Old coach

Total Knee Replacement folks question:

I had my right knee replaced last June. My rehab went great and with my Ortho and PT's blessing, I returned to riding. My range of motion was -5 to 125 degrees. I gradually progressed my rides/activity throughout the fall without any issues.

This winter, I hit it hard in the gym-weights, indoor cycling, walking, and elliptical expecting to get out and rock this spring. The snag I ran into in the last month is post work-out/ride and the next morning the knee is sore. It's not the joint, it's more tendinitis type of pain. When I am riding and warm-up, no pain issues. It's just after. I realize I may be overdoing it, but I thought if if I was going to have issues, it would have been 3-4 months post-surgery, not 8-9 months.

My question for my fellow TKR's, is this the new "normal" for my knee and I? Will i always experience some stiffness, discomfort, and even pain, at times? My titanium knee is still much better than the pre-surgery knee and it doesn't hurt when I am active. I just am not sure what I should be expecting? I go back and see the Ortho in two months, and I hate to completely back off until then.

Any advice would be welcome!

metalheart44

Here is my experience. Right TKR in January 2015, left TKR in August 2015. I worked hard in the gym after January TKR, not so much after the August one. May through July I had few issues with RTKR, although it continued to be stiff at times (especially after sitting for any length of time), some minimal discomfort, rarely any pain. I started riding after LTKR in October and have only built up miles and speed over the past couple of months. Today was a harder ride day for me (45 miles at 16.8) but no pain or discomfort in my right knee, but some discomfort after the ride in my August knee. I had the same experience after a climbing ride last week. Both knees are stiff after I sit for a while and there is some clunking when I walk, but not all the time. I have no pain or discomfort in my January knee, but the August knee is sill not 100%, I can tell when I am riding and afterward that it is just not the same as the January knee. The good news for me is that the January knee is doing well and feels strong. It gives me hope that more time is needed to get the August knee back in shape. The recondition part of riding has been the most challenging for me, but I know that is just a matter of time now. With better weather I am riding more and feeling stronger.

My fit has changed and there have been a number of changes to cleat position (father back), saddle height (higher), and fore and aft position. Each of those change came about as a result of some discomfort while riding and then making adjustments to address the issue. Sometimes the adjustments were just a couple millimeters, but those changes made a differences. If your fit is ok, then I would guess that backing off a bit will solve the soft tissue issues. I found that it is a constant adjust process of addressing level of effort and discomfort. Steady and in my case slow progression had been the nature of the beast.

I hope your recovery continues and you have nothing to loose by backing off a bit and seeing how things develop.

canklecat

No knee replacements for me, but I've been around several folks who had 'em. You're way ahead of most folks if you're exercising regularly. Most people won't and either the knee surgery never heals properly or they don't get the full benefit.

My right knee was strained and bruised several times playing sports, and in several crashes -- cars, motorcycles and bicycles. But never enough to warrant surgery. When I feel any twinges I take it easy for a week, stretch, ride in lower gears for less stress, use topical analgesic creams and massage my own knee. So far, so good.

FWIW, sudden changes in barometric pressure seem to provoke more joint aches, including the knees. I used to laugh when my grandparents claimed they could feel weather changes approaching in their joints, but I ain't laughing now.

One of my best friends, now in her early 70s, has hip and knee replacement surgeries. She's continued to play tennis and lift weights, but complains that she still experiences some nagging pain that she finds discouraging. Her next knee replacement is coming up and this time she's going into a rehab unit for awhile to see whether a more regular, rigorous physical rehab exercise schedule will help. And she'll be cooperative with getting exercise after she returns home.

My mom has had two total knee surgeries, one when she was in her 20s, the other at around age 69. She never really got much benefit from the surgeries, although the surgeries didn't do her any harm. She doesn't do pain, at all, ever. She doesn't even do minor discomfort without very vocal complaining. So her first knee has never had much range of motion because she wouldn't exercise when she was younger.

But I pushed her through her second surgery several years ago, staying with her full time to be sure she used the range of motion exercise machine, walked, etc. So that knee has healed much better and she's had no complications. But at 77 she still doesn't like to exercise and considers it a huge chore to walk 200-400 yards to and from the mailbox or around the building.

My granddad was even worse. He was so uncooperative with rehab he couldn't keep a physical therapist for more than one or two visits. He seemed convinced the surgeon was going to amputate his leg at the knee, set the lower leg on a table somewhere else, then try to glue, staple and sew the thing back together. He was afraid any exercise would break the leg off permanently, so he refused to do any physical therapy. So his knee atrophied and would slip out of joint throughout the rest of his life. He'd been very active before the surgery, but just developed some mental block about the whole ordeal and never got past it. It limited his mobility and eventually exacerbated his lifelong bouts with COPD and congestive heart failure caused by smoking.

Old coach

Nice x-rays MH-did you get the rust-proofing with the titanium?

Thanks for the advice and encouraging words. The only good thing about the quirky Midwest spring season is that the weather does not always allow me to ride as much as I would like-forced rest!
Stillness is how I would describe my current knee "issues." A couple of ibuprophen usually take care of it.

You mentioned something else, I have been considering-getting a professional fit. I've been reluctant to do it because of the expense, but several other riding friends have talked about the positives too. Probably need to reconsider it.

Thanks!

rsrider215

I have had both knees replaced, right knee - 2003 and left knee - 2013. I still get some soreness, for a couple of hours, and slight swelling post ride/workout in my left knee and I do work hard when I ride or workout. I believe it is getting better as time goes on and that this is normal. My right knee doesn't bother me at all.

Just keep doing what you are doing and listen to your body, it will let you know when it needs a rest or to slow down.

I consider my new knees as one of the best things I ever did for myself. I am going to do some road bike criteriums this summer and cyclocross this fall to fill my need for some competiveness since I don't do soccer and basketball any longer.

Good luck...

ZmanKC

I had my right knee done in 1999 at age 46. It's not given me any problems while riding but most of the time feels stiff and sore when I get up after sitting for awhile.

It's not like a real knee but is far superior to what my real knee had become. My left one is heading down the road to needing a TKR. I hope to put it off as long as possible.

Miami Biker

Hi. Did right TKR in 2005 and had great recovery. Moved to Florida in 2008 and in Sept 2008 began cycling for first time since high school-age 63.

Tomorrow turn 71 after 29,000 miles with 6,000 per for last three years. Average 2016 long ride in mid 40s and speed this year at 18 (in a group).

Never had trouble or pain in right knee that was replaced. Yes we are all different. Left knee still original and some pain but avoiding TKR for now.

Not everyone recovers 100%. You do the best you can. Assume you did the suggested exercises post surgery. Talking to your doc should get you further than stuff from any of us here in the forum.

Think positive and good luck.