Is your left knee jealous of the new knee's bling?


S

My left knee feels exactly the same way it did when I was 20 years old. Never had a problem with that side.

15 mins on the trainer today. Knee wasn't so happy about it.

Shut up knee.

May have to push my riding plans back a week, we'll see, hopefully it loosens up by Saturday, I'll be on the trainer daily. I can't just hop on and ride, I have to loosen it up on a stationary trainer first, takes me 5 mins of rocking the knee to the outer edge of the circle before I can force it over and then a couple of minutes to loosen it up, I can rotate the legs backwards first, then once they get loose enough I can force it around forwards, then I have to push that for 100 revolutions or so to get it limbered up, then I can get on a road bike and try to ride.

Who's pcad?

Just kidding, uncle. Nice progress thus far, even with the minor setback.

Serious question from one contemplating the TKR: was there a tipping point that led to your surgery or can you describe the compromise you experienced that led to your decision? I have been on the fence for a few years and I am still on the fence. Sometimes cortisone helps for 3-5 months, sometimes not. When a ride has more pain than not, then I think about the TKR, but then things get better with a cortisone shot. Hiking, walking any distance, and those types of things are just not possible, but I can ride a good percentage of the time without pain or with a cortisone shot to mitigate the pain.

I think he was basing it strictly on looks Gramps...

TKR time for you. For 20 years my ACL reconstructed knee was fine for the activities I wanted to do, cycling, hiking. Then for the last five years it got very arthritic, but I was still getting 6-18 months of very good results from Synvisc shots. I knew they wouldn't last forever, and as soon as it was apparent those shots were no longer working I scheduled the surgery. I had a good knee surgeon lined up, I've known him for 28 years, he's one of the best in the USA, so that helped. But find a good one and get it over with, it's a month or two of pain and a few months of tough rehab, but you'll be back on your bike and walking/hiking without pain in 3-4 months. Well worth it.

90% of the people you'll talk to will generally say they should have had their hip or knee replacement five years earlier, my guess is once I'm back on the bike riding 200 miles a week in a few months I'll feel the same way.

Thanks, I appreciate the reply!

10 miles on the road bike today on the MUP. Slow, little ring, 13 mph or so, but kept it spinning for 40+ minutes, minimal pain/discomfort. The knee is getting more flexible. Should be riding daily soon, riding hills within a couple of weeks. Tomorrow is 7 weeks post-op.

Congrats on the progress.

Seriously, what is involved in a total knee replacement and why did this become necessary? Sounds horrible...good luck healing.

It's become rather routine, they have been doing them for 40+ years. My surgery was a long time coming. People generally get knee replacements because of prior damage to the knee (as in my case) that involves cartilage loss, and once that gets bad enough it's your only option. Or your knees can just wear out. But considering the progress they have made it's a great procedure, a few weeks of pain, then some tough rehab, but generally you're back to pretty normal for a lot of stuff (like cycling) within a few months.

They essentially implant one of these:



I'm amazed at how fast it's coming around. I'm 7 weeks out, by 4-5 months out this will feel like my healthy, natural knee. Hell, I can already ride a bicycle, that's amazing.

Looks like someone's CAD drawing for patent filing?

I'm wondering whether cycling is good for knees (assuming you do it right--no high stress low cadence). I don't have a history of knee problems, and they don't hurt, but I weigh 200 and am 57.

Patent drawings look nothing like that.

Yes, cycling is generally good for knees and it won't wear them out unless there are other problems, usually not caused by bicycling.

I weigh 200, have ridden at 220, and I'm 60. I climb 300,000 feet per year and have ridden around 170,000 miles. No knee issues yet.

Awesome. 7 weeks is pretty fast. I would think that from a lot of cycling, other parts surrounding the knee, like muscles were in good shape, and that was helpful.

Fast recovery compared to most TKR patients I suppose, but pretty typical for active cyclists 40-65 years old who have the procedure from what I've seen online. I've seen accounts of people cycling 4-5 weeks post op, which is kind of amazing. I was able to get my knee around the crank revolutions for the first time @ about 5 weeks post op, got on the road bike for 10 mins or so a few days after that, did my first real ride @ just shy of 7 weeks post-op.

My surgeon told me I'm going better than 90% of his patients, but you figure 90% of his patients are older, fatter and less fit than a 56 year old long time active/competitive amateur cyclist.

I'll rest today (it's rainy here anyway), ride again Fri/Sat/Sun, it's supposed to be warm and dry. Hope to get it up to 30 miles. Still avoiding any steeper grades.

Regarding steep grades, ever consider (God forbid) putting lower gears on your road bike?
You still have the Ti mtb? You might be able to use it as part of your rehab.

Bring it on you filthy casual, see you in the peloton

For all joint replacements it's a balance between how long they will last before a need for replacement and how much you can reasonably endure. For me, with a recent hip replacement, the guideline was my ability to work effectively and the ability to get sleep that was uninterrupted by pain. When either or both , as it was with me, became the case then surgery was the answer.
The vast majority of orthopedic surgeons routinely and reliably perform both Hip and Knee replacements. They are considered the " bread and butter cases" of orthopedic surgery, i.e. commonly performed. The ankle and shoulder require a person who has more experience with the procedure.

Personally, I would not want surgery from anyone who does not specialize in knees and hips, but YMMV. I selected a surgeon with those qualifications and who is also a cyclist, not someone who rides a bike, but a cyclist. The tipping point issue is one part of the equation: I have trouble sleeping --at times --because of knee pain, I have trouble walking any distance --at times --, and I have otherwise restricted the range of activities I do because of my knee(s). However, I can cycle for a reasonable amount of the year without pain, but then there are those times when every ride has more pain than not. I am 70, I have had two heart attacks, but I am in good health and ride 6000 or so miles a year and most of my rides involve climbing. I can average 18mpg over a reasonably flat 45 mile course, so I am no speed daemon, but I am happy with where I am cycling. I decided that given overall health can change in a heartbeat --- or not --- I am going ahead (at PCAD's urging!) with the TKR while my health allows it.

My past hesitation is the unknowns about cycling post-TKR. Now, there is plenty of literature that says riding a bike is good exercise post TKR, but riding a bike and cycling 200 miles a week and climbing 12-15k a week are different things. I have consulted four different surgeons and 2 suggested that I might not be able to ride at that level after surgery. The surgeon I selected gave me a strategy for how we would proceed after surgery to keep riding at my current level. As far as I can tell from a casual look at the medical literature, there just isn't a lot of data about the long-term effects of high activity among persons with TKR. There are a ton of anecdotes from individuals who have done remarkable things, but in the four years I have been contemplating this I have also heard enough horror stories of TKR gone wrong that I realize things there are no guarantees. I have not done a literature scan in 6-9 months, but the studies I have seen before do show some promise that those who have successful surgery without significant complications have a good chance of riding at whatever level we choose.

Good luck with the hip and let's hope there are no knee issues in your future!