Need encouragement for upcoming knee replacement

[bjoyful]

I am scheduled for a total knee joint replacement in March. Anybody else out there who has had one that can give me some encouragement? I have never had any surgery and am really worried about the whole thing and wonder if I will be able to bike "like before." Normal riding was to ride 10-20 miles 3 -4 times per week and then do longer rides 30-40 miles every month or so. However during the winter months I normally use a trainer as the cold seems to activate the arthritis more. I'm 56 and didn't want to have a replacement now, but I've tried Synvisc and Supartz injections with no real relief and doing stairs has become extremely difficult. I quit cycling and spin class (knee pain became too intense), but if I can stand it, do you recommend I try to get on the trainer as a way of "preparing" for having the surgery? I'm worried also about falling while biking after surgery and what that could do, clipping in and out? Will I have a biking life after the knee replacement? As you can read, I'm working myself up to be a "mess" and need some reassurance from anyone else who has had total knee replacements.

[Zen]

I'm gonna lay it right out here. You will probably be in a pretty good amount of pain immediately after this but if you have good PT it will only be a a short time before you're back to normal. A new normal.

No problem riding, it will be part of your PT anyway.

The most important part of this is not the replacement itself but the PT.

[kmehrzad]

My neighbor had a double knee replacement last July and the beginning of September I saw her riding her hybrid bike on the W&OD Trail. I couldn't believe it was her riding so soon after having both knees done. She's in her mid to upper 50's (I think). Hopefully you'll recover as quickly.

[Biciclista]

ps if you're worried about clipping in and out, your clips are too tight. The few times I've fallen, i did not stay clipped in and do not remember clipping out.
good luck to you. My husband will be a candidate for this surgery one day too, so I will be watching your progress.

[Trek420]

I'm 53, my joints are a train wreck. Someday I will be right there with ya'. But I hope I will do everything I can to delay that. I will train, strengthen, stretch, keep moving and for me most important right now try to lose weight to take stress off the joints. This is because my particular type of arthritis I've been told does not respond well to surgery.

I have no medical experience, can't tell you if your decision is right or wrong and can't imagine your pain. Your pain is your pain. What's "oh heck I'll pop a tylenol and go ride" to you is "stay in bed" to me.

But I'll consider knee replacement when I can't walk with a cane, or maybe two canes. Or maybe when I can't even swim.

It's not a knee replacement it's an amputation. And once you're on that road if you don't train and do PT like a pro athlete and they have to do it again .... go in and cut away more bone .... and again ....

I think it's different for us. By us I mean those who train. I think a lot of things are different because we ride, run, walk .... move

I have several nonathletic friends who went through joint replacement, initially they were enthusiastic about PT because of being pain free. But because exercise was really not part of their lifestyle they quickly fell off the bandwagon. All 3 have had to do it again .... one's now in a wheelchair after the 3rd.

My aunt just had both knees replaced at 80'ish. A lifelong and daily swimmer and gardener it finally got to be just too much. She's back to both activities daily. That would be my goal if I can swing it, do everything I can do to forestall the day.

I'd even ::::gasp:::: get a recumbent before getting my knee replaced. But then if you decide to do it I'm sure the PT will hurt but do whatever your PT says and keep at it for the rest of your life.

[OakLeaf]

My mom had both knees done a little over two years ago, at age 70. She doesn't regret it for a second.

+1 to what Zen said. Don't be shy about taking your pain meds, and if they give you side effects you can't tolerate, ask your doctor to try something different. PT will hurt like @#$@%, but it will make all the difference in whether your surgery is successful.

My mom was never a cyclist, but she's been a birder for many years, and had her knees done because she couldn't climb trees any more. She's back at it (although I'm not sure her ortho approves ).

Stationary bikes were not part of her PT, actually. Unless your PT is a cyclist who can help you with fit, you'll probably want to have your bike re-fit after you're released from PT. Poor bike fit can cause trouble even in healthy knees, and you'll want to make sure your alignment and range of motion are where they should be - and they probably won't be the same as they were before your surgery.



PS to Trek... you obviously get better advice than I do but I will say that all the PTs told my mom that most people put off arthroplasties much too long. If someone waits until they're near-immobilized by pain, then their muscles become deconditioned, and recovery is much, much more complicated. My mom, on the other hand - well, let's just say sometimes denial is a workable strategy. She continued to exercise through her pain until she decided it was the pain, not the exercise, she refused to tolerate any more. As a result, her progress through PT was stellar and she's back to climbing trees.

[KnottedYet]

One of my patients had 2 knees and 2 hips replaced, and rode the DALMAC every year. (300-400 miles)

Every one of my TKR patients gets put on the stationary bike immediately. Rocking the pedals back and forth helps mobilize the knee and is incredibly useful even if they can't pedal in full circles.

Before your surgery your doctor will send you to "prehab". That will be 2 or 3 visits where the PT evaluates your entire leg and gives you specific exercises and stretches to address the tissue problems that need to be improved before surgery.

Surgery itself is intense, I won't sugar-coat that. But they will not let you out of the room or wake you up until they've put your knee through full range of motion and are sure it's perfect.

Rehab may be with the same PT who did your prehab. Rehab is all about getting your tissues healed up from the incisions and getting your muscles and nerves caught up with the perfect knee. The joint itself is fabulous, you just have to get everything around the joint up to speed. You'll leave the surgical suite with a knee that goes from 0-120, but the next day it will hardly move as your body goes into high gear to heal. Don't panic! It all comes back!

I would think that after trying all the non-surgical options and being in pain every day, you will be very pleased with your replacement!

[Trek420]

My mom, on the other hand .... continued to exercise through her pain until she decided it was the pain, not the exercise, she refused to tolerate any more. As a result, her progress through PT was stellar and she's back to climbing trees.

Hey, I can't climb trees now!

*\0/* *\0/* *\0/* Oakleaf Mom! *\0/* *\0/*

Whatever keeps us climbing trees and riding bikes. Keep moving!

[bjoyful]

Thank you KnottedYet so much for your knowledge about the subject!! It was very helpful--perhaps by March I will be ready physically and psychologically!!

[Trek420]

Before your surgery your doctor will send you to "prehab". That will be 2 or 3 visits where the PT evaluates your entire leg and gives you specific exercises and stretches to address the tissue problems that need to be improved before surgery.

Knott (and/or other medical type folks): sounds like a doctor would send you to PT for evaluation and to get ready for PT afterward. So by definition they won't do the surgery unless you are ready for the rehab.

bjoyful it sounds like "when the patient is ready the knee will come"

Keep us posted and wishing you many many happy miles. Oh, and welcome to TE!

[kmehrzad]

I'd even ::::gasp:::: get a recumbent before getting my knee replaced. But then if you decide to do it I'm sure the PT will hurt but do whatever your PT says and keep at it for the rest of your life.

Hey Trek, I have a recumbent, in fact I have three of them - two long-wheel base bents and one short-wheel base bent. I have no back or knee problems but just enjoy the ride. It's very relaxing and they move quite well. Give one a try sometime; don't wait until you physically need one to keep riding.

[Trek420]

Mmmmmaybe Right now I don't have room for another bike but if we did .... Like Jimmy Carter I've got bike lust in my heart for a recumbent tandem.