Knee replacements
 

Hello all and Happy New Year. I don't want to bore you all with a list of injuries that I have managed to incur over the years but after 2 left knee surgeries (fractured knee cap and ACL) I have been having lots of knee pain while walking and doing stairs etc. Climbing poles and towers for 37 years has not helped either. While riding my bike if I wear one of the elastic knee braces with the hole cut out for the kneecap I seem to do pretty good. I went to see a knee specialist a couple weeks ago and after several x-rays he said I am at the point of having a knee replacement. As he put it " You are standing at the door, you just have to walk through it". There is bone on bone and it's not going to get better. I can still do 30 - 40 miles on a ride averaging between 12 an 14 miles an hour. I don't ride with anyone and I certainly don't push for speed, I just enjoy riding. Just asking those of you that have had a knee replacement, how did it go and how was the recovery time until you were back riding your bike, did the pain go away and do you have any regrets ? Having had several shoulder surgeries and also a spine fusion, for some reason I am having a lot of anxiety about the knee replacement. I appreciate your advice and input, boomer.

I’ve known many people, my wife included, who have had both knees replaced. Doctors tend to wait sometimes for a person to be older, as they know the plastic that replaces cartilage has a finite life expectancy of 30 years or so. I think they now have knees where they can go back in and replace that stuff. Generally, of all the people I’ve known, those who are fit in some way, actively cycling, etc…. tend to recover better and more quickly. One riding buddy had both done over a years period and was back and riding about 3 mos. after each surgery. Cycling is not an activity that stresses the joint as much as walking or running, so is a recommended activity. It’s also a somewhat painful operation, compared to hip surgery, is what I know. Depending on your pain tolerance, expect to be on some serious pain meds for a short while. Taking those speeds the healing.

Replaced both knees in 2024. Right in Jan, left in May. I was prescribed a ROM therapy bike each time and was spinning the day after surgery. The ROM bike adjusts pedal radius, starting small and working your way out. The prescription was for 3 weeks, then I moved to a bike I set up on basic rollers before surgery for 2-3 weeks—after that, I started riding outdoors. This is in addition to walking and doing all the stretches and exercises learned in PT, weight training for legs, etc.

it’s a tough surgery with lots of aches and pains afterwards. The prescription painkillers help you through the first few weeks and I found it all to be quite manageable. I recommend “prehab” PT so you learn the exercises now and build up your quads and glutes as much as possible. Being an active cyclist will help you have the right mindset for recovery. I was amazed at how quickly abilities come back. I rode 25 miles today on a mostly flat route. 20 miles last Saturday in rolling hills. No knee pain and can stand on the pedals and crank up short steep hills again like I could before knee arthritis symptoms began! Between cycling, hiking, gym days, I try to work out an hour a day or longer.

#1– A guy in our group was back in the group after 6 weeks.
#2– My wife is a hot shot orthopedic specialist DPT and says shoulders are the very worst of any joint surgery to rehab.
#3– My dad waited too long.

I had total RIGHT knee replacement in October 2023 (I also have an artificial LEFT hip from about seven years ago). Don’t get me wrong…the recovery is no cakewalk. But in hindsight…not that bad. Like two months post-op I was pretty much back to normal. I had a bone-on-bone situation too. Before the surgery, I could ride without pain. But getting up out of the saddle for a sprint/hill was out of the question. Just too much pressure/pain on the knee. The day before my surgery, I set up my stationary trainer in the garage. My surgery was very early in the morning, and I was back home around noon. Having discussed it with my surgeon, and physical therapists, forty-eight hours post-op I was on the stationary bike just slowly spinning, working on my range of motion (you’ll want the seat adjusted higher at first). I was doing that several times per day starting out at about 15 minutes every several hours, and gradually increasing the time and intensity. Two weeks later (after the staples/stitches were taken out) I was back out on the road riding. A couple of months after the surgery I began testing getting out of the saddle. THAT pain was gone! But it was still awkward, and weak because I hadn’t done it in so long. Working on that ever ride I can now climb with intensity, and that has probably been the biggest contribution to regaining the strength in that knee. — Dan

I had a total knee replacement in 2017. After six months I was skiing again, both X-country and downhill. I cycle, ski, hike, and backpack. No problems, no aches all these years. The knee feels great.

Thanks for posting this. Getting a new knee next month and great to hear how well you've done!

Great replies and encouraging words from all of you, thank you very much. It got me to thinking that I have a Specialized Crossroads bike that I rode very little. It's an upright bike that I got a 2-3 years ago. Right after I got it I developed Rheumatoid Arthritis and was unable to ride. After I got that somewhat under control I ended up with a road bike then a gravel bike. I'm thinking that it will be my rehab bike. Can any of you recommend a stationary stand that I can get for the rehab ? I have a lot of time to prep for this as I probably won't get the surgery until October. Thanks again, boomer.

How much pain you have and how long it takes to recover is all over the place.
I took me about 5 months before I was really riding well, but I have seen people get to the same place in 2-3 months.
The pain was minimal the first 2 days, then substantial once the meds they put in the joint wear off (for the first 2 weeks, if I could have undone it I would have!).

After 6-7 months I could pretty much do whatever I wanted (hike, bike, work out; just no more running), but it was a good 18 months before it really felt normal.
TGhe people I have seen who don't do well are mostly those who don't take the rehab seriously.

Almost 3 years ourt and I would definitely do it again.

Good luck!

I can't recommend anything...yet. That said: I have a recumbent stationary, my main bike (Giant Cypress DX) in a Giant branded stand during the winter (so right now) and one of those small ones that you use just sitting in a chair. In about 30 days or so and moving forward I'll be able to let you know what is working best for me and what they recommend as I move forward. I guess the right thing for me to say right now is "Stay Tuned"...

FWIW - my surgeon told me that the reason the one I was born with lasted as long as it did was because of all the time I spend riding now...

Whatever stand you go with just make sure it is really stable so that it doesn’t become detached and fall over especially when getting on/off. I went with my old roller trainer … front wheel removed and fork is clamped into a support with QR.

Dan

Don’t be surprised if your knee joint feels very cold when exposed to cold temps and wind. It’s an odd side effect. Also you need for airport security to run a wand over your legs, you think they would be used to this,

Dan - Thank you for the advice on the stand. I can see myself crashing getting off.
Steve B - I wear an insulin pump so I am used to airport security and getting the 3rd degree. I can't go through the machine and always have to request a pat down because of the CGM sensor that I wear. TSA has gotten much better as they realize that diabetics do have to fly sometimes. Several years ago I was brought in a room in Denver and literately stripped down to my underwear and all of my contents of my backpack dumped on a table to make sure I wasn't carrying anything that wasn't allowed. My wife sat there horrified. It wasn't the search part but their attitude about the whole thing. It has gotten much better. Now with the metal knee ? This will be fun. Thank you both for replies.

jan 2nd was my 1 year anniversary of my new knee, left knee total replacement. no regrets no pain, range of motion is my constant goal along with strength training. go for it mine was pretty easy and not a lot of pain. never took pain meds.

I’ll chime in, had both my knees replaced last year, left on Feb1 and right on April 25. Im 73 and in good overall physical shape. Was a 5 day a week runner for more than 20 years, hence the new knees. A couple of observations, first and most important picking your surgeon. I’ve read about several TKRs going south because of the surgeon. I’m fortunate to live in the Greater Boston area and had several well vetted choices. Secondly find a good PT he/she will be critical in your recovery. I did pre surgery PT and, for the most part, was in good shape prior to the replacements. I was a pretty consistent rider of 20-25 miles 3 or so times a week. No sugarcoating but the recovery can be tough. Obviously we are all different so your experience may differ but a few things seem consistent. Sleep can be tough, I spent the first four month sleeping in a recliner as I couldn’t get comfortable in bed. I used the pain meds for about 7-10 days and they helped. Had a good in home PT for the first two weeks. Young guy who actually cycled cross country for charity so he was empathetic. There seems to be conflicting opinions about PT, should you force your knee to the point of extreme pain in order to achieve greater range of motion. My PT did not ascribe to that theory and it goes way back in time. No Pain No Gain is common amongst athletes but recovering from surgical pain is different than an injury. Your knee has been through pretty significant trauma. Your ROM will return over time. The other challenge for me was just having patience. I’m 11 and 8 months into the recovery and all is well. I was riding outdoors 4 months after the second surgery, and was riding indoors well before that. I am very happy I did this and glad I took the surgeons advice about scheduling them fairly close, best decision besides choosing him, I made. While I could cycle with my old knees, almost everything else was painful. Would like to travel a bit more and see some more of the planet and now feel confident that I will be able to do that. Good luck whatever you decide.

I haven't had any surgeries. Your "bone on bone" statement is why I'm responding. Don't know if this can help, but I have bad knees with no cartilage probably due to all the biking I've done. 15 yrs ago went to 2 doctors and both said I didn't need surgery, tho they wouldn't tell me more than that. What did solve my problem, in addition to going to an alternative medicine practice, was/is/will be taking fish oil supplements. I highly recommend it if you think it'll help you. I started with Cod liver oil pills and then when they got expensive changed to Omega 3. I felt no difference between the 2. These doctors will say anything to extract $ from you/ins. company. Be careful!

good day fellas, I'll pass my experience on, blew my ACL out in 89, ortho doc then said I could be a guinea pig, and do an ACL replacement and do 6mo of PT, but without insurance and newly married in college, it wasn't an attractive offering, also he did offer I could start cycling and build up my accessory muscles and...probably be as well off for some time. As a Nurse Practitioner, that was a good choice for me, and now 30+ years later, at 52, I had a total knee replacement. Raced prior up to cat 3, love cycling, but the 2-3 years prior to my replacement my knee felt unstable and like a cheese grader during rides and I was literally limited in that, my knee would effuse/swell after 1hr rides, and even working in my office it was limiting me. My MRI of the knee evidenced that, and it was bone on bone and no injections helped. My ortho doc was hesitant to offer replacement but I insisted, and said now and not at 75 when I won't be as active, and if you don't, I'll find one who will. He was sport med fellowship trained also and agreed. I was asking about activity quite a bit in relationship to knee replacement longevity and initially he couldn't really answer that. Anyway, I was back in 3 wk to work, painfree, and on the bike. But, on the bike, the first year I admit I was hesitant as I don't want a 'redo' knee surgery since he didn't really have any info on that. He couldn't provide any literature on long term knee data in cyclist, so I backed my riding down on my own intuitively, but just last month he sent me a recent study that did evidence long term observational data that cycling specifically did not change outcomes or need redo surgery due to cycling itself, so it made me more comfortable riding longer and more frequently now. After you have surgery, you will notice your artificial knee will make noises, and when I ride mine squeaks quite rhythmically so that was why I was hesitant. It clicks, but no problem. On the bike, it feels great from a power standpoint as my prior knee was with laxity and I could literally feel that. I think another key is that you don't want any needless accidents or injury after a surgery like this. Nonetheless, hope my experience helps others.

My wife had a complete knee replacement. It was a pretty grueling healing process and she was in pretty decent shape. Anyways after about a year or so she is pretty much back where she was. She was very diligent about PT and exercise.

Don't put it off. My wife has had both knees replaced, first one in her early 60's went fine. Second one at about 70 was a much more difficult recovery. Knee issues also throw off other things, like hips, back, etc. Get it done, focus on recovery and enjoy the benefits.

Well it's been 6 weeks since surgery and I've been back on a stationary bike for the past week or so...here's my thoughts:

I have a bike in a stand and a recumbent stationary and I've been drawn to the recumbent stationary for a few reasons -

1 - The recumbent is so much easier to get on than the bike on the stand. On a good day I need to use a stool to get up on the bike in the stand (as well as the upright stationary at physical therapy). I feel so much more comfortable at this point just sitting on the recumbent.

2- The seat distance is so easy to change on the recumbent while I'm sitting in it that I can get it to right where is comfortable to pedal and move it in tiny increments as I get more and more flexible.

3 - Since there's a lot of muscles in my leg and back that I've barely used since the surgery, I felt that the recumbent would be more comfortable at this point. I'll get back on the bike in the stand once I'm feeling stronger and before I'm back on the road/trail.

I hope this helps - I know you originally inquired about a bike stand but wanted to share my experience.

Thank you all for your replies. I knew there would be some experts here on this topic. Why not ask people who have gone through it and get their opinions. I have the Tour de Cure ride coming up in 2 weeks and hopefully I can get through that. Thanks again for the replies and advice, boomer.

Both of my knees replaced (a year apart), outside on my bicycle within about 3 months and on tours within the year of each surgery. Surgeries were worth it! Good luck.

I still have both original knees, for how much longer is tbd, if the right knee does not straighten itself out. (2 cortizone injections in the last year)

Torn left acl, repaired 1996.
I went through PT with many other patients rehabbing from knee replacement, several a decade older than me.
They all seemed to have an easier time, which makes no sense to me.

fat biker

Thanks for all the great advice. I am new to the 50+ thread, although I am 74. I just made an appointment with my orthopedist. My Synvisc injection isn’t meeting my expectations. So far cycling doesn’t give me to much trouble, but I can’t run and work or uneven surfaces are a problem. I am thinking a knee replacement could be in my future.

Are the different procedures and different hardware? Any recommendations?

Good question, both my knees were made by Smith and Nephew, a well known name in the joint replacement world. They are off the shelf but they make several models that a well versed surgeon would decide what is the best fit for you. Alternatively there is a company, Conformis, that has a newer more cutting edge approach. They do an MRI of your joint and then a 3D printer makes your customized knee. While it sounds pretty impressive all the latest data shows no advantage to this approach. Coincidentally Conformis did file bankruptcy and were acquired by a company Restore3d.
I can only speak for myself obviously but I have had very good result and now a little more than a year after am very happy with the outcome. I’m 73 and was in a similar situation as you, cycling was reasonably ok but everything else was a struggle. I think I was walking like I was 93 and not 73.
Good luck with your decision.