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Knee replacement
NB: Originally posted elsewhere on the Global Riders Network and appears via syndication.
After putting up with the pain of damaged knees for the past few years and having just retorn all but one ligament and shredded what was left of the miniscus and articular cartilages, I'm going for knee replacement surgery and looks like it will be total knee replacement, but deciding if I can get away with the less radical surface replacement.
So the question is - anyone still riding MTB's after these types of surgery. Any recommendations/suggestions/information? Any and all info will be appreciated.
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Had to have it done a 2nd time as the first lot of artificial knee's were defective & they broke!!
Same here (Except for the "broke" bit), a good friend had both done one year apart, just a couple of years ago. he's not a mtbr but a theoretically retired crayfisherman in his 70s, meaning he's at it everyday of the season. Because the knees are used to absorb the impact of the boat slamming into the waves, I would think it's not that dissimilar, punishment-wise, possibly worse in fact. I should also add: he's an ex rock'n'roller from the Snakepit who still takes over the floor, given half a chance...
After the op, the Dr told him: No pain, No gain, and it was exactly that. If you want to regain flexibility, you just have to exercise, exercise, exercise, and the better your form is when you go in, the quicker you'll get back on top.
Beyond this, I'd say: same as your bike, make sure you get a good mechanic!
Best of luck.
Two broke! - urgh - almost as bad as the recall on hip and knee joints already fitted! That really inspires confidence :/
Thanks CyclinAl: I'm expecting some intensive therapy fortunately will be transferred to a hospital after the Op that has a full recovery gym and spend a week there, should be painful, I mean interesting
any more?
I had major knee surgery a couple of years ago. Not a knee replacement but cartilage graft. It's supposed to delay knee replacement but quite a new procedure which hasn't been proved yet. It's no longer funded via private health insurance. Unfortunately it didn't work and the experience was similar to having an axe through my knee and a lot worse than pre-op. Patients in for a knee replacement were doing way better than me.
It's been a long rehabilitation road to try to correct muscle imbalance in my right leg. Was back on the bike after 6 months but very much weaker. There are lots of posts on mtbr regarding knee replacements so they may be useful for you. I am a big fan of SportsMed subiaco as they have helped me immensely. My rehabilitation program at the hospital where I had the operation was not effective in getting my VMO quad strength back at all and the program they gave me has been very effective. Would be interested to know how you go as a knee replacement for me is likely in the future. I highly recommend anyone with knee issues to go the physiotherapy route before surgery.
I work in the orthopaedic medical device industry and the general concensus is that resurfacing and partial knee replacements are just delaying the inevitable total knee reconstruction.
The technology and accuracy nowadays of computer navigated and patient customised implants has vastly improved outcomes.
See http://www.aboutstryker.com/knee/procedures/tria...
Also, one of the best ways to find the best implants is through the national joint replacement registry. The australian orthopaedic association (AOA) racks the performance of every hip and knee implant done in Australia.
The lastest registry results are here https://aoanjrr.dmac.adelaide.edu.au/annual-repo...
The most important thing to do is to visit a few orthopaedic surgeons to get opinions.
If you would like some names of ortho surgeons, PM me.
Good luck.
Oldernslower: I saw you settled for "Healed knee ligaments". Was that the natural way, by taking it easy till it was better or did it involve some medical intervention? And what was your final appraisal on the knee replacement option? C'mon, you're pretty good with the detailed technical analysis!
Cjmaw: And you took the dive! Best wishes for a prompt recovery.
Can you let us know how you go? (Bit of a diary like...) I'm not at that stage yet but I can't help feeling that it's a decision a lot of us will have to contemplate one day. So the more first hand info, the better the decision.
Thanks
CyclinAl
Disclaimer:
I'm no expert on this area THIS IS NOT MEDICAL ADVICE so you should read the following as my perspective based on my experience only, and look for discomfirming info on the points made (here endeth the disclaimer!)
I'll give the long story (soz) as it better explains my decisions.
So the 'fuller' story is that I have stuffed knees (body?) due to a misspent youth, misspent middle age and now a misspent 'mature' age :/. So with climbing, skydiving, MX, speedway, road racing, MTBing, squash, etc. etc. I've torn, dislocated, fractured or broke just about everything above, below and between the femur and collar bones which have survived untroubled! Had both meniscus and cartilage operated on and the knee joint scraped and drilled twenty or more years ago, so the knees were past the use by date even then. They were prone to dislocation due to loose ligaments (years back they just stuck you in a plaster cast if you tore knee ligaments) and a little arthritic (due to meniscectomy?)
Recent injury was while 'training' for the C2C and pushing bike up 30% grade (I did say misspent) the knee twisted, made the usual graunching sound and sharp pain. In addition my back also complained (previously fractured vertebrae) so was laid up with that for a couple of weeks – ie enforced rest.
When back recovered I cycled a few times but the knee pain suddenly got worse and had to revert to crutches for a few days (I have my own pair
). Having had it before, I knew I had torn ligament(s), that they were almost certainly still attached. Option was to have it examined or just rest it. I decided to just rest it further and see if the ligaments healed ok and if the joint itself was further damaged. The ligaments improved, the knee became more stable BUT the joint itself ached and bloody hurt. Took the plunge and saw a surgeon who recommended a knee replacement (there are a number of types, this was for a partial (resurfacing) not total replacement where they cut the old joint out).
The scans revealed – arthritis, further meniscus and other cartilage damage and torn ligament except for one, arthritis and impact damaged joint.
That is when I put the original post up. I got good advice for which I am exceedingly grateful, which I finally accepted, and am looking at a second opinion. Have the names of a couple of recommended people in the field so am more confident about the future.
However, the rest, for around 8 weeks, has resulted in the ligaments healing, the knee stabilising a bit more and the joint being less painful with less swelling. I can now do some weight work and cycling and am back in training for the Karii, recently did 40km and the pain was manageable. Not sure if I'll make the Karri 100 but will just have to see.
So I was lucky enough to have excellent advice from a member of this board and the link given on here by Jpack. I would suggest you read the report if you considering a knee joint operation. For example, in one type of replacement 25% come loose over 5 years and need re-operating on. Also search for the evidence on Meniscectomy and 'arthroscopic surgery' on medical websites that allow access to articles/abstracts such as this: http://www.jaaos.org/content/15/11/647.abstract .
And get good advice. I've not stated the members name who kindly gave his time and advice as I would prefer not to drop them into having to handle queries without their permission – hope you understand.
So the healing, this time, was the 'natural way', but that was for my knee with my experience.
Verdict on the knee replacement option: Get good advice and referral to someone who deals with sports people. Maybe get multiple opinions. Read the links given by Jpack and familiarise yourself with the terminology. Don't do what I initially did, decide that the knee had finally given up the ghost and needed replacement, so I went to the surgeon expecting a knee replacement and didn't ask the right questions. Research the literature on Meniscectomy and 'arthroscopic surgery', but ONLY from authoritative web sites.
Verdict on Meniscectomy and Arthroscopic Surgery – for me with my experience my decision, leave it and see how it goes – THIS IS NOT A MEDICAL ADVICE but based on my experience with my history. There is some evidence that this surgery is not required on some injuries – but that is contentious and disagreed with by some. For me not having arthroscopic surgery again, was easy to make. Research the literature on Meniscectomy and 'arthroscopic surgery', but ONLY from authoritative web sites.
Again apologies for the length but it provides the context and hopefully helps and not confuses – happy to answer other questions on here or PM me.
Hi CyclinAl,
My operation was not as big as Oldernslower was going to have with a knee replacement.
I had a left knee reconstruction with an ACL replacement using a hamstring graft, some medial ligament work and meniscus work, and at the same time had a plate and screws removed from my left ankle from a previous surgery a couple of years ago as it was annoying me when wearing my motocross boots.
This is my 3rd knee reconstruction on the left knee, all motocross related.
This operation was carried out on the 6th December, light passive physio and walk with full weight added by crutches on the 2nd day and discharged home.
First couple of days at home was full bearing with assistance from crutches and trying to keep swelling under control with ice packs on knee and ankle.
About 7 days after operation was full weight bearing without crutches, and continue to carry out passive physio trying to get full extension and flextion.
First doctors appointment 12 days after operation and was able to drive myself to doctors in manual car.
Doctor was happy with progress and said I was about 3 weeks ahead of schedule.
Is now just over 3weks since operation and am stationary cycling on my roadie on wind trainer, Hardly any swelling or pain.
The thing that gave me the most grief out of all this was my ankle after having plate removed,
Sorry if this is a bit long winded but that is the progress so far.
Should be able to return to work on full duties on 13th January , I'm a mechanic by trade, but no motocross for 9 months from operation date , which is a killer, hopefully get back on mountainbike trail riding in a couple of months.
Chris
Those older (and hopefully younger moto people on here) will all know the name and remember him as one of our best. I used to ride with him occasionally and his advice on knees was " until you can't walk on it don't touch it". I remember one dumb crash he had all but tore the last of one knee ligament but he just took six months off and hit the gym and road cycle. Obviously not medical but from a bloke who put his knees and body through a lot his belief was replacement are never 100%
Yep, remember Glen Bell well, raced a few races against him back in the Mr Motocross days .
Was a great rider, will always remember those flourecent orange Marlboro yamahas.
I had to get the knee done as just about every time I landed of a decent jump onto a flat landing the knee would give way and pop out of joint.
Last local race I did at end of this year, in the 6 lap race knee gave way and pop out of joint 5 times ,and that was wearing knee braces, was just getting to painfull and doing more damage.
I had put surgery off for about 12 months but had to bit the bullet and get it done.
I wish i could have read this thread before my last menisectomy.Before the operation i was able to run ok,now i think my running days are over.It's only running i have the problem with just too sore to run anymore than 500 metres.
Thanks for the follow-up Oldernslower and Cjmaw.
), just adequately comprehensive, and full of the valuable common sense that only comes from first hand experience.
I didn't think your replies were overly long (Though coming from a bloke credited with the longest post ever, it may not mean much
And I think their service to the general public interest is clearly demonstrated by Bluray's post above...
Most readers will probably think this is "old fart" BS but just remember, one not-so-distant day, provided Alzheimer hasn't also taken its toll, you may well find yourself thinking: "Shit! What was that bloody post about buggered knees, surgery and staff..."
So, if you two guys don't mind, it'd be great to hear from you as you endeavor to pedal your way out of creeping crippledom