Pcad, I just had my left done (6 weeks from surgery), I just finished PT with 132 degrees (I am 54 years old), and it will get better as the swelling goes down. I had my right one done in 2003, I have 140 degrees in that one, and 5 months after surgery carried my daughter on my back on a 4 mile trek uphill to a local rock formation (Delicate Arch, UT)

I'm not.

This is a double edged sword, I trained really hard this summer getting ready for my surgery (Lost weight, built up my leg muscles). But then I kept blowing it during PT by doing too much, too soon. Patience and steady progress is what you want to shoot for. You do your PT, you have a goal to shoot for and you will do fine. I went out and bought a new Giant Defy 1 a week before surgery and that was my goal (It is sitting in my office), to be in top shape to ride that rocket when the ice thaws.

My Dr. told me before I went in the first time that I would go through 3 stages:

1. It would hurt so much that I would curse myself for having it done.
2. Pain level would be about the same as pre-surgery
3. My life would be so much better, I would curse myself for not having done it sooner.

Hope this helps

Terry

Pcad,
I have several friends with both single knee and both knees replaced. To the letter everyone has said it was the smartest thing they had ever done. As with most orthopedic surgeries the quality of the surgeon makes the difference as well as the mind set of the patient. You are still young and pretty fit. the core strength and musculature of your legs will help tremendously when, if ever you do have the replacement should you choose. One thing that really can get to my knees is cleat or clip placement and causing the foot to turn in, even a small amount.

Best of luck and it is nice to see you here at 50+.

Bill

So I see my orthodpod tonight for the last shot and I'm discussing all this. He thinks I am very far away from a TKR. Then on the way out, I tell him the Meloxicam (NSAID) I take when my knee flares up doesn't work for me anymore. I tell him maybe he should prescribe something different, he agrees. He gives me two samples in his office, one is Celebrex (I've taken that before, years ago). I take ONE Celebrex on the way out the door. Within an hour my knee feels 200% better. So that's encouraging. I really need an effective NSAID, and maybe between those and the Synvisc (now I may have to go twice a year) I can keep this under control for a long time. He is the most experienced knee guy on the planet (THOUSANDS of TKR's, reconstructions, scopes, he is the best) and he is rather insistent that I can function this way for a long time. He must know something about evaluating patients with bad knees. More than any of us at any rate.

Let's hope he is right.

Thanks for all the input, VERY encouraging. My doctor, with all his thousands of patients, hasn't done a TKR on an avid road cyclist.

Had mine done in October of 1999 so I've got a little over 11 years of experience.

I got back into cycling in March 2009 as cycling was one of a few things I could still do. Running and any sport that involves jumping or quick changes in direction are not recommended.

I've had good luck with cycling and haven't had any issues with the knee.

Definitely hold off until the next generation of replacement knees hits the market. You know, the ones with the same little motor they put in Contador's bottom bracket. You'll be the next Lee Majors.

If it will help I've had both knees replaced one in 03, one a few month later in 04. My doctor told me two things were forbidden if I wanted the implant to last. 1.) I can not get down on my knees for any reason 2.) I can't hammer when I ride my bike anymore. I can ride my bike from here to the moon but I can't hammer for the speed anymore.

My doc told me that he want's me to keep riding as long as I can 'cause that's great low impact activity that I can do for years even if I just toodle around the neighborhood.

Now one point to be fair: since there are millions of baby boomers getting TKR the tech behind the implants is getting better by leaps and bounds. Heck, my implants are now considered old school to the newer implants! Work with your doctor to time the TKR just right to get the latest tech implants at just right time for your body.

Oh yes, not everybody heals the same and how well you heal depends on your grit to do ALL the after surgery therapy. The surgery therapy is no time to be a wuss. Nope, no time at all...........

There are some of us for whom placing a chunk of metal inside the body is just not a good idea. I hope Pcad isn't one of them (us). I first found out about this when I had some crowns replaced. After two years of having the hygienist telling me I wasn't flossing enough as evidenced by the swollen gums where the crowns were (I was flossing four times a day), I switched dentists. My new dentist found that the crowns had a surgical stainless base metal instead of gold. I replaced the crowns with porcelain-covered gold and the swollen gums were no longer a problem. Twenty years later I found my right leg in need of a bit of bolting back together. I found that my previous poor reaction to surgical stainless was still intact. Fortunately, the bolt only needed to stay in for a month.

I can't imagine the horror of getting a TKR and then finding out that I am allergic to the base material. It is highly unlikely that you will have any issue with the TKR materials, but you might check into it. Of course, like bikes they don't use steel anymore. Maybe by the time you need the procedure they won't even use Ti anymore, it will all be done with plastic.

Good luck with the injections and the new NSAIDS. The longer you hold out the better the materials/techniques get, balanced against the misery of constant pain. Getting old ain't for wimps (said my uncle, who also insists that 80 isn't old).

My surgeon, who has done thousands of knee replacements, didn't think riding hard would be a problem. It's not high impact. Weight bearing, but no impact to speak of. Prosthetic knees apparently handle that well.

The Synvisc appears to be kicking in. He does think I can get by with Synvisc shots for a long time to come. I sure hope he's right about that.

I have more hardware in my body than Lowe's has on aisle 7. Two back fusions and a knee reconstruction. Giant screws show up on my leg xrays, it's pretty strange. Brackets in my back.

Had TKR a little over three months ago - the best decision in a long time. I spent 4 years in significant pain trying to put it off - what a waste! Walking with a walker the day after surgery, home at three days. Walking with a cane at 12 days. Without a cane at 14 days. Golf at one month, bicycling again (after 4 years) in two months. If my other knee decides to go, I will not wait.

The key, however, as everyone has said, is a positive attitude and working very hard at PT. I may be an exception, but at 70 years of age and 70 pounds overweight, one would think it recovery would have been a lot slower.

So - go with the synvisc, but don't discount getting TKR when you really need it. My bet is you won't regret getting it done.

Hoping to avoid a TKR, but if it gets to the point where it hurts to ride the bike and walk, I wouldn't hesitate too long. I get some pain, but not too much of that yet, even when it's bad, more stiffness and discomfort than anything else. Rode hard again today, knee feels pretty good, so hopefully the Synvisc is working, it does seem that way.

I would be trying to ride hard and race (at least do TT's and rides like Nyack with the racing boys) after a TKR, so if it comes to that I hope it's possible to do that. I'm hearing mixed reviews on that.

Be aware that MIS is not applicable to all knees. If the knee has had a prior incision, MIS techniqures are usually not applicable because of the scar tissue and possible tears of old incisions that could occur when the MIS incision is S-T-R-E-T-C-H-E-D to make room for the doc to work. That's the case of my right knee, which will soon require a TKR (I've pushed it back from age 42 to 59), but it has had three incisions and two scopes over the years.

One other new technique involves a "Custom knee" built specifically for you.

http://www.texashipandkneecenter.com/whats_new.html

They use MRI and scans to build a replacement knee specific to your body, rather than using an "off the shelf" joint.

In my opinion you can learn as much or more about replacement results by visiting with a few physical therapists as you can talking to the doctor. If you know one I would try to visit with him before deciding who and where.

That's just my two cents, but I've had a lot of knee surgeries.

My doctor said that he DID NOT want me standing to pedal faster (hammer) since that placed a shock load on the implant that could loosen it in the bone or either spit the plastic bearing or at least add lots of extra wear. Other that that he ok'd all the SITTING riding I can stand!!!

Now my right knee is all stiff and swollen. Apparently that's a rather common side effect of Synvisc, particularly if you've had multiple applications of the drug. Temporary. Hopefully it will just subside. I really don't want to get the knee drained (ouch). I don't think I'm even willing to undergo that procedure. Eff that action. I can limp around for a week. Not sore, just stiff and uncomfortable. I'll call him tomorrow.

I had mine done when I was 63 and have averaged 5-7K per year since. Your last paragraph is true beyond true. I could kick myself for suffering for the 3 or 4 years before I had it done. Feel free to pm me about this if you like.

My right knee is stiff, swollen about as bad as it has ever been, and somewhat sore. I'm reasonably sure it's just a Synvisc reaction, that it will calm down and I'll be on the bike again by the weekend. But this is nasty. Hope I don't have to get it drained off. This side effect is not unusual with Synvisc, particularly after repeated courses with the drug (this is my fourth round of shots). Usually temporary and self-resolving. No particular sign of infection or allergic reaction so far.

I know it would be tough to stay off the bike for 6 weeks, but I think I would get the surgery, rather than take steroids for the rest of my life. That's easier to say, than to do though.Good luck.

Knee is 25-30% better today. Swelling is down, pain is much better. Hope to be back on the bike by Monday.

I'm not worried about time off the bike to recover from TKR surgery, more about whether it's a long term solution. Steroids? I'm not getting steroid injections. Synvisc is not steroids.

No steroids is good to hear.
I wish I had a quick fix for this arthritis.

Pcad,

I had one of my ankles fused with 9 screws and a plate last December. It had osteoarthritis resulting from college sport injuries. 15 years ago I had to give up basketball and softball and found cycling. I could ride my bike all day but couldn't take a 1 mile walk with my wife. I had last been to the doctor 10 years ago when he suggested the fusion surgery since there were no artificial ankles that would have sufficed or cartilage injections. I went a new doctor in October of 2009 and got the same answer. The doctor said that I would be the one to make the call on the fusion surgery. I scheduled the fusion that day based on completing the last cyclo cross race, finishing the “honey do list” and being recovered somewhat for the holidays. Imagine my wife's reaction when I got home from the doctors with the news.

In my case I knew it was time to get the fusion and give up the pills that I needed to take for inflammation. I was able to think back a few years about things I could do that I longer would, due to the pain or aggravation of working around the pain. Just pushing a wheelbarrow was a painful endeavor that took much concentration. If your injections give you the quality of life and mobility you desire then why would you have a TKR? If a new knee will give back mobility and no pain then why not have the TKR? That will be your call alone since you will live with the results.

You made a wise decision to post you question on the geezer forum. Many of us have some new replacement parts, parts from someone else, animal parts, shiny screws and plates, and even some with a few parts missing.:D

I had a TKR in October, 2008. After rehab I have no issues. it feels like the real thing except it doesn't hurt. I rode 5,921 miles this year on 3 different recumbents and expect to do more next year since I just retired. You have to work at the rehab but it's worth it.

It's not that simple. The Synvisc injections will work for a while, but they may well lose efficacy at some point (which may already be happening) and then you're on drugs all the time, then the TKR starts looking more urgent. I don't want to ride a recumbent bicycle with a TKR, I'd like to RACE a regular bike, and that's weight bearing (if low impact) and much more stressful on a TKR. I'm getting mixed signals on whether this is possible. Again, I suspect that it is, but some doctors warn you against it to err on the side of caution. My doctor seemed to think once I was rehabbed that I'd have the range of motion and I could hammer my bike.

Oh well. I'm not there yet. Knee is 20% better today, that's a great sign, hopefully I'm back on my bike by Monday.

Thanks for all the responses, keep them coming, this is really about the only place I'm going to get this informed feedback. But don't get the idea I'm as old as you guys.

Corrected for accuracy... And I am glad your knee is better and I am sure it will be fine.

I believe the correct formula is

SMARTNESS = 100 + your age.

Smartness is realizing how dumb you really are.