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  1. #1
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    Total Knee Replacement

    Hello,

    I would like to know if anyone out there that mountain bike rides and or races has had a total knee replacement ? I am facing a total knee in june and love to mountain bike race but I am really nervous that I might not be able to ride as aggressivley as I do now.

    Any advice is greatly appreciated.

    Liz

  2. #2
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    had a total left done 12-28-12 started riding 4 weeks after surgery.pt was going good so they gave me the ok.It has been a learning adventure.Been putting in long base miles and ride according to discomfort.Just listen to dr an pt therapist.what is reason for tkr? if you dont mind asking.

  3. #3
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    take a look at this product before you pull the trigger on the knee. I have been working in the medical device world for years now. I carry this product along with several others (including total knee devices) and I have seen fantastic results with it.

    I personally have about 250 patients in the Santa Barbara area on the BioniCare and have seen fantastic results. Not an overnight fix, but if you are trying to buy some time before you have to get the replacement this could help

    Knee Osteoarthritis Treatment Hand Rheumatoid Arthritis Treatment

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    Hi Liz, Im Paul and Iím posting here because I strongly believe that sharing my sisterís story can help others Ė before you are done testing and make a decision please read..

    About 2 months ago my sister had a TKR. It happened to be that I had the same surgery myself 2 years ago. Itís not an easy thing to go through, and I made sure to be as supportive of my sister as possible. The surgery went well, she was recovering, and then, all of a sudden, 2 days after the procedure she almost bled to death. Thereíre many things you take into consideration when going through knee replacement Ė will the surgery go well? Will I wake up from anesthesia? Will my new knee be rejected or not. I discussed these things with my physician in detail, and so did my sister. But apparently, thereís a risk of internal bleeding caused by anticoagulants that are injected after surgery, to prevent the blood clots formation. The risk is not exceptionally frequent, but my sister happened to be in the unlucky part of statistics. When she was in an emergency room, I realized that going through the similar procedure in a different hospital I wasn't even prescribed anticoagulants. I remembered being on baby aspirin and a portable compression device for about 10 days after the surgery. During my recovery period, I didn't think too much of it. But when my sister was bleeding to death, I kept thinking that if she was prescribed that device instead of anticoagulants, her life would probably not be at risk.

    I did some research and found the name of the device. Itís called ActiveCare+SFT, it applies soft compression to your legs, and somehow prevents clots formation without a need of anticoagulants. Hereís their website. They also have a list of hospitals where this device is prescribed.



    Read about it, and please spread the word! This is the best life saving tip anyone can give you if youíre going through any lower limb replacement surgery.

    MCS Learn How to Reduce DVT Risks .

    Another site to help you with your concerns for riding again..

    Bike Riding After A Total Knee Replacement | LIVESTRONG.COM

    I was back to riding (road) within a cple months, I really feel it depends on the person and how determined they are... Do that physical therapy and strengthen and condition your knee and you will be riding in no time... Best of luck, Paul

  5. #5
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    Sorry for the late reply , but my knee has so much arthritis from an old injury and I also have basically no miniscus so it rubs bone on bone. It almost looks deformed from all the arthritis and I also have 3 bone spurs and that all combined is limiting my range of motion and making any type of cycling uncomfortable . It stinks and I'm scared ! All I want to be able to do is cycle and weight lift and mountain bike race , thats all I ask...

  6. #6
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    I did not have knee surgery but bilateral (2 at once) hip resurfacing about 4 years ago, it is similar to THR. I also had very bad arthritis in both hips and was bone on bone. I have no problems mountain biking and zero pain although I do ride with more caution. I could race if I wanted to but I did plenty of that in the past and do not desire to do it any more. There is a procedure called knee resurfacing that is now available but I do not know much about it, but it is worth looking into. There can be cycling after joint replacement, but the surgeon and device choice is critical. They are not all created equal. If the surgeon screws up or is not super experienced you in for a very tough road, you will not be able to live w/o painkillers never mind ride a mtb. I cannot emphasize that enough. Good luck

  7. #7
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    Both five years ago

    Had both replaced five years ago. My 63rd birthday ride:

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  8. #8
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    I am 5 weeks and 2 days post total knee replacement surgery, I have been on the stationary bike over 3 weeks now. my flexibility is actually better now than before my surgery. still doing my rehab gaining strength and stamina again. this stiffens up when walking for extended periods of time. my therapist is impressed of my progress and says the good progress is due to riding before surgery. my doc said the only thing I can't do is mogul ski. I might try the actual bike this coming week just riding around the neighborhood. I think it will be a couple months before starting some easy trails. I'll see what the doc says.

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    No moguls, FTS!

    I see a lot of heli skiing in my future.

  10. #10
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    I had a TKR last April (2013), biking is key to recovery I promise, did a lot of stationary for a little while the started on bike paths about week 4 and worked up from there. I was riding my dirt bike at 4 months and doing MTB trails about the same time. I am doing fine right now riding both, no limitations other than a little scar tissue still breaking up from time to time. Only thing I wish was is that I had not waited so long, lived in pain way to long, mine started by shattering the top of my tib June 2010, tibial plateau fracture.

    TKR = no more running, you can but your knee won't last as long! no more moguls' as someone already mentioned. But pretty much the rest is fair game.

    TKR's are pretty much routine surgeries these days, there really isn't a bad prosthetic but do meet with a couple doc's and make sure you agree with their recovery plan, aggressive, passive etc. resurfacing ( not even sure they do that)is nothing more than a interim solution, you'll get a knee eventually anyway, same for partials. Most people that get one are not like us,they are already not active and live sedentary lifestyles, probably don't do their PT like they should after surgery and complain later.

    I met with four or five surgeons before mine, honestly and this is just an opinion, if they mention an osteotomy, resurface or partial I say run, don't walk..away. Most knees are considered 90% knees meaning at 15-20 years 90% of folks across the board still don't need a revision. Honestly after breaking my tib I would take a knee replacement surgery any day, the recovery was 10 times easier. It is rare that people reject the prosthetic and infection protocols are very complete these days. My wife is also a surgical RN so between my own research and her I have a pretty good feel for it. Let me know if you have any other questions.

    My avatar is after I broke the tib, 4 hours putting it back together, bone grafts, plates and screws, ACL, cartilage and MCL damage...long long recovery plus they had to removed the plates and all screws during the TKR surgery, overall the TKR was easy.

  11. #11
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    Gobylvr I wonder how you are doing now??
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    I am at the start of this myself. I've had several scopes and micro fraction and knee is shot. I still ride but need lots of Advil to continue and avoid standing and grinding up hills. Running or even good walks cause lots of pain so my only decent exercise has been my rides. Had two doctors say I need TKR but because I'm 48 they say they would do partial first. I really don't want a partial as I've heard lots of negative stories.

    Should I be forceful in not wanting a partial?

  13. #13
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    Second opinion

    Quote Originally Posted by MTB Dad View Post
    ...Should I be forceful in not wanting a partial?
    Get a second opinion. One orthopedist said I wouldn't be able to bike, while the second opinion encouraged me to bike. I took the second opinion and I have biked thousands of miles since!

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    I had a third doc (friend) look at my MRI as well and agreed TKR is gonna be needed but just cause I'm under 50 they keep pushing a partial. I'm only 14 months short of 50 so I don't get it...
    As long as I can continue riding I don't care just don't feel like going through major surgery twice as it seems partials don't seem to last from what I've read and heard.

    Anyone have an opinion on partial?

  15. #15
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    MTB Dad- my orthopedic surgeon told me good candidates for PKR are rare and that he can't know for sure until he's in there. I am also in that pre-surgery limbo and hoping to make some good decisions. I can no longer climb out of the saddle because the bad knee doesn't have the strength to make the full rotation. It really pisses me off. I am 56.
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    Finally got the attorneys on both sides to allow surgery. Injuries were all at work so I've been jumping through all the WC hoops. I am to have surgery in 36 days. I found a doctor I like and as you stated LadyDi the doc says once in there he'll know for sure but he is still leaning toward PKR as the other side looks really good on all MRI's.

    Only thing I can do exercise wise is ride and that's with lots of Advil. I'm riding close to my fastest times on my 20 mile loop with about 40% of it being climbs. If I do more miles I get pain and swelling.

    Anyone riding with PKR and if so are you still going as hard as before? I gave up all other sports due to pain and swelling but cycling has been my saving grace which is perfect as it's always been my #1 past time. If I can still ride is all I care about.

  17. #17
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    Looks like we'll need to ask George Bush how he's doing with two new PKRs.

    (please people don't jump on me for posting a Fox news article- it's knees, not politics).

    What we can all learn from Bush's partial knee replacement surgery | Fox News
    Last edited by LadyDi; 09-24-2014 at 04:14 PM. Reason: Bad link
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  18. #18
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    Ok I'm typing this in my hospital room after having a PKR early this morning. I'm still a bit out of it but it wasn't too bad. I've already walked up and down the hall with the PT specialist. Says I can prob get on the bike in about 3 weeks, wahoo!!!!

    Boy I wish I was on my bike!!

  19. #19
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    Okay, now I wish I hadn't started a new thread (and titled it exactly the same!). I was in a pain fog at the time.
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  20. #20
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    Total Knee Replacement.

    Quote Originally Posted by gobylvr View Post
    Hello,

    I would like to know if anyone out there that mountain bike rides and or races has had a total knee replacement ? I am facing a total knee in june and love to mountain bike race but I am really nervous that I might not be able to ride as aggressivley as I do now.

    Any advice is greatly appreciated.

    Liz
    I had TNR of right knee 10 days ago. Swelling is starting to go down in my calf. Still can't go 360 degrees on stationary bike. I rode aggressively (for New Jersey) leading up to the surgery so I was in great shape when I went in. (Heart rate 49). Doc was so impressed day after surgery I was discharged with a cane instead of a walker. Biggest problem is knots in my calf from walking bow legged so long before surgery (he straightened my leg during surgery as beforehand it was half inch shorter than my good leg). Reading the posts is inspiring. I hope to get 360 degrees by Monday 12/29 and on asphalt by 1/15. Biggest problem is that I ride with my dog three days a week and he is getting ripped off because I am off the bike. He is a great trail dog, well mannered with other dogs, other riders and horses. There is asphalt off rode trail near my house. We'll keep you posted.

    Mike

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    Total Knee Replacement

    Quote Originally Posted by gobylvr View Post
    Hello,

    I would like to know if anyone out there that mountain bike rides and or races has had a total knee replacement ? I am facing a total knee in june and love to mountain bike race but I am really nervous that I might not be able to ride as aggressivley as I do now.

    Any advice is greatly appreciated.

    Liz
    I am 14 days post TKR, but my road to the OR covered 27 years and 6 surgeries and one non FDA approved treatment . I originally blew my knee part snow skiing that resulted in a full reconstruction. 7 years later, I had the knee "cleaned up." Roughly 8 years after the clean up, I had the two step Carticel (cartilage implants) procedure performed. Two years ago I tore my meniscus wake surfing. As a last ditch effort, I had a PRP and stem cell procedure. While I believe this procedure has merits for knew injuries, I did not benefit from this procedure.

    While I was hoping to be further along in my range of motion, the past scar tissue is slowing this down. Both the Dr and PT are pleased with the progress given my history. Currently I am at 85 degrees flexion and -5 extension. Leg strength is improving daily due to 3 times weekly PT and PT at home on the off days.

    Ironically, I was asked by a nurse during pre op, why would I go through with a TKR at 53 years old. My reply was simply so I could ride again as the post ride pain became so great, that I do not ride in the months prior to the procedure.

    Not so ironic was the decision to have this done. My Dr (who is also a MTB rider) said that when the pain kept me from riding, I would know it was time.

    I will post notable updates as I progress.

  22. #22
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    My Experience

    I had a total knee replacement seven weeks ago. I am 55. I trained for the surgery by pushing myself riding 3 days per week. I began my own bending exercises in the hospital bed that night and asked for a home program the next day. I started physical therapy three days per week three days after surgery.

    I worked out twice a day, either PT plus evening or morning before work plus evening.

    I was greatly rewarded. At my appointment today the doctor said my strength is six months post surgery and my range of motion is one year post surgery.

    I have only gotten on the bike outdoors once because of schedule, PT three mornings a week and horrific northeast weather. I am now cleared to ride and just picked up new bike shoes and cleats from LBS.

    I do not think a total knee replacment will hurt you at all as long as you follow pre op instructions (to avoid risk of infection) and are dilligent in your PT. Given the fact you are getting surgery in June, you could be back on the bike in August.

    I would not anticipate any limitations.





    Quote Originally Posted by Call Me FJ View Post
    I am 14 days post TKR, but my road to the OR covered 27 years and 6 surgeries and one non FDA approved treatment . I originally blew my knee part snow skiing that resulted in a full reconstruction. 7 years later, I had the knee "cleaned up." Roughly 8 years after the clean up, I had the two step Carticel (cartilage implants) procedure performed. Two years ago I tore my meniscus wake surfing. As a last ditch effort, I had a PRP and stem cell procedure. While I believe this procedure has merits for knew injuries, I did not benefit from this procedure.

    While I was hoping to be further along in my range of motion, the past scar tissue is slowing this down. Both the Dr and PT are pleased with the progress given my history. Currently I am at 85 degrees flexion and -5 extension. Leg strength is improving daily due to 3 times weekly PT and PT at home on the off days.

    Ironically, I was asked by a nurse during pre op, why would I go through with a TKR at 53 years old. My reply was simply so I could ride again as the post ride pain became so great, that I do not ride in the months prior to the procedure.

    Not so ironic was the decision to have this done. My Dr (who is also a MTB rider) said that when the pain kept me from riding, I would know it was time.

    I will post notable updates as I progress.

  23. #23
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    Eight weeks post surgery and I am trail riding. 5.5 miles Saturday on flats, today on my normal weekday before work trail. About 1/3 slower; 44 minutes instead of 34 minutes but there was ice I had to walk over so its not a real gauge. Did the log overs and easy hills. Some stiffness afterward but by mid day I was fine. All in all a good first ride. When the ice melts we'll get a true test.

    Keep on plugging away at two a day PT/exercise. Every day you will do more. Slowest thing now is quad growth. That's the next step.

  24. #24
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    You all are doing great! I'm 3 1/2 months post LTKR and back on the cyclocross bike so far, and clipless. I did 14 easy bike path miles Sunday and am paying for it with some increased swelling & stiffness. This "two steps forward/one to three steps back" nonsense has been a theme in my recovery. I'm okay with it as long as the eventual outcome is good. This far out I just need an occasional extra-strength Tylenol. I don't have full flexion yet, so I've got a shorter (170 vs 175mm) crankset ready to swap out on my 29er. I estimate I'll be trail-ready in a couple weeks. My knee feels MUCH stronger overall, no issues clipping in or out at lightest tension on Time atacs, residual quad weakness because of the surgical approach. I'll get there!
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    Updates

    Rode for 45 minutes yesterday with my dog who is a veteran trail dog and my daughter's dog who is a newbie we are babysitting while she is in Paris. No problems riding but overnight the IT band (ligament on the outside of the knee) was sore and woke me up several times. Worked itself out over the course of the day although tender in the morning. Guess that's what we mean when we say three steps forward two steps back. However, no pain while riding is great. I'll take the pain the next day.

  26. #26
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    Hi mrothmel- I'm up to 20 mile road/bike path rides, and I believe I'm ready for fireroads and easy trails. I feel better riding than just about anything else. Does your incision scar's appearance change throughout the day depending on your activity? Mine sure does!
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    Scar

    Hi Lady Di:

    I've not noticed any change in my scar during the day but I only look at it twice a day. I don't wear dresses. ;-{ )

    Seriously though, since the scar fully closed up I put Vitamin E cream on it every morning and it is healing nicely. Mine is extra long 6.5 inches because he had to remove a screw from my prior reconstructive surgery.

    Mike

    Quote Originally Posted by LadyDi View Post
    You all are doing great! I'm 3 1/2 months post LTKR and back on the cyclocross bike so far, and clipless. I did 14 easy bike path miles Sunday and am paying for it with some increased swelling & stiffness. This "two steps forward/one to three steps back" nonsense has been a theme in my recovery. I'm okay with it as long as the eventual outcome is good. This far out I just need an occasional extra-strength Tylenol. I don't have full flexion yet, so I've got a shorter (170 vs 175mm) crankset ready to swap out on my 29er. I estimate I'll be trail-ready in a couple weeks. My knee feels MUCH stronger overall, no issues clipping in or out at lightest tension on Time atacs, residual quad weakness because of the surgical approach. I'll get there!

  28. #28
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    I had a TKR in December of 2012... after that, the extreme pleasure of a hospital acquired MRSA infection. To get that under control, a spacer is put in my knee and a PIC line inserted to dose antibiotics directly into my heart for several weeks, then a few weeks off followed by opening the knee to swab. Tested positive for the bug, another replacement, another 2 weeks... multiply this until you get to four replacements. The last time, Dr. says "I think we got it this time". So at least I got a knee this time, except when the cultures came back to check for slower growing bacteria; still positive for MRSA. I take antibiotics daily (Doxycycline) to keep it under control, no problems after 6 years but if I don't take the meds for a few days, knee starts feeling "funky". Got back on the bike, good news, no problems! Mtn. biking has been my salvation through and after all this. If you are in a similar situation, you can do it!

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    I am now a few days shy of 5 weeks. While quad strength is coming around slower than I hoped for, I am riding the Aerodyne for 10 minutes three times per week while in PT. My range of motion is 0-110 with reduced swelling. I am using just a cane when out of the house and feel the cane will not be needed at all in 7-10 days. Stopped all prescription pain meds two weeks ago and rarely take Advil. The knee still hurts and I use a sleep aid as I was so tired from not sleeping. I notice pain in my shin and soft tissue around the knee that I would classify as a 4-5 on a ten scale. Ice and massage have been key as well as minimal heat. Ready to set up the trainer and move into the next phase. Good luck to the other TKR people that have posted.

  30. #30
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    stberhard stubborn infections like that are a nightmare! So sorry about all the problems and revisions, glad you can ride.
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    Curious about other experiences. I am 2.5 months post knee replacement. I initially had a problem with my calf spasming at night because the doctor lengthened my leg in the process to make it even with my good leg. That pain is gone. However now I wake up with overall stiffness in the joint. I ride the stationary bike for seven minutes and go back to sleep. Just interested if other people's healing process involves different "pain" as the swelling goes down and other issues heal. I am cutting back my home exercise program from twice a day to once a day hoping it expedites healing. Any thoughts would be welcome.

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    The weather here in New Jersey has precluded outdoor riding for most of February. The issue cold below 20 and ice, some covered by snow, which obviously creates dangerous riding conditions. We are doing an easy 11 miles of trail riding tomorrow morning in Wharton State Forest. Longest since surgery. I will let you know how I do.

  33. #33
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    Quote Originally Posted by mrothmel View Post
    Curious about other experiences. I am 2.5 months post knee replacement. I initially had a problem with my calf spasming at night because the doctor lengthened my leg in the process to make it even with my good leg. That pain is gone. However now I wake up with overall stiffness in the joint. I ride the stationary bike for seven minutes and go back to sleep. Just interested if other people's healing process involves different "pain" as the swelling goes down and other issues heal. I am cutting back my home exercise program from twice a day to once a day hoping it expedites healing. Any thoughts would be welcome.
    Your stiffness is likely due to edema in the joint. It can persist for half a year or more. At 10-12 weeks out I still had considerable swelling and stiffness. One thing I have learned is to treat "stiffness" as pain and take something for it. Extra-strength Tylenol works for me.

    I'm currently four months post op and back to work at a job that involves lots of walking and long hours on my feet. The first week back was *Not Fun*, but I am acclimating. Last night the Restless Leg Syndrome that plagued me earlier in my recovery came back. It's very annoying, but I can't call it pain- it's more like a need to keep moving and stretching that entire leg. I'm going to try a hot soak with good 'ol epsom salts.

    Every recovery is different, and folks who were previously accustomed to a physically active lifestyle have the most difficulty with enforced downtime. Weeks 8 through 13 were honestly my darkest hour; I was doing everything by the book yet not progressing as quickly as I though I should. Just one week ago I was cursing my decision to have this surgery, but today my knee feels strong and I'm very happy. I'm back on both road and mountain bikes, and slowly building my miles. Yesterday I did 23 miles and 1250 ft of climbing and practically forgot about my knee. Like you, I jump on my exercise (spinner) bike several times a day just to loosen up.

    It sounds like you're doing really well, and making good decisions about your activity. Rest is super important. Maybe consider some gentle warm water exercise, but don't neglect ice & elevation "toes above nose"- you still need it- yes, still!
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  34. #34
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    Dear Lady Di:

    Thank you for your encouraging post. You should be a doctor. I do have a bit of edema on the outside of my knee where the pain and stiffness are. I will keep exercising twice a day but ice after my nightly exercise as well.

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    mrothmel I had calf and shin pain in the beginning and now have slight to moderate shin pain and still have stiffness at night. Heat and ice as well as acupuncture help the calf and shin immensely. My PT says this pain is part of the process and is due to re gaining my gait. I also experienced pain in the tendons in the back of the knee and that has minimized as well. I massage the knee and ice as well as stretch 3-4 times per day and do strength exercises one-two times per day. Twice daily biking is too much at this juncture, so I do this once per day. Good luck.

  36. #36
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    I have been noticing that as one pain goes away, you notice a new one. I think its because the brain can only handle pain from one place at a time. However, I see it as progress each time one pain goes away. Next areas are swelling around patella. (I kept my own because it was in good shape) and slight pain along shin muscle due to leg lengthening. Snow still keeping me from outdoor bike riding. Hopefully next week. It has to melt some time.

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    Just do your exercises two times a day every day as prescribed by PT and you will progress. I am 12 weeks post. Still have swelling and some knee pain when hiking and stiffness in the morning. You will shed the cane. I would ride more but ice and snow in NJ are killing those plans.

  38. #38
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    I had double TKR two years ago. I am 54 and still road race (mostly crits). I was racing 4 months after my TKR. My knees feel much better than before the TKR. I can't run because it feels awkward, but riding is great. Yes I have had some spills but no problems with the knees. I'm riding dirt bikes (motorized) with Don Joy braces and still enjoying life. Make sure you stretch regularly and keep fit. I thought the double TKR was not bad but my knees were way past there replacement time when I finally gave in. It was like a new beginning for me. Finished 4th overall Cat 3-4 crit series in UT last year.

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    fun and observations

    Fun: Last Sunday got to ride with my Trigger (2.5 inch tires) in the snow. Only fell once when I went to slow. Boy was knee sore next day. (3 months post TNR). Tuesday I rode again 4.5 miles after snow melted and my knee felt great afterward.

    Observations. In my surgery Doctor kept my knee cap because it was in good shape. However, it was sore. Started taking Cartilage Companion (glucosamine/chondroten) and it feels better. Now my pain is along IT band (outside tendon) and a bit in lower quad. Not bad pain though. Stiff knee still wakes me up in the middle of the night. Also top outside of calf is a bit tender. However, nothing interferes with any activities. Just allowing healing process to continue.

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    Had my PKR Oct. 28 and just wanted to give a quick update. Prior to PKR I rode a lot and have for yrs. I was able to lightly ride after 5 weeks. Slowly ramped up after that to really racking up miles. I still have pain but not as bad as pre-surgery.
    There is light at the end of the tunnel!! Remember cycling and swimming are the best rehab for TKR and PKR!!

  41. #41
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    I am 5 months post TKR. Had a rough few weeks transitioning back to 12 hour workshifts and am now on a low-dose prescription anti-inflammatory called Meloxicam. I am doing leg presses, etc. at the gym and riding more. I am back on clipless pedals, and I replaced the 175mm cranks on my 29er with 170's. While I was at it I replaced my cf bars and seatpost. I love my bike more than ever. No pain at all over rocks. I always have initial stiffness in my surgical knee for the first few pedal strokes. This eases up after a while, and I hope it goes away completely over the next year or so.

    Someone mentioned "other" leg pains- I get IT band pain, also at the hamstring and calf muscle insertion points. So bad it intereferes with sleep sometimes. That is why I am taking it slow and only gradually increasing my miles. Next week I will attempt the climb to Griffith Observatory (in L.A.). I figure if I can complete that climb, no matter how long it takes, I am well on my way. Fingers crossed!
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    Checkup yesterday. Almost eight years now for both knees and had x-rays and thorough checkup yesterday. Knees are perfect. I do virtually all climbing pulling rather the pushing and doc said continue what I've been doing. Average ride last year 40 miles and 5.5k climbing, twice a week.
    Last edited by Wherewolf; 03-28-2015 at 09:01 PM.

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    Thank you for road map

    You are about 1 1/2 to 2 months ahead of me. Nice to know my symptoms are normal. First ride longer than 4.5 miles tomorrow. Pretty flat but maybe about 10-15 miles. It will be 32 degrees when we start. (Jersey is the new Arctic). Looking forward to leg feeling good afterward. The nice thing is that I'm starting to get definition in my quad.








    Quote Originally Posted by LadyDi View Post
    I am 5 months post TKR. Had a rough few weeks transitioning back to 12 hour workshifts and am now on a low-dose prescription anti-inflammatory called Meloxicam. I am doing leg presses, etc. at the gym and riding more. I am back on clipless pedals, and I replaced the 175mm cranks on my 29er with 170's. While I was at it I replaced my cf bars and seatpost. I love my bike more than ever. No pain at all over rocks. I always have initial stiffness in my surgical knee for the first few pedal strokes. This eases up after a while, and I hope it goes away completely over the next year or so.

    Someone mentioned "other" leg pains- I get IT band pain, also at the hamstring and calf muscle insertion points. So bad it intereferes with sleep sometimes. That is why I am taking it slow and only gradually increasing my miles. Next week I will attempt the climb to Griffith Observatory (in L.A.). I figure if I can complete that climb, no matter how long it takes, I am well on my way. Fingers crossed!

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    First Big ride

    Rode 16 miles today. Mostly flat. Wharton State Forest in New Jersey. Knee is stiff at part of quad right above knee cap. I'm sure I'll pay. I'm icing it now. Kept up with the front of the group. Denny my dog did his first major ride of spring as well and did fine too.


    Quote Originally Posted by LadyDi View Post
    I am 5 months post TKR. Had a rough few weeks transitioning back to 12 hour workshifts and am now on a low-dose prescription anti-inflammatory called Meloxicam. I am doing leg presses, etc. at the gym and riding more. I am back on clipless pedals, and I replaced the 175mm cranks on my 29er with 170's. While I was at it I replaced my cf bars and seatpost. I love my bike more than ever. No pain at all over rocks. I always have initial stiffness in my surgical knee for the first few pedal strokes. This eases up after a while, and I hope it goes away completely over the next year or so.

    Someone mentioned "other" leg pains- I get IT band pain, also at the hamstring and calf muscle insertion points. So bad it intereferes with sleep sometimes. That is why I am taking it slow and only gradually increasing my miles. Next week I will attempt the climb to Griffith Observatory (in L.A.). I figure if I can complete that climb, no matter how long it takes, I am well on my way. Fingers crossed!

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    LadyDi - Your post is timely. I'm still dealing with IT Band pain as well as other soft tissue pain. I'm 10 weeks post OP and while I was hoping to be back on the bike, I know this will take more time that I hoped for. I have to remind myself that after 6 surgeries, this will not be a normal recovery. I was consistently at 115 degrees and on a good day could get to 120, the past two weeks my best effort is 110, which is what I had pre surgery. I'm hopeful this will continue to improve. Best of luck on your climb.

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    Wherewolf- This is awesome news. You're climbing to mileage ratio is impressive and my style of riding and I can't wait to get back on the trail. While every TKR is different, do you recall where you were at 10 weeks and what was the first 6 and 12 months post surgery like?

  47. #47
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    Right FJ, it takes time to stretch out all those tendons and ligaments. Same presumably with scar tissue. Whenever I do something new, or get overly aggressive on the bike or at the gym, I pay with a week of extra pain & swelling. Last week I was just sitting and chilling in a kid's swing at the park when I accidentally flexed my knee too much. OUCH! I did not hear a crack but it would be nice if I at least broke up some adhesions. I don't advocate this technique, by the way- very painful!

    My surgeon says it's normal to lose ROM during recovery when we're on our feet a lot, then regain it after rest, ice, and elevation. Ugh, this recovery ordeal is getting old, and so am I.
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    Dear Call Me FJ:
    110 degrees at 10 weeks is fantastic. Keep stretching and home exercise program twice a day. The IT band is the biggest issue as mine will still wake me up 3 1/2 months post surgery. As long as you can pedal stationary bike you can pedal a rode bike.

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    You don't want to know

    Quote Originally Posted by Call Me FJ View Post
    Wherewolf- This is awesome news. You're climbing to mileage ratio is impressive and my style of riding and I can't wait to get back on the trail. While every TKR is different, do you recall where you were at 10 weeks and what was the first 6 and 12 months post surgery like?
    Don't get alarmed, but I have continued to have severe knee pain. I took two years off the bike due to the pain, and I still hurt, even after seeing a pain specialist for a whole year. So I went back to riding. I got a spinal cord stimulator implant about four years ago, which makes everyday activities tolerable. But I still hurt a lot on the bike despite taking codeine every three hours. Virtually all my climbing is done pulling via clipless pedals, because pushing on climbs hurts more. I had the knees checked last week and the doc said they are still perfect and I can pull and ride all I want, or can tolerate.

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    By accident I found a good stretch for the IT band. Before surgery one of my stretches was to sit cross legged and bend forward to try to touch my nose as close to the floor as possible. To stretch sit cross legged with operated leg ankle under unoperated knee. Lean forward and try to touch your nose to the floor. You will feel it in your IT band.

    Six weeks post surgery I rode asphalt. The the February freeze came to New Jersey and riding was impossible. Rode 16 miles Sunday. Leg was like rubber on Monday. Rode 4.5 miles on Tuesday and leg was stiff. Rode 4.5 miles today and leg felt great. Just keep riding until your knee gives up trying to hurt you because it realizes you won't give in. (Did ankel weight exercises and stretches on the off days plus half hour walk up the "Mount" in Mt. Holly (a whopping 200 feet above sea level).

  51. #51
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    Rode 15 miles yesterday and I feel like I got rid of all the scar tissue in my knee. Not as stiff when I get up after sitting for an extended period. I think mountain biking is excellent therapy for total knee replacement.

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    Quote Originally Posted by mrothmel View Post
    Rode 15 miles yesterday and I feel like I got rid of all the scar tissue in my knee. Not as stiff when I get up after sitting for an extended period. I think mountain biking is excellent therapy for total knee replacement.
    So true!
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    mrothmel, this is great news. While I still have swelling and stiffness at the end of the day (12 weeks post op) I am seeing the light at the end of the tunnel. I had my 3 month follow up and the Dr said everything is healing fine. I will take to the road tomorrow for a 3.5 mile ride and hope to be on the dirt in the coming months once i can handle climbing. The rides in my area have a fair amount of climbing and I know I am not ready yet. Keep up the great work.

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    reply to fj

    Quote Originally Posted by Call Me FJ View Post
    mrothmel, this is great news. While I still have swelling and stiffness at the end of the day (12 weeks post op) I am seeing the light at the end of the tunnel. I had my 3 month follow up and the Dr said everything is healing fine. I will take to the road tomorrow for a 3.5 mile ride and hope to be on the dirt in the coming months once i can handle climbing. The rides in my area have a fair amount of climbing and I know I am not ready yet. Keep up the great work.


    I don't know when swelling goes away. I still have a bit four months post. Not obsessing over it. knee is stiff for a few minutes when I wake up. It can also get stiff after riding or sitting for extended periods.. However stiffness. doesn't mean you hurt anything and its the only way to rebuild the muscle. At 3 months you are ready for flat trails. Four months you are ready
    for whatever your body can take. Keep on riding.

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    Good and Bad

    Quote Originally Posted by mrothmel View Post
    I don't know when swelling goes away. I still have a bit four months post. Not obsessing over it. knee is stiff for a few minutes when I wake up. It can also get stiff after riding or sitting for extended periods.. However stiffness. doesn't mean you hurt anything and its the only way to rebuild the muscle. At 3 months you are ready for flat trails. Four months you are ready
    for whatever your body can take. Keep on riding.
    Had good and bad with IT band over the past month. Went back to PT to have it worked on and they really worked out the part above the knee to the hip. Went to Colorado and only had welling one day after a hike. Had a massage and the operated IT band was softer than the non operated one.


    Now the bad: I was stretching Thursday (sitting cross legged and leaning forward) when the portion of the band that runs over the knee popped like a gun shot. I figured that was an adhesion that "unadhesed." However, now my knee is swollen and more tender than it has been in months. We'll see how it goes the next few days and then call the doctor.

  56. #56
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    Quote Originally Posted by mrothmel View Post
    ...Now the bad: I was stretching Thursday (sitting cross legged and leaning forward) when the portion of the band that runs over the knee popped like a gun shot. I figured that was an adhesion that "unadhesed." However, now my knee is swollen and more tender than it has been in months. We'll see how it goes the next few days and then call the doctor.
    Holy Heck! It's been about a week since your incident- did this ever resolve??
    I haven't had any big "pops", but I've heard of them. Maybe I'm not trying hard enough.
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    Adhersion pop

    Quote Originally Posted by LadyDi View Post
    Holy Heck! It's been about a week since your incident- did this ever resolve??
    I haven't had any big "pops", but I've heard of them. Maybe I'm not trying hard enough.
    Still stiff when I sit for a long time . . Like driving a box truck fro.m NJ to Arkansas where my son is moving. Feels better as the day wears on which is good. Nurse practicioner said that's why we say it takes year to heal. Gonna order a foam roller from amazon. She said take ibuprofen which works.

  58. #58
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    Update: I am now 10 months post op left total knee replacement and feeling so much better! I battled stiffness, inflammation and fatigue for a long time, but it seems those issues have finally resolved. I am up to 75 miles (road + mtb)/week and slowly adding elevation. After more than a decade of not being able to mash, and actually forgetting how to mash, I can climb out of the saddle again. I'm a little awkward because it's been so long, but I will re-learn. My knee is stronger than it has been in many years. This makes me incredibly happy!

    So, to anyone potentially facing knee replacement, I'd like to offer reassurance that the surgery was worthwhile for me, and I am very glad I did it. Yes, I was off the bike for some time during recovery, and yes it sucked, but I am back and stronger. Will I race? Nah, competition isn't in my blood. But I can ride and hike with my friends, and do what I want to do. This means a lot to me.

    My left leg is nice and straight. Unfortunately, when I ride I can look down and see that my other knee is beginning to twist inwards (valgus malformation) from osteoarthritis. It needs to be replaced, too. I'm hoping to hold off until next year. If the meniscus -what little remains- tears again I'll go sooner.
    Last edited by LadyDi; 08-25-2015 at 12:28 AM.
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    LadyDi - This is great news. TKR is a big decision to make and and even larger commitment to PT. Congrats on your mileage, that is impressive. I was not able to get out of the saddle until about three weeks ago. I am approaching 8 months and while it has been a slow but steady road to recovery, I am glad I did this. I stiff suffer from sore tendons on the back of the knee which leads to stiffness and soreness, I am confident this will resolve its self and would recommend my ortho in a minute. Keep hammering!!

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    Dear Lady Di:

    Glad to hear you are doing great. I had a set back with an Adhesion pop two or so months ago, but I am close to normal again. Stretching is back and I just did 30 miles of mountain biking over two days at Raystown Lake Pa. Still a little stiff in the morning when I wake up or after I sit in the car a long time but other than that ok. I just measured my thighs this morning and there is a one inch difference between operated leg and non operated leg. Glad I had it too. (December 15 2014 so I'm 8 mos post surgery)

  61. #61
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    Quote Originally Posted by LadyDi View Post
    ...
    My left leg is nice and straight. Unfortunately, when I ride I can look down and see that my other knee is beginning to twist inwards (valgus malformation) from osteoarthritis. It needs to be replaced, too. I'm hoping to hold off until next year. If the meniscus -what little remains- tears again I'll go sooner.
    Quoting MYSELF^, little did I realize when writing it that last week's post would prove ominous and foreboding; days later I tore the last bit of lateral meniscus in my right knee and am now bone-on-bone there. My next total knee replacement is in the works, and I'll have it hopefully within the next few weeks. For anyone wondering how I can look forward to such a big surgery, it's the anticipation of two strong knees that drives me.
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    Dear Lady Di

    Sorry to hear right knee needs work but I like the attitude. I am 10 months post knee replacement. Very good. Stiff in the morning but I stretch every day. Can pull my heel back and touch my butt. Leg strength very good. Passing people 15 years younger pedaling uphill. Happy with result.

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    Lady Di,

    All the best for the second TKR. You will do just fine.

  64. #64
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    Is anyone able to. Stand and climb after a partial knee replacement

    im about seven weeks post right medial makoplasty (pkr). I've been pushing it hard and my knee isn't too happy with my tactics. Sure sittin on my butt and ridding the flats is reasonably good but two things sure aren't. A) trying to get off my seat and pedal standing. B) climbing. Even seated

    The worse by far is the standing when my right pedal is around 12:00. For those maniacs like myself who climb standing, all your body weight and all your strength is momentarily 100% through thT right side and much if it is routed via the patellar tendon , so enormous compression of the underside of the patellar femoral joint onto the structures below occurs. Very very very intense pain.

    I am actually a anesthesiologist so I have no one to blame but myself for the rebound in inflammation that occurred. But I am willing to wait for the inflammatory cells to slowly move on out. That according to some of my surgical friends could be as long as a year if you actually look scientifically at the process.

    My question is : anybody with a partial or total knee able to get out of the saddle,and really put the power out.

    I originally dis paired over my f Ed up knee from a horrific ski accident.
    One day I met a damn good rider in the Santa Cruz mountains when my son and I were poaching the good stuff and he was post total and riding up a freakin storm. BUT HE WAS DOING IT SEATED. and I couldn't get it out of him if it was by choice or necessity. My greatest joy is off my keister.

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    Dear Cyclopath:

    I did not even start to ride until 7 weeks post knee replacement. You are being too aggressive for the point in time you are post surgery. Do not despair. Take your time.

    Do your physical therapy twice a day!

    Mike

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    mrothmel and others , there is a specific question I'm looking for an answer. " are you able to stand and pedal ? For how long and on what kind of incline. Our mountains are very young out here which makes them super steep. I appreciate your input.

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    Dear Cyclopath:

    I can now ride fully 10 months post surgery. I would say six months post surgery I was still stiff after riding.
    Getting range of motion is a long process. I was doing well and then had an adhesion pop in my IT band along the knee cap which set me back. Ultimately you will be able to do everything you did pre surgery, just not 7 weeks post surgery. In my experience at 7 weeks post surgery you should be riding easier trails and building up flexibility and strength. Listen to your body. If you can't do something, its because your body is not ready to do it.
    Mike Rothmel

  68. #68
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    @cyclopath 1000, following my left total knee replacement I regained the ability to mash (climb out of the saddle) after 11 years of not being able to. But it took me 11 months to get there! Then my right knee failed- as we knew it would- and was replaced yesterday. You will be back to climbing sooner than me, but seriously don't push it. Healing, whether partial or total knee, is a long process.
    Bionically Modified

  69. #69
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    CYCLOPATH
    Listen to Lady Di. She was an inspiration and help to me during my recovery.

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    So I just returned from a post op visit (7 weeks) with my surgeon. So basically everything looks great ie X-rays shows the implants in perfect position etc. he thinks my knee is fabulous with over 150 degrees of flex ion etc. " it's the soft tissue that can take up to a year to recover" " you have to appreciate that you knee alignment is significantly altered by the return of the proper height and angles by putting in the medial compartment, in essence the patella and the patellar tendon IS tracking along a slightly altered path"
    This was aware of. Basically I has nothing left medically and. Was using all sorts of tricks to route my weight and force through the lateral half of the knee. My surgeon is confident that within months this will quiet down and while he doubts I can cause any real damage in the absence of a real compressive fall, it obviously makes sense to not push myself so hard that my effusion and my pain kicks up too hard.

    So I'm going to stay seated and ramp up as tolerated. I will stand and climb when it feels right.

    He a.so showed me how my right quad is basically atrophied vs my left. It's like a jelly roll. he said Marc this happens the moment I take a knife to your knee". It's 100% predictable. When that comes fully back its all gonna be good.

    He actually mountain bikes and knows what I'm talking about when I say my joy is the climb way more than the descent. All my friends know this.


    I posted this for two reasons
    1. To see what others experience was
    2. To help others who are wearing out get some tangible advice.

    My previous Google search yealded up a bunch of bs ads from docs and worse hospitals putting out advertising bereft of details.

    Anybody in the future that wants to contact me I will be happy to oblige.

  71. #71
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    wow i had an amazing day. I reached a goal of my recovery: i am about day 59 of a mako partial medial uni knee replacement. Today I stood and climbed on middle /middle of my 29 er pivot with an old school triple. Not that is was 100%pleasant but it was 1000%more pleasant than the 8 miles of standing on a flat Davis, ca bike path. Yeech for the flat pavement next to my/ur goal:sweeeet single track winding through untrammeled beauty. but i checked with my surgeon , got films last week or so and was encouraged to push it to tolerance. Ya know I am an physician who has a pretty good gestalt on physiology and just what eactly is going on during surgery. as in I spend most of my life in the or. So my anterior patellar pain is probably due in part but not entirety on inflammatory cells and even fibroblasts infiltrating the prepatellar fascia. The infiltration takes the natural flex like a bow and arrow away so when moved the arc is disrupted and its efficiency fall and it puts excessive strain on the periphery of the injury causing severe overload pain. ie your body is signaling that the tendon is weak and could disrupt. But you gotta get the flexibility back so the tendon uniformly stresses and relaxes. That is the trick to work it out and to build back atrophied muscle so that the body can begin to deliver wattage to your pedals and not further injure itself but restore normal function. This is why professional athletes from injury and surgery get to maintaining muscle vitality and connective tissue loading.

    Anyway call me crazy but I want to get off my bum. This is my riding style and its a pure joy to climb in this manner.
    And it was what a steep 25 -30 ft embankment.. come on kids stuff!But when i stood up on a pretty steep deal for four pedal strokes i muscled that baby up that hill. Day 59!So while i was at it i threw in 20 repeats! Damm that's good even if i have to run the ice machine all night.

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    Good job. I was doing great then several months ago had an adhesion pop onmy IT band. Set me back but now I am great. Can touch my heel to my butt stretching and did 40 miles througj NJ Pone Baamrrens on Saturday. 10 months post surgery.

  73. #73
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    Cyclopath- I was not able to stand and climb until 5 months post op.

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    well on Wednesday i decided to really try it all out. so i went to Rockville hills regional park with my tall boy. yes i had a blast. yes i was a dumb f to try it. i was able to pretty much climb it all but seated. whereas under more controlled climbs out of my nearby drainage ditch was fine, on real singletrack it was verey unwise because i couldnt really produce the power and the pain was not good. unfortunately sitting at Rockville on the good stuff is an invitation to disaster and i had a couple of tumbles. sort of hit that knee a little on the side but i had pads on. nothing permanent. we are going to Mcdowell mountain park in Fountain Hills for a week and I plan on easy riding there and afterwards if i am still alive we found a sweet rv site in Sedona and at
    Flag.

  75. #75
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    Thanksgiving day, so three months post partiall Right medial makoplasty. I'm making great progress in the past week. Now I'm able to stand and ride under many but not all conditions. I've decided to ride what I feel I can do and to avoid doing segments that I might be able to clear pre op. So I can do 98% of Rockville park which is pretty good. My knee is still not totally there and it's sore and stiff but hell I'm riding and not just enduring the ride. I'm feeling the passion. So anybody out there contemplating this ... Take heart.

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    You have to do some cycling and let see how much pain you are feeling. If you are not feeling any pain then it is ok to go ahead for the Race.

  77. #77
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    Never intended to race. I only ride for joy not recognition.

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    Hi,

    Before my TKR i couldn't straighten my knee and had a 20degree bend, my leg was also bent inwards by about 15 deg (at the knee) so i was bow legged.

    I'm 4 weeks post op, i'm easily walking 2 miles without a stick, and the knee stiffens up quite a bit afterwards but is ok after some ice and stretching.

    I'm at 4 degrees off straight and not bow legged anymore and have approx 110-115 deg bend.

    I started on a turbo setup last week and have problems/pain for the first minute as i struggle to get over the top of the stroke (170 cranks which i used pre op) , after that i'm ok and can cycle for 10 mins without problems.

    When doing my straightening and bending exercises it's incredibly painful but the physio is ok with what i'm doing.

    In your experience will my range of motion keep increasing as i seem to be stuck at the same point all week? Unfortunately because of the christmas holidays i won't be seeing my physio this week who says he's very happy with my progress especially considering my pre op condition.

    I continue to be upbeat as i can walk further than i have been able to in years but one or two doubts have snuck in.

    Thanks for reading.

  79. #79
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    Stumo,
    So that pain coming around the pedal is pretty much my experience. I am four months out of a medial side uni not a Tnr. I am an anesthesiologist and it's from needing to literally flip the patella up and away to gain access to the joint. You with a total also had the underside of the patella "resurfaced" which is a euphemism for it the cartilidge being chopped off and a piece of plastic cemented there.

    The good news is that it will gradually improve. Take a look at your quadricepts on that side vs your other knee and you will find it is way way smaller and atrophied. That happens from the torniquet that was inflated over the muscle. It reportedly takes a year for that to return and by them the patella should gradually stop hurting as the tendon heals from the trauma and inflammation of surgery.

    I really really pushed my rehab. I now can mostly ride standing and can climb semi steep standing. Every day that horrid patellar pain gets a bit better. I actually did a powder day at Heavenly on Xmas day. Lots of snow and I stayed on open stuff without any extremes because my right leg is weak still but I linked fifty plus turns and in some ways seeing that I actually had a functioning medial side it felt more stable.

    If you don't have a powered knee cooler buy a don joy on the Internet. I sleep on my back with a zillion pillows to get the fetal position. My knee is on a square giant bolster plus pillows. It keeps the leg elevated without lateral pressure which seems to work best.

    Slowly work on knee bends but stabilizing yourself. That walker they gave you is a good exercise aid btw. I now do a bosu ball on one leg. You want to slowly ramp it up. Be careful believing physical therapists wisdom too much. They are used to old frail people.










    Quote Originally Posted by stumo View Post
    Hi,

    Before my TKR i couldn't straighten my knee and had a 20degree bend, my leg was also bent inwards by about 15 deg (at the knee) so i was bow legged.

    I'm 4 weeks post op, i'm easily walking 2 miles without a stick, and the knee stiffens up quite a bit afterwards but is ok after some ice and stretching.

    I'm at 4 degrees off straight and not bow legged anymore and have approx 110-115 deg bend.

    I started on a turbo setup last week and have problems/pain for the first minute as i struggle to get over the top of the stroke (170 cranks which i used pre op) , after that i'm ok and can cycle for 10 mins without problems.

    When doing my straightening and bending exercises it's incredibly painful but the physio is ok with what i'm doing.

    In your experience will my range of motion keep increasing as i seem to be stuck at the same point all week? Unfortunately because of the christmas holidays i won't be seeing my physio this week who says he's very happy with my progress especially considering my pre op condition.

    I continue to be upbeat as i can walk further than i have been able to in years but one or two doubts have snuck in.

    Thanks for reading.

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    Dear Stumo:

    Keep on plugging away. At 11 months I was able to touch my heel to my butt. More importantly, you should have a home exercise program. I exercised two times a day. If I had PT, I exercised one additional time. On days with no PT, I did home exercises twice a day. It dramatically increases your recovery time.

    Also, don't be afraid of set backs. I was doing great and than an adhesion on my IT band popped. Lost alot of range of motion, but kept plugging away stretching every morning and riding.

    You should be able to start riding easy stuff six weeks post surgery. As you get your wind and strength back keep going as tolerated. I think riding makes the healing faster.

    Best of luck.

    Mike Rothmel

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    Thanks for all the great conversation. I am a lurker with lurking knee issues. I have been curious for years at what point people made the decision to have the knee(s) replaced.
    I joke with my wife about replacing the left leg with a peg leg with a SPD cleat on the end. Would be great for tap dancing as well!

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    I read this thread with great interest. Thanks to all those who told their stories of recovery. In particular Lady Di, you've not posted since having your second TKR. I hope you are doing well and are recovering quickly!!!! and would love to hear from you.
    I just got my TKR date, Feb 4. Both knees have been a long standing issue but my right is by the far the worse. This Summer on a short but steep climb something went pop and I could not finish the ride. It was the kind of pain ya feel in your gut. I stayed off the mountain bike and road my hybrid on our local bike path and at the beach. After two long months, lots of ice and pain meds I was able to get back on the mountain bike. Climbing was okay but it was not the same. The knee felt like it might explode at any time especially on the steeps.
    I have begun a program of daily stretching to increase ROM and use a foam roller. I plan on riding the hybrid at least 3 days a week and the mountain bike one day a week till the surgery. When the knee feels like its gonna give out on the steeps I stop and walk the bike. When not riding I do scaled down version of P90x of strength maintenance.

    Any other advice on increasing my recovery time would be greatly appreciated!!!!!!
    Last edited by stoplight; 01-02-2016 at 09:29 PM.

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    thanks guys.
    ive got an Aircast cryocuff (similar to the donjoy)which is a great piece of kit, im using it a lot. ive got exercises to straighten my leg and also increase the bend which are working but progress is slow. ive gone from 7 deg off straight to 4 deg in a week and 105 to 110 also last week. maybe im expecting too much and it'll take time but i'm doing the full list of exercises 3 times a day( straightening, bending, stepups etc) and walking 2+miles . im not going easy on myself because the phyiotherapist is happy as i want to be able to cycle and ride my KTM dirt bike. Mike, you said at 11 months you could touch your heel to your butt..... so in those 11 months you've slowly made progress.... maybe im expecting miracles and it to happen too quickly but i also know i'm in for the long haul which will be painful and at times demoralising. my thigh is still swollen ( calf is back to normal size) and i feel that i'm fighting the swelling as well as the muscle when doing my bending exercises. unfortunately i cannot take NSAIDS due to use over many years has made me sensitive to them and gives me asthma for a few days after using them. i still have a very positive attitude and know there will be setbacks which i hope will not lessen my enthusiasm. i think that once i can get outside on a bike and not suffer the pain at the top of the stroke i will be even happier. thanks again for reading my rambling post and thanks for all the help and inspiration. cheers guys

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    Quote Originally Posted by Crankyone View Post
    Thanks for all the great conversation. I am a lurker with lurking knee issues. I have been curious for years at what point people made the decision to have the knee(s) replaced.
    I joke with my wife about replacing the left leg with a peg leg with a SPD cleat on the end. Would be great for tap dancing as well!
    i initiallly got knocked off a motorbike 20 years sgo and suffered the joint at the back of my femur breaking. it was fixed with 2 screws and recovery took a long time due to the 8 weeks or so for the joint to heal then the long physio to enable weight bearing and mobilisation. from that point on ive never been able to straighten the leg and over the years the inward bend of my lower leg got worse and worse. all the time i could mountainbike (whistler twice doing a lot of the stuff there, crabapple hits, a line, dirt merchant etc etc) but i could never walk far. over the years i have knocked my knee( sometimes incredibly hard) and its always recovered but in May this year i very lightly knocked it and must have hit it in the right spot as it swelled up bigger than it ever had done and i also couldnt put any weight on it. the doctor and i said we will wait for the swelling to go down and see how the knee is then. the swelling took time to go but unfortunately the knee didnt recover well enough and certainly nowhere near the preknock condition. at that point we decided to get the TKR done. ive always been told to try to keep your knee for as long as possible before getting TKR. once it starts to severly impact on your daily life (including sports/hobbies) then do someghing about it. hope thst helps your decision as its not one to be taken lightly. good luck whichever way you go.

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    I have done a fair amount of research on TKR and mountain biking in hopes of finding a common thread of those who have chosen the TKR over approved methods, strength conditioning, stretching, ROM, meds, etc. While reading a post on another site I realized something I had not thought of. I know 15 guys who have had TKRs and all said the same thing, feels great, no more pain, glad I did it. Then I realized none of those fellas are active exercisers, none of them ride road or mountain bikes, none of them hike or walk for exercise and none belong to a gym. When I started deep reading this and other threads I realized many of you who have had TKR have knees that are basically blown apart or weakened to the point that a TKR is really the only option. As I read further I also realized that many who had the TKR and are riding are often doing what I am doing now, ride, ice, ibuprofen. That got me thinking maybe my knee is not that bad after all, a question only I can answer for sure. Then I read this....periphrased from a fella who had a TKR...."TKR's are designed for the passive, not the active athlete".... I got some thinking to do for sure and am certainly interested in any observations from those with fair knees to knees on the edge of explosion and those who have chosen the TKR...

  86. #86
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    You'll know

    You will know when it is time for a TKR. I had knee problems, and multiple surgeries, for many years. When the kees finally went I knew it, and a MRI confirmed so. Few people ride as much as I do, 40 - 66 mile rides with over 5K of climbing, about 2 1/2 times per week. And I do one hour at the gym 3 1/2 times per week. After more than seven years the knees are still perfect mechanically (just confirmed by an orthopedist). However, I still have some sort of mysterious nerve pain in both knees and they hurt all the time. However, they hurt whether I bike or not, so I bike.

    Total Knee Replacement-tahoe-8-5-15.jpg

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    Stoplight there is wisdom in your very conservative view of what a Tkr can and cannot do. I am an anesthesiologist and your view is the traditional orthopedic view, though they don't necessarily say it point blank. I in fact thought that was the reality until i ran into an excellent rider in Santa cruz way last spring who was riding well with a Tkr , WITH THE ENCOURAGEMENT OF HIS SURGEON.

    NOW I AM IN THE OR most days until recently and was persuaded by one of the total reps to consider a robotic uni. I didn't think I was a candidate due to the fact that I had stretched and at least partially torn my acl 25 years ago when I had a huge medial meniscus bucket handle tear from hitting a mogul on ice wrong.

    To my delight I was judged a good candidate. Now for some more truth to the comman man: not all orthopods are created equally. And some will advise surgery that should or could be either done otherwise or even not at all.

    I am insanely active at 65 and anybody who has ridden with me knows I prefer insane climbs. It takes a year to recover to your fullest. Fullest doesn't mean to when your God given knee was perfect! Fullest means as good as it's going to get.

    Just like gearheads know all the details of how a shock or a multilingual suspension works, your knee and what is put in to replace the faulty parts is a technical issue and requires understanding of mechanics and anatomy etc etc. googling stuff just is going to give you advertisement s by hospitals and docs that want your business. Most ortho pods are not in the position to do a uni let alone a total. And a robotic uni is even a smaller group. My guy has done over 300 robotics. That's the minimum number I would let a guy mess with my knee to have under his belt. Can you truthfully find out the true number he has done :NO.

    AS for the guy selling tens units : give me a break!!!
    For less active people there is a medial block with radio frequency ablation of the nerves around the joint line that can delay Tkr.
    Peeps get all sorts of viscous s..t injected into their damaged joint. My advice is based on seeing septic joints: dont put anything into your knee smaller than your elbow.

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    Day 32 and I can now use Spuds on the turbo, before today it was very painful at the top of the stroke and couldn't carry on and i seemed to be limited to around 5 mins when using flats (due to there not being any float).

    It's a milestone for me as that's where i was at pre-op so from here on in it's all a bonus.

    A 2.8 mile walk, step ups and bending/stretching exercises were my day today.
    Last edited by stumo; 01-02-2016 at 05:28 AM.

  89. #89
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    Here I am! My knees were replaced one year apart. I'm currently 11 weeks post op RTKR and back on the bike(s). Cycling is easier than walking! Happy New Year, everyone!
    Bionically Modified

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    Quote Originally Posted by cyclopath1000 View Post
    Stoplight there is wisdom in your very conservative view of what a Tkr can and cannot do. I am an anesthesiologist and your view is the traditional orthopedic view, though they don't necessarily say it point blank. I in fact thought that was the reality until i ran into an excellent rider in Santa cruz way last spring who was riding well with a Tkr , WITH THE ENCOURAGEMENT OF HIS SURGEON.
    Yes sir!
    The more I read the clearer my answer has become
    Before I make my final decision I will go ahead with the appt on Tuesday with a PT set up by the TKR team. I appreciate those who offered their experiences and opinions and with that in mind I offer this to those who are considering a TKR.

    In context of this conversation I realized there are two kinds of knee pain. Day to day consistent knee pain and knee pain while cycling. Chances are pretty good if one is experiencing day to day knee pain they are experiencing it while cycling. I would have to think the motivation for a TKR in that scenario would be to reduce the day to day knee pain and then cycle as recovery permits.

    My day to day pain is not debilitating except for roughly two months out of the year, Summer into Fall. It wakes me up and night, is stiff, aches and hurts throughout the day and of course that pain carries over to cycling.
    This has been the case since 2008 when it was clear the 7 surgeries over the years for torn meniscus and arthritis has resulted in a bone on bone condition. If my knee hurt the other 10 months there would be no doubt I would pursue a TKR but it doesn't. Oh it can rear its ugly head on occasion but for the most part the pain is quite manageable.

    Until recently I have a had little knee pain while riding except for the most recent small but steep climb resulting in a pop which also happened from Summer into Fall. I was able to rehab the knee with pancake rides, ice and ibuprofen. A couple months later the pain subsided but it was a long two months. It was during this time I conceded to the long standing invitation from my Ortho Pod(I thought I was the only who called them that) to take advantage of the TKR I had been approved for in 2008

    Part of my concession was feeling like my cycling future was in doubt and if the TKR prolonged my cycling I was all for it. That is when I began reading this and other threads pertaining to TKRs and mountain biking and made the realization what I was putting at risk. The very thing I want to prolong and protect, cycling in the manner I do now, is what I would be putting at risk by going forward with the TKR. Of course before I decide for sure I will have another meet my Ortho Pod and whoever else I can sway into a conversation!!

  91. #91
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    Thanks for your input stoplight! I appreciate all the honest insight regarding knee replacement! Sometimes I snowboard and mountain bike with some pain. More accurately , it hurts after. I would rather deal with the pain than giving up on the activity.
    Cheers,

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    Quote Originally Posted by Crankyone View Post
    Thanks for your input stoplight! I appreciate all the honest insight regarding knee replacement! Sometimes I snowboard and mountain bike with some pain. More accurately , it hurts after. I would rather deal with the pain than giving up on the activity.
    Cheers,
    Oh, by the way, that's why I am so crappy at both, and crash on my face, if anyone asks!

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    Quote Originally Posted by Crankyone View Post
    Thanks for your input stoplight! I appreciate all the honest insight regarding knee replacement! Sometimes I snowboard and mountain bike with some pain. More accurately , it hurts after. I would rather deal with the pain than giving up on the activity.
    Cheers,
    that pretty much sums up where I am currently.

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    Quote Originally Posted by cyclopath1000 View Post
    ... i ran into an excellent rider in Santa cruz way last spring who was riding well with a Tkr , WITH THE ENCOURAGEMENT OF HIS SURGEON. ...
    Peeps get all sorts of viscous s..t injected into their damaged joint. ....
    The first ortho I saw said I would not be able to bike after TKRs. The one who did both of mine encouraged me to bike. And that was 20,000 miles and 2,622,611 ft. of climbing ago (yes 2.6 mil.) . I rarely ever do less than a 40 mile ride with at least 5k climbing. Had them checked out last Spring and the doc said they are still perfect, and to keep doing what I've been doing.

    I did have regular Synvisc injections for about two years and they helped. But I had an allergic reaction on the last one and that ended them.

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    my surgeon said the only things he wouldn't recommend after TKR are running and skiing ( i guess they are major, well known sports) i asked about cycling, specifically MTB and he said keep doing it ( road riding would kill me with boredom).

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    Met with a good friend of mine who had a TKR Mid Oct. I asked him to dig deep and discuss with me why after all this time he finally decided to have the TKR. Turns out 4 months prior to agreeing to have TKR his mostly manageable knee pain became unmanageable. He opted for 800 milligrams of Motrin daily and ice and rest and his pain level was a difficult 6-7. Eventually that level of pain led to the realization he may have to give up bird hunting and ocean fishing. That is when he decided it was time for the TKR.

    All I have communicated with and those stories I have read all share one common attribute, their daily pain level was so great it became unmanageable with pain meds and/or their exercise/recreational activities were threated by their unmanageable knee pain.

    I advised my Doc today to cancel the knee surgery. When the day comes as it has come for all you I will man up for the TKR...until then....I will ride like the wind.....pack with ice and Ibuprofen as needed

  97. #97
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    Stoplight, it sounds like you're making the right decision for you at this time. My story is different, apparently, in that my left knee prior to TKR had grinding bone-on-bone Grade 4 osteoarthritis with NO PAIN. I remember a time when it used to hurt, but that was years ago. Nah, it was just extremely weak. My orthopedic surgeon says he sees painless OA occasionally, but it's rare. As you can imagine, the decision to proceed with TKR was difficult and took me the better part of a year. My epiphany occured when I realized how limited my life had become due the stupid weak knee; I could no longer balance on my left foot, climb or descend stairs, dash across an intersection, hike without trekking poles, keep up with friends, or start pedaling on an uphill. I healed well from LTKR and was beginning to enjoy life again. I knew my right knee was deteriorating, but I wanted to hold off on replacement for as long as I could. Unfortunately I kept suffering degenerative meniscus tears at work. Now THAT was painful, not to mention inconvenient! The last time it tore xrays confirmed that this knee was also bone-on-bone. By then I was completely fed up and ready to get 'er done. Recovery from two TKR's has been brutal but I have no regrets.
    Bionically Modified

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    Quote Originally Posted by LadyDi View Post
    Stoplight, it sounds like you're making the right decision for you at this time. My story is different, apparently, in that my left knee prior to TKR had grinding bone-on-bone Grade 4 osteoarthritis with NO PAIN. I remember a time when it used to hurt, but that was years ago. Nah, it was just extremely weak. My orthopedic surgeon says he sees painless OA occasionally, but it's rare. As you can imagine, the decision to proceed with TKR was difficult and took me the better part of a year. My epiphany occured when I realized how limited my life had become due the stupid weak knee; I could no longer balance on my left foot, climb or descend stairs, dash across an intersection, hike without trekking poles, keep up with friends, or start pedaling on an uphill. I healed well from LTKR and was beginning to enjoy life again. I knew my right knee was deteriorating, but I wanted to hold off on replacement for as long as I could. Unfortunately I kept suffering degenerative meniscus tears at work. Now THAT was painful, not to mention inconvenient! The last time it tore xrays confirmed that this knee was also bone-on-bone. By then I was completely fed up and ready to get 'er done. Recovery from two TKR's has been brutal but I have no regrets.
    If you do not mind me asking LadyDi, are you able to ride in a manner you thought you might post TKR? and how long did it take to get there? and are mainly road or combo mountain bike rider?

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    Sure thing. I forgot to mention that I had been unable to stand and mash the pedals for 10+ years. To my shock and delight I was standing and mashing approximately 10 months post LTKR. I might have been able to do it sooner, but it didn't occur to me to try! By 10 months I was climbing 1800 ft. over 15-30 miles road or mtb and working on overall fitness. Unfortunately the OA in my right knee progressed rapidly and I needed the second surgery. I am now 3 months post op RTKR/15 months post op LTKR. At this point I am still on road & paved path, max 15 miles and 300 ft elevation gain. I'll tackle an easy trail next week if the weather cooperates. Remember that I was pretty de-conditioned leading into both surgeries with significant quad atrophy, so return to where I'd "like to be" will take a while. And I'm not getting any younger, lol. Complete recovery from TKR takes a good 18 months, but my first knee felt almost normal by 10-12 months.

    I hope my story helps. Some patients are back on the bike sooner, some later. My non-cycling friends are amazed (and aghast) that I ride at all, but of course they wouldn't understand. I will post a riding pic when I'm back on the trails.
    Bionically Modified

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    Quote Originally Posted by LadyDi View Post
    Sure thing. I forgot to mention that I had been unable to stand and mash the pedals for 10+ years. To my shock and delight I was standing and mashing approximately 10 months post LTKR. I might have been able to do it sooner, but it didn't occur to me to try! By 10 months I was climbing 1800 ft. over 15-30 miles road or mtb and working on overall fitness. Unfortunately the OA in my right knee progressed rapidly and I needed the second surgery. I am now 3 months post op RTKR/15 months post op LTKR. At this point I am still on road & paved path, max 15 miles and 300 ft elevation gain. I'll tackle an easy trail next week if the weather cooperates. Remember that I was pretty de-conditioned leading into both surgeries with significant quad atrophy, so return to where I'd "like to be" will take a while. And I'm not getting any younger, lol. Complete recovery from TKR takes a good 18 months, but my first knee felt almost normal by 10-12 months.

    I hope my story helps. Some patients are back on the bike sooner, some later. My non-cycling friends are amazed (and aghast) that I ride at all, but of course they wouldn't understand. I will post a riding pic when I'm back on the trails.
    Thanks LadyDi, appreciate your narrative!!! It sounds like you are doing great!!!
    and yes it most def. helped!!! One day I will be amongst those bionically modified...but until then...ride like the wind until I can't!!

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