crank shortner usually used on recumbents for people with limited ROM. I hated it but it worked. At the gym, I rode both recumbent and upright exercisers up to an hour in length. By the way, for people who recommend getting a recumbent bicycle. I had one years ago. You have to be a very good spinner or you will fry you knees especially if you ride agressively. I put in many miles walking and in Sept I said the hell with it. I'm getting on with my life. I bought an upright and have been riding 20 miles a day up and down hills ever since. Yes, I stand on the pedals,a lot. Let me also say that standing on the pedals does not create as much lateral movement in the knee as say skiing or doubles tennis, both are recommended activities. What you want to worry about is keeping your weight down as this will wear out the knee faster than any low-impact sport. No, I'm not riding as much as I used to. But I'm still riding. Many bikes now come with 175mm cranks, more torque. Let me recommend that you go to 170mm cranks. Most bikes in the 70's used to come equipted with such. You spin a little more but it's less stress on the the knees. Also, may I recommend a book; Total Knee Replacement and Rehabilitation by Daniel Brugioni and Jeff Falkel
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Old 12-24-05, 02:35 PM   #9
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Sounds like you're identifying two factors as being detrimental to the knees:

- lateral wobbling
- high loads

So it would make sense to keep your knees moving vertically without wobbling while using low gears to lessen the loads?

I've never had knee issues, and I want to keep it that way. I came up on someone on the road the other day and noticed his knees. They were tracing roughly a figure-8 with being pull out as he nears the top of the stroke (I assume from yanking up) and then it move suddenly inwards on the downstroke, probably from a sudden push/mash on the pedals. I'm justing thinking this can't possibly be good for the knees...
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Old 12-31-05, 04:49 PM   #10
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I am 54, have had six knee surgeries. Until the last it was all cartilage damage dating back to my early 20's. Five years ago had ACL replacement with cadaver ligament. Was advised to have a TKR about ten years ago. I can still cycle 40+ miles per day. I use a touring bike and an upright position, and clipless pedals.

My advise is do not have the TKR until the pain of everyday is so bad you can't stand it. I'll stick with that advise. It scares me, have had two friends in early 60's die of blood clots from TKR.
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Old 01-01-06, 09:11 AM   #11
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"My advice is do not have the TKR until the pain of everyday is so bad you can't stand it. I'll stick with that advise. It scares me, have had two friends in early 60's die of blood clots from TKR."

Good solid advice, mate. TKR has advanced light years since the dark ages of the 60's but there
still is risk. Since TKR implants DO have a limited lifespan waiting IS the thing to do in all cases.

In my case I faced a wheel chair or TKR my joints were that far gone. I was not ready to pack it
in either. So TKR was the only choice I had. I pushed my body as far as it would go so now since
I've already used up my "second chance" by getting TKR I damned careful as there is NO third
chance left.

Ride as hard as you can while you can then treat your TKR with care as they MUST last the rest
of your life.
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Old 01-01-06, 01:10 PM   #12
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I disagree with you tightwad. I have advanced poly-titanium-non-cemented knee. Baby-boomers are coming to age and to say they advancements won't continued to be made in this area would be silly. I ride 20 miles a day, walk 5 miles a day and still peak bag on occasion. To not live in constant pain was well worth the risk. It's the years in your life; but the life in your years
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Old 01-01-06, 02:58 PM   #13
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"Baby-boomers are coming to age and to say they advancements won't continued to be made in this area would be silly."

Where did I say that?? It's very true that with millions of boomers that will need TKR both materials
and the surgury will advance. However, a TKR is still a man made implant and will NOT last like the
original God made. The implant , while firm for most things, will not take the abuse a real knee will
when it comes to heavy sports or falls. For crying out loud that same heavy sports and /or falls is
what took out your God given knee ........didn't it??

The ortho doctor I used deals with factory workers and farmers who have joints worn out from
decades of very hard labor. The joints he uses are not for sissies but for real men and working
women who know hard work. Because of the people he operates on he knows he'd better tell it
like it is so that his patients know what they can do as well was what will wind them back up
on the table to try to fix a damaged implant. So I take his counsel seriously as that's how it's ment.

You can do as you will. But if it's wrong you will pay for it later. I've seen what happens when an
implant was driven out of the bone and through the side of a poor man leg due to a fall. NOT FOR
ME, mate. I ride about 25 to 50 miles a week.......at a gentle pace that doesn't strain my knees
but it doesn't matter as each person needs to ride at a comfortable level for themselves.
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Old 01-01-06, 06:11 PM   #14
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You're still basing your opinion on the materials used for TKR of Today and on the knowledge of physicans of today. I'm saying advancements are going to be made. No, heavy sports is not what took out my knee. A VC motar round is what ruined my knee. On that same note, I know servicemen today who have had their lower leg blown off and they are going back into combat because of the prosthetic devices they wear. Something, unheard of in the 60's. Why, because of the ADVANCEMENTS being made
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Old 01-02-06, 12:31 PM   #15
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Quote:
Originally Posted by Gene James
You're still basing your opinion on the materials used for TKR of Today and on the knowledge of physicans of today. I'm saying advancements are going to be made. No, heavy sports is not what took out my knee. A VC motar round is what ruined my knee. On that same note, I know servicemen today who have had their lower leg blown off and they are going back into combat because of the prosthetic devices they wear. Something, unheard of in the 60's. Why, because of the ADVANCEMENTS being made
Your original post asked if cycing might be bad for knees if you were to ride 150 mi or so. This is
what I replied to. I'm sorry to read that VC motar round caused your injury but that just means
that by now you've had some time to adpt....maybe?? It also sound as if you're wishing for
new "advanced' knees now. Is this so??

My comments can only be based on my own experience for all who read the forums. It goes without
saying that advancements in both material and surgury skill WILL come in time for the betterment
of all. However, I can only comment on the materials / surgury of today.
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Old 01-02-06, 09:09 PM   #16
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Tightwad; With all due respect, I had the TKR in Feb;04. Untill that time I lived in constant pain as I'm sure you did.All I'm saying is this; If you do nothing but sit on couch and walk to bathroom, your TKR will last a lifetime, but what kind of life is that? I figure I'm going to get on with my active life and let the chips fall where they will. With a little luck,15-20yrs from now joint replacement will be commonplace. They are already using ceramics instead of polyethylene in hip replacements which lasts longer. I lived in constant pain. I'm not going to replace that with living in constant fear of wearing out my new knee too soon. And yes, I had a pulmonary embolism and almost died in recovery. But I didn't. I've had cars almost hit me when I'm riding my bike but they didn't and that doesn't stop me from riding.
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Old 01-04-06, 06:10 PM   #17
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Quote:
Originally Posted by Gene James
Tightwad; With all due respect, I had the TKR in Feb;04. Untill that time I lived in constant pain as I'm sure you did.All I'm saying is this; If you do nothing but sit on couch and walk to bathroom, your TKR will last a lifetime, but what kind of life is that? I figure I'm going to get on with my active life and let the chips fall where they will. With a little luck,15-20yrs from now joint replacement will be commonplace. They are already using ceramics instead of polyethylene in hip replacements which lasts longer. I lived in constant pain. I'm not going to replace that with living in constant fear of wearing out my new knee too soon. And yes, I had a pulmonary embolism and almost died in recovery. But I didn't. I've had cars almost hit me when I'm riding my bike but they didn't and that doesn't stop me from riding.
Somehow , mate, you and I are on the same page.......but not really.

We both understand that each person is different in several ways from their outlook on life to the
speed at which they heal. I approch life with a caution when it comes to falling. You approach life with more gusto. So be it. All is well.

As to what's in the future for implants.......
The sky's the limit with all the Boomers that will need to have joints replaced. I'd bet that joint
replacement will almost become "zipper" surgury in time it will be so common place.
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Old 01-07-06, 12:10 PM   #18
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I had TKR (right knee) a bit less than two years ago. Prior to having the surgery, I'd gotten to the point where walking was difficult and my range was limited to a couple of blocks, even using a cane. Riding was out of the question. Now I have no problems at all.

I'm no racer. I'm a bike commuter and recreational cyclist. For my kind of riding, I have no problems. I don't have the total range of motion I had before surgery, but I have more than enough for cycling. I can walk all day. I can hike all day in difficult terrain. In November, I spent a week in Joshua Tree and hiked all day, and even did some climbing.

Some of the newer knee replacements do allow for some limited torque, by the way -- my surgeon showed me the model he'd be putting in my knee, and showed me the range of torque it allowed as compared to older models.

No replacement lasts forever, so depending on your age, you'll be repeating the experience. I've heard that some of the newer ceramic replacements have a longer lifespan than the steel/titanium models.

The surgery really isn't bad. I had the surgery on a Thursday. The next day the doctors came to my hospital room and got me on my feet. The day after that, I was sneaking out of the hospital for a smoke (I know, I know). The day after that I went home. I was back at work the following Thursday.

Physical therapy is crucial. I don't have full range of motion because I didn't (couldn't, really, due to my work/travel schedule) do as much therapy as I should have.

It might be true that you won't be a competitive racer after surgery. But I can't think of any reason why you won't be able to ride, and ride hard. Ride centuries.

Don't worry. If you've gotta do it, it really isn't as bad as you might think.
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Old 01-07-06, 12:33 PM   #19
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I was 59 when I had both knees replaced at the same time. Two doctors doing the surgery. One told me to ride a bike after I was recuperated and the other one said I should not ride a bike. OK....so I bought a recumbent trike and have been riding all over the place for the last two years.
I still had my bike when I was fully recuperated, and tried it, but could not make the turn on the cranks. But now I've got so much more range of motion since riding the recumbent....Hell now at 63, I'm having so much fun that I'm getting ready to get a new tadpole in April....yee haw!!!!!!!!!!!!!!!!!
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