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  1. #201
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    Quote Originally Posted by rockman View Post
    At this point I'd be more worried about what your PT thinks than your surgeon.
    +1

  2. #202
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    I had total knee replacement on 10/29/17. I was on my stationary bike after 2 weeks. Riding my road bike at week 4. And started mountain biking on the 6th week. I get up out of the saddle, and ride anywhere I want. No issues. I am about to teach my 220+ beginner clinic. I push and lift weights at the gym. Swelling was completely gone at week 8. I can bring my heel to withing one finger widith of my buttocks. I am 67 years old. I will have my left knee replaced in 2 weeks. Doctors need to be told that most mountain biking does not look like a mountain bike video on you tube. They are concerned about collisions with obstacles. Or landing huge jumps. Nowadays, when ride, I am a lot more cautious and pull my punches. I have nothing more to prove to myself or anyone else. But I can still get in some very exhilirating rides that get my heart rate up. I have never had numbness in my toes, rockman. INMHO, I think it is odd that your doctor is not concerned about that, or your swelling, but is concerned about mountain biking.

  3. #203
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    Quote Originally Posted by chris7777 View Post
    I I have never had numbness in my toes, rockman. INMHO, I think it is odd that your doctor is not concerned about that, or your swelling, but is concerned about mountain biking.
    No numbness here. My knee feels surprisingly like...a knee. Hard to believe there is an implant in there. Still some minor swelling and flexion is ~125. I'm at 15 weeks and haven't talked to my surgeon in 2 months. Might try the telemark skis tomorrow.

  4. #204
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    I'm happy for you Chris. After talking with many doctors, physical therapists and reading here about other's recoveries I'd say you are the recipient of a serious miracle. You have good reason to believe in God. May your second knee be as good as the first.

  5. #205
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    He told me before surgery it could be 3 to 6 months and up to a yr for swelling and numbness to go away,and the fact I'm a lettercarrier with a walking route so he said it could take the longer amount.

  6. #206
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    Just an update but I finally got 130 deg flexion at the 5 month mark. Back to mtn biking technical trails and alpine skiing. Stoked!

  7. #207
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    Chris - do you happen to know what brand implant you got? Stryker, Zimmer, Smith & Nephew, etc?

  8. #208
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    TKR Preparation...Any wisdom at all!!

    Greetings
    Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...

    57 yo lifelong athlete
    I ride off and on road and swim.
    Thanks
    Bicycle Bill

  9. #209
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    Quote Originally Posted by wmbeverleyblanco View Post
    Greetings
    Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...

    57 yo lifelong athlete
    I ride off and on road and swim.
    Thanks
    Bicycle Bill
    Go into it in the best shape you can. Seems obvious but I was also hitting the weights pretty hard. Who cares if it hurts. That diseased knee is going bye bye.

  10. #210
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    Quote Originally Posted by wmbeverleyblanco View Post
    Greetings
    Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...

    57 yo lifelong athlete
    I ride off and on road and swim.
    Thanks
    Bicycle Bill
    Work on your core. Youíll rely on your stomach muscles a lot.
    Keep us posted.

  11. #211
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    Total Knee Replacement

    I had my total knee replacement FIVE years ago and I have a baker's cyst right now. The knee swells up in bad weather and is full of scar tissue despite 3 surgeries to remove scarring. Don't really know how at this point to treat the baker's cyst. I suppose some ice?

  12. #212
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    Quote Originally Posted by wmbeverleyblanco View Post
    Greetings
    Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...

    57 yo lifelong athlete
    I ride off and on road and swim.
    Thanks
    Bicycle Bill
    Quadriceps, quadriceps, quadriceps.

    And buy a stationary bike for postop rehab re:range of motion and maintaining the quadriceps.

  13. #213
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    Hey all, just read this whole post.
    Hows everyone doing? any updates?

    I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR.
    I'm worried life will just be revisions every few years for the rest of my life

  14. #214
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    Well I'm two years out from the makoplasty which just was my medial compartment not the whole knee. I actually just had semi emergency c3&4 neck surgery because hmmm one too many head vs tree or log etc. So I'm forced to take three months off from hurtling off things. But this past year I be ridden often and ridden hard. Because I'm meshing my native knee cap with metal medially and I have all my ligaments such as my stretched acl , my knee let's me know it's there. I also did a five hell ride day April 3 of this year at revelstoke. So whatever you decide to do just realize it's not oem. And it's probably not a good idea to run, jump or otherwise overload the materials. As in don't jump off that rock. Good luck. If u r in misery go for it.

  15. #215
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    Quote Originally Posted by pat shanks View Post
    Hey all, just read this whole post.
    Hows everyone doing? any updates?

    I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR.
    I'm worried life will just be revisions every few years for the rest of my life
    The unicompartmental knee will have good longevity, but the arthritis process that created the need for it may well be progressive, so yes, if you have a PKR it may well need to be revised. Statistically, the 7 year cumulative risk of need for revision of a unicompartmental knee replacement is about 20% for patients younger than 55. On the positive side, revision of a unicompartmental knee to a total knee replacement is a relatively straightforward operation in the hands of a Fellowship-trained joint-replacement specialist, and that revision to the total will have the usual expected 20+ year longevity. On the downside, that only gets you into your 60's before you might need revision of the TKR, and (at least currently), that operation is kind of a big one.

    OTOH, your options are limited. The alternative is just continue to limp around and have your activities limited. Sucks to be in that position at age 33, but I suspect that you'll be glad you had it done, if you do.

  16. #216
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    Quote Originally Posted by pat shanks View Post
    Hey all, just read this whole post.
    Hows everyone doing? any updates?

    I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR.
    I'm worried life will just be revisions every few years for the rest of my life
    Look into amniotic stem cell therapy. Itís a knee injection that will reduce pain and swelling and possibly rejuvenate damaged tissue and cartilage. Itís relatively new to orthopedics but has been used in other areas of the body with tremendous success. My buddy had both knees injected a year ago and said he forgot he has bad knees. I had mine injected a month ago so too soon for me to give an opinion. We both rode 18 miles with 1700 feet of elevation yesterday. Insurance doesnít cover yet so youíll pay several thousand out of pocket depending on where you go....but if you have your knee replaced youíll pay several thousand out of pocket anyway. Youíre too young for a knee replacement.

  17. #217
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    There is no good evidence that stem cell therapy is beneficial. It may be, but there isn't anything that proves it. Yet.

    In the meantime, there are a variety of "alternative medicine" clinics that are hawking some version of "amniotic stem cells". If you're going to go with this treatment, which may have benefit but is totally unproven, make sure you understand where you're getting it from. There are a variety of chiropractic "wellness" clinics that are perpetrating a hoax. Be careful who you get such treatments from.

    https://www.fda.gov/forconsumers/con.../ucm286155.htm
    https://www.regenexx.com/amniotic-st...herapy-review/
    https://www.thedenverchannel.com/new...rketing-claims

  18. #218
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    Cuyana speaks the truth! If u have loss of joint.space either medially or laterally and the other half is good ( yes that's what I had from various ski injuries a uni is such an excellent solution. Yes u are so much a youngster but nevertheless if you have one good and one bad half +/- your patellofemoral joint area , it can be a pretty sweet solution. Now as I've said I'm an anesthesiologist but I've never worked in a place that does makoplasty. In fact I never heard about "makoplasty" before a rep in a spine room mentioned another guy who services makoplasty. Now I've gotten into all sorts of things on this post about the specific testimony plus one of the excellent academic surgeons claims he can do a uni better. Ok !! But I was quite impressed with both the theory and it's execution on me. If u do for a uni by whatever means, I suggest u find a person who has done at least 200 unis and totals really don't count in my book. It's a different operation.

  19. #219
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    Quote Originally Posted by cyclopath1000 View Post
    If u do for a uni by whatever means, I suggest u find a person who has done at least 200 unis and totals really don't count in my book. It's a different operation.
    Yes. Not your local general orthopedist. An orthopedist who has specific Fellowship training in joint replacement (Adult Lower Reconstruction). For something that you will be relying on for 20+years, you want your knee replaced by someone for whom total joint replacement is more than a hobby. You want it to be the focus of his/her practice.

  20. #220
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    Even fellowship training in total joints in my experience is not sufficient to pick a person to do a uni. I really an only aware of one guy in my area ( major metropolitan area ) who has the volume of uni s to get me excited. Lots of advertising by hospitals etc of what they have to offer , unfortunately for most people it's impossible to get the accurate numbers on case volume for specific proceedures. But if the 33 yo wants to contact me , I might get specific as to who and where I got mine done. It's unethical for me to publicly post it. So I have to get to know u.

    There are a few newer operations that the variance of operator skill is extremely great, for example arthroscopic repair of labral hip tears. When I finally got to work with a master it was one of those moments of wow ! But that's basically the only operation the guy even bothers doing these days. Leaves all the rest for mere mortals.

  21. #221
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    Quote Originally Posted by cyclopath1000 View Post
    It's unethical for me to publicly post it. So I have to get to know u.
    Not clear on what the ethical breach might be.

    I had bilateral unicompartmental knee replacement at the Mayo Clinic in Rochester.

  22. #222
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    I disagree. I think a aggrieved surgeon could make it a med board issue. I'm certainly not in the mood to find out. So if anyone wants specifics they have to contact me.

  23. #223
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    Comment on stem cell therapy.......i had 2 stem cells. After the first one, my knee felt better than it had in 2-3 years. Second one didnít help at all.....i think my knee was too far gone.

    Iím 48. Had TKR 2 years ago in December. Wish i had done it a couple of years sooner. Absolutely zero limitations on what i can do now vs previous. Zero loss in mobility. That being said i had good mobility before.

  24. #224
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    Quote Originally Posted by pat shanks View Post
    Hey all, just read this whole post.
    Hows everyone doing? any updates?

    I've been battling a bad knee since 2005. I'm 33 and after ACL surgery failure, Menisectomy, microfracture, HTO...im looking at a PKR.
    I'm worried life will just be revisions every few years for the rest of my life
    I'm now 11 months post-TKR. I've done two Grand Canyon river trips and competed in two Enduros. 2nd Amateur 50+ in the recent Flagstaff Enduro (37th overall). I was skiing at 4 months. Not much pain if at all anymore. 130 deg flexion although I tested that pretty good on a wet log rollover and slid out to the side with my foot underneath me. Not sure what foot to butt is but at least 150 deg and it hurt like crap. Some soft tissue damage but my ortho just said I got a "flexion manipulation" for free and not to worry about it.

    As for revisions or the joint wearing out I'm not worried about it. Staying in the moment and if I wear it before I'm 70 so be it. Good luck with your decision. At age 33 I'd stick with the natural joint for as long as possible, maybe even trying another ACL graft. I got nearly 30 years out of a patella tendon graft. But osteoarthritis killed the joint.

  25. #225
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    I'm about a month from my first TKR. What is your experience in mtb trail riding with knee pads: recommended/required or doesn't matter?
    Hey everybody, ride my wheels! They ride good, real good.
    I'm a wheel builder. SRLPE Wheel Works. Send me a PM.

  26. #226
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    Quote Originally Posted by 4slomo View Post
    I'm about a month from my first TKR. What is your experience in mtb trail riding with knee pads: recommended/required or doesn't matter?
    I used knee pads on advanced trails before my surgery but I still hang it out there a bit. After the TKR I generally wear knee pads all the time. You really don't want to take a direct hit to the kneecap for obvious reasons. I run these: https://7protection.com/us/product/flex-knee/

  27. #227
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    I came across some exercises, best advice is to start with a Physical Therapist, which is what I will be doing tomorrow morning:
    https://www.verywellhealth.com/total...rcises-2696473
    https://www.healthline.com/health/to...gery/exercises
    https://www.allinahealth.org/health-...nee-exercises/

    Quote Originally Posted by wmbeverleyblanco View Post
    Greetings
    Any wisdom to share to prepare for (Pre Hab) for an impending TKR ...no date set...

    57 yo lifelong athlete
    I ride off and on road and swim.
    Thanks
    Bicycle Bill
    Hey everybody, ride my wheels! They ride good, real good.
    I'm a wheel builder. SRLPE Wheel Works. Send me a PM.

  28. #228
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    I've only fell once on my knee without wearing knee pads and lacerated the skin. The implant is just too Damm close to your skin anteriorly to chance it. I always wear them mountain biking. I was riding a moped in a rally when I fell. So for me the answer is I never ever ride serious stuff without knee and elbow pads. The usual course of lacerations over knees and elbows is staph infection of skin and bursae. At least for me. Multiple times. There are some great pads out there now.

  29. #229
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    Thanks for both confirmations!
    Hey everybody, ride my wheels! They ride good, real good.
    I'm a wheel builder. SRLPE Wheel Works. Send me a PM.

  30. #230
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    Quote Originally Posted by Martinb46 View Post
    Comment on stem cell therapy.......i had 2 stem cells. After the first one, my knee felt better than it had in 2-3 years. Second one didnít help at all.....i think my knee was too far gone.

    Iím 48. Had TKR 2 years ago in December. Wish i had done it a couple of years sooner. Absolutely zero limitations on what i can do now vs previous. Zero loss in mobility. That being said i had good mobility before.
    I just had some arthroscopic surgery on my foot with microfracture and the surgeon said it's available and some people have them injected to "aid" in recovery, but the efficacy is not proven. Studies aren't showing any definitive difference at this time, or not enough studies, something like that. It's intriguing of course.
    "It's only when you stand over it, you know, when you physically stand over the bike, that then you say 'hey, I don't have much stand over height', you know"-T. Ellsworth

    You're turning black metallic.

  31. #231
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    Hi There, I was wondering if anyone in this forum had a TKR surgery made recently with the Mako robotic technology and what the result and recovery timing for coming back to good mountain biking (all mountain/Enduro style), Thanks

  32. #232
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    The value of Makoplasty is largely that it shoulders some of the decision-making regarding prosthetic fit and alignment from the surgeon. It's useful especially for surgeons not trained in or particularly skilled in unicompartmental knee replacement. That can be a tricky procedure. It has good results in the hands of an experienced surgeon, but in many ways its downfall has been inconsistent results when done by surgeons with less training or experience in the procedure. The Mako robot can make up for some of those deficiencies.

  33. #233
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    Ya gotta know how to use the equipment with any of these computer assisted medical therapies. If the spacial location devices aren't set up correctly so the stored ct scan is accurately alligned with your actual body, all hell breaks lose. But yeah that's what my surgeon so loved about my post op visit : just how perfectly the axis and orientation of the implant side is in perfect plane to the native tibial plateau and femoral condyle. And remember the native side wasn't opened for comparison as it would need to be with a freehand uni. That's what makes the results so astonishing.

  34. #234
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    Quote Originally Posted by Emtbiker View Post
    Hi There, I was wondering if anyone in this forum had a TKR surgery made recently with the Mako robotic technology and what the result and recovery timing for coming back to good mountain biking (all mountain/Enduro style), Thanks
    Not sure if it was a Mako but my TKR was computer controlled, robotic-assisted. I was riding gingerly at 2 months and full-on at 4 months. Did an enduro race at 9 months and 10 months, respectively.

  35. #235
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    Quote Originally Posted by rockman View Post
    Not sure if it was a Mako but my TKR was computer controlled, robotic-assisted. I was riding gingerly at 2 months and full-on at 4 months. Did an enduro race at 9 months and 10 months, respectively.
    Those would be the expected results for any unicompartmental knee, robotic or otherwise.


    Quote Originally Posted by cyclopath1000 View Post
    Ya gotta know how to use the equipment with any of these computer assisted medical therapies. If the spacial location devices aren't set up correctly so the stored ct scan is accurately alligned with your actual body, all hell breaks lose. But yeah that's what my surgeon so loved about my post op visit : just how perfectly the axis and orientation of the implant side is in perfect plane to the native tibial plateau and femoral condyle. And remember the native side wasn't opened for comparison as it would need to be with a freehand uni. That's what makes the results so astonishing.
    Those would be the expected results in the hands of any experienced joint surgeon, robotic or otherwise.

  36. #236
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    Damn and here I thought I was special but just an average TKR Joe. Guess the point is I got to pretty much where I left off. I finished 2nd in 50+ in the Flag Enduro. Riding at race pace is not anything close to recreational riding. I was quite pleased with that and my decision to go ahead with the surgery. However, I'm extremely paranoid about crashing or hitting the knee. I wear knee pads on pretty much every ride even if it's a cruiser.

    I think my surgeon did 8 or 9 TKRs that day. I made sure I was #2 or #3 and not #9!

  37. #237
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    Mako total knee robotic has been introduced only on early 2017, could you tell me about your post surgery and recovery? , Pain, timing for walking, driving, etc. Problems?
    I should get the Mako TKR in a week but I am very scared about that. I am 60yo and although my knee is in advanced OA I still ride very aggressively and use to do some enduro race on E-bike. My pain so far has been accetable but my real problem is walking (only 500mt,max), no more hiking, no more skiing. My surgeon is not very familiar with enduro MtB, he just told me that biking is an allowed sport after TKR but we know that riding on enduro trails it is not exactly "biking". I still don't know if it is really the time for this surgery or i shoul still wait for it. Thanks for your help.

  38. #238
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    Also, do you know the name of your implant ? Is it the triathlon from Stryker?

  39. #239
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    Mako total knee robotic has been introduced only on early 2017, could you tell me about your post surgery and recovery? , Pain, timing for walking, driving, etc. Problems?
    I should get the Mako TKR in a week but I am very scared about that. I am 60yo and although my knee is in advanced OA I still ride very aggressively and use to do some enduro race on E-bike. My pain so far has been accetable but my real problem is walking (only 500mt,max), no more hiking, no more skiing. My surgeon is not very familiar with enduro MtB, he just told me that biking is an allowed sport after TKR but we know that riding on enduro trails it is not exactly "biking". I still don't know if it is really the time for this surgery or i shoul still wait for it. Also Do you know the name of your implant. Is it the Triathlon by Stryker co.Thanks for your help.

    QUOTE=rockman;13937789]Damn and here I thought I was special but just an average TKR Joe. Guess the point is I got to pretty much where I left off. I finished 2nd in 50+ in the Flag Enduro. Riding at race pace is not anything close to recreational riding. I was quite pleased with that and my decision to go ahead with the surgery. However, I'm extremely paranoid about crashing or hitting the knee. I wear knee pads on pretty much every ride even if it's a cruiser.

    I think my surgeon did 8 or 9 TKRs that day. I made sure I was #2 or #3 and not #9![/QUOTE]

  40. #240
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    Quote Originally Posted by Emtbiker View Post
    Mako total knee robotic has been introduced only on early 2017, could you tell me about your post surgery and recovery? , Pain, timing for walking, driving, etc. Problems?
    I should get the Mako TKR in a week but I am very scared about that. I am 60yo and although my knee is in advanced OA I still ride very aggressively and use to do some enduro race on E-bike. My pain so far has been accetable but my real problem is walking (only 500mt,max), no more hiking, no more skiing. My surgeon is not very familiar with enduro MtB, he just told me that biking is an allowed sport after TKR but we know that riding on enduro trails it is not exactly "biking". I still don't know if it is really the time for this surgery or i shoul still wait for it. Thanks for your help.
    Well I guess we're somewhat similar in that I really had no issues with my bone on bone knee riding and racing mtb. Anything load bearing, however, had become painful and I had given up skiing and hiking. So, it's a quality of life decision. If you can live with just biking then put it off for awhile. Like most others, now that I have had it done I echo the refrain of "why didn't I do it sooner"? I'm back to skiing and could even run if I wanted. Enduro racing is very aggressive riding so that's a risk-reward dealio. Good luck with your decision but I suspect you won't regret it.

    With regard to your other questions, your pretty much walking that same day albeit with a walker. It's the first two weeks that suck and then after that hopefully weaned off the painkillers and hitting PT hard to get the flexion back. I was driving my TDI Golf with a stick shift and operating the clutch with my leg at 4 weeks I think. The whole thing is really amazing actually. Far easier than my previous ACL reconstruction.

  41. #241
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    Sorry to bother you but I have finally found someone can tell me what i was wondering.
    Could you please answer a few more questions:
    Do you know if your implant is the Triathlon by Stryker?
    How long have you had the surgery right now?
    How long have you been in the hospital? did you do PT at the hospital too?
    Can you hear any mechanical noise or click in your new knee when you pedal?
    Doing your Enduro riding after surgery, have you had the chance to point your prosthesis leg to the ground for avoiding a fall? Any problems?
    Can you go downhill standing up on the pedals for a long time ?
    Thanks a lot for answering me.

    Quote Originally Posted by rockman View Post
    Well I guess we're somewhat similar in that I really had no issues with my bone on bone knee riding and racing mtb. Anything load bearing, however, had become painful and I had given up skiing and hiking. So, it's a quality of life decision. If you can live with just biking then put it off for awhile. Like most others, now that I have had it done I echo the refrain of "why didn't I do it sooner"? I'm back to skiing and could even run if I wanted. Enduro racing is very aggressive riding so that's a risk-reward dealio. Good luck with your decision but I suspect you won't regret it.

    With regard to your other questions, your pretty much walking that same day albeit with a walker. It's the first two weeks that suck and then after that hopefully weaned off the painkillers and hitting PT hard to get the flexion back. I was driving my TDI Golf with a stick shift and operating the clutch with my leg at 4 weeks I think. The whole thing is really amazing actually. Far easier than my previous ACL reconstruction.

  42. #242
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    Quote Originally Posted by Emtbiker View Post
    Sorry to bother you but I have finally found someone can tell me what i was wondering.
    Could you please answer a few more questions:
    Do you know if your implant is the Triathlon by Stryker?
    How long have you had the surgery right now?
    How long have you been in the hospital? did you do PT at the hospital too?
    Can you hear any mechanical noise or click in your new knee when you pedal?
    Doing your Enduro riding after surgery, have you had the chance to point your prosthesis leg to the ground for avoiding a fall? Any problems?
    Can you go downhill standing up on the pedals for a long time ?
    Thanks a lot for answering me.
    -I have an Omni
    -I'm at 14 months post surgery
    -2 night hospital stay. Started PT that same day.
    -I do get some clicking or minor noise walking around but nothing while I ride.
    -I have bailed to the side of my TKR leg several times with no issues. I also crashed and broke my collarbone, 4 ribs, and scapula at 5 months on a black diamond trail. Knee escaped unscathed.
    -no issues using a seat dropper and standing while long periods. Which is pretty much any enduro race. Downhill sprinting. Lower back probably limits me there more than anything. The newer bikes with longer reach also help.

    Frankly, it's been just what my surgeon said it would be. Now, at a year I don't even think about it. If I was 27 instead of 57 then I might feel differently but I'm still quite competitive and can go as fast as I care to. Really I hold back a bit because I don't want to crash. Bone just don't heal as fast at our age. That risk-reward thing rearing it's ugly head and the pendulum tipping more and more to the side of reason.

  43. #243
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    Those people who have resumed normal activity after 4 weeks post-replacement make MY knee hurt!

    I think those doctors need to go back to med school (in my opinion).

  44. #244
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    Quote Originally Posted by Forest Rider View Post
    Those people who have resumed normal activity after 4 weeks post-replacement make MY knee hurt!

    I think those doctors need to go back to med school (in my opinion).
    Fake News! There was nothing normal about my activity level at 4 weeks except going to PT. Getting back to normal is more like 4 to 6 months.

  45. #245
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    I had ACL replacement and no way could I get out and climb mountains and shred downhills at 4 weeks.
    Can't imagine the risk involved with the implant shifting a millimeter then volunteering to have surgery again to fix the self-inflicted mistake.

    If a broken bone takes 6 weeks to heal before it's said to be safe to ride, how long do we think it takes for a hole drilled into the bone to heal.

    Eeks.

    Having gone through recover, in no way am I anxious to resume activity too soon.

    It might feel great right now but in 5 years, maybe not so much. I'm 9 years or so post-op and have since become a mountain biker, marathon runner, etc....none of which I had done before surgery.

  46. #246
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    The knee prosthesis is cemented to the bone. It can't shift. It's as solid on the first day post-op as it is a year later.

    Knee joint replacement has nothing to do with ACL surgery. Except...the knee, of course....

    I had bilateral unicompartmental knee replacement about 6 or 8 years ago. I was back at work with a cane two weeks later (I'm a surgeon), threw the cane away at four weeks. Riding the road bike at 6 weeks, riding the mountain bike at 8 weeks. I did OT while I was in the hospital (which was dumb, but I didn't have anything else to do). Didn't really do any PT. They gave me 60 oxycodone tabs at discharge. I used about 8.

    (these were unicompartmental protheses. a TKR is a bit of a different ballgame

  47. #247
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    The only good thing left in my knee at the time of surgery was my ACL patella tendon graft from 1989. A pity to hack it out of there after going strong for 29 years.

    I did have a scare where I slid on a wet log with my foot in daffy position and went down with it directly underneath my weight. So, a forceful flexion to 150+ degrees. It hurt like hell but was mainly surrounding area connective tissue damage. The prosthesis and Cayuna indicated above was unaffected. The cement is space age. Guess in that scenario the risk is tearing the quadricep tendon but my surgeon just shrugged and said I got a mechanical manipulation for free.

  48. #248
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    Quote Originally Posted by rockman View Post
    The cement is space age.
    Yes, although they've been using the same cement (methyl methacrylate) for more than 50 years.

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    I am a sales rep/consultant for a company that sells the instruments and implants for these procedures. If anyone is considering surgery and doesn't have a trusted surgeon, if at all possible I recommend talking to a device sales rep in your area. We are in the unique position of being in the OR and watching dozens if not hundreds of these cases with multiple surgeons. We usually have a pretty good idea of who the most skilled surgeons are and who you might want to avoid.

    Just a thought.

  50. #250
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    Quote Originally Posted by BEETROOT View Post
    I am a sales rep/consultant for a company that sells the instruments and implants for these procedures. If anyone is considering surgery and doesn't have a trusted surgeon, if at all possible I recommend talking to a device sales rep in your area. We are in the unique position of being in the OR and watching dozens if not hundreds of these cases with multiple surgeons. We usually have a pretty good idea of who the most skilled surgeons are and who you might want to avoid.

    Just a thought.
    What about the surgeons using the brands of implants you don't sell?

  51. #251
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    Quote Originally Posted by Cuyuna View Post
    What about the surgeons using the brands of implants you don't sell?
    Basically a sales reps job is to know the industry and to know the surgeons. We know their reputation and skill level, case volume, issues or complications with their products or techniques, their outcomes. It's our job to know this whether they use our stuff or not. Plus we spend all day every day in hospitals, labs, trainings, industry meetings. I think I know who the best guys around are for any given surgery just by osmosis.

    If a friend or family member needed a TKA in Arizona there is a short list of who I would recommend and none of them use the products I sell for that surgery.

    Not saying a sales rep should be a primary source of information or anything. Just that if you happen to know anyone in the industry it's worth shooting them an email.

  52. #252
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    Quote Originally Posted by BEETROOT View Post
    Basically a sales reps job is to know the industry and to know the surgeons. We know their reputation and skill level, case volume, issues or complications with their products or techniques, their outcomes. It's our job to know this whether they use our stuff or not. Plus we spend all day every day in hospitals, labs, trainings, industry meetings. I think I know who the best guys around are for any given surgery just by osmosis.

    If a friend or family member needed a TKA in Arizona there is a short list of who I would recommend and none of them use the products I sell for that surgery.

    Not saying a sales rep should be a primary source of information or anything. Just that if you happen to know anyone in the industry it's worth shooting them an email.
    I donít disagree with anything you said. I regularly deal with medical device reps and have for far longer than youíve been one. I have great respect for them and their professionalism, agree that they understand the surgeon landscape better than almost everyone (including other surgeons), and that they could be a very useful source of information on surgeon and hospital capabilities. Your recommendation about checking with one is a good one, but their accessibility to the general public is generally poor, and if they are truly professional then they will keep such opinions to themselves. I canít think of anything a device rep could do that would sabotage his/her job or reputation more profoundly than rendering opinons on surgeon qualifications to the general public. Iím surprised that an experienced Ortho rep would make such a recommendation.

  53. #253
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    I took a different approach and asked all the PTs in town who they had the least problems with. It was almost unanimous in terms of which surgeon had the best results. I live in a town of 70,000 with perhaps ~6 surgeons to choose from. I talked to 3 before making my decision.

    Not sure if that falls into the same level of professionalism that Cuyuna is referring to but if your active and outdoorsy for any length of time you end up knowing either first hand, or by name and reputation, all the players: surgeons, nurses, PTs, etc. The medical device reps not so much.

  54. #254
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    Quote Originally Posted by rockman View Post
    I took a different approach and asked all the PTs in town who they had the least problems with. It was almost unanimous in terms of which surgeon had the best results. I live in a town of 70,000 with perhaps ~6 surgeons to choose from. I talked to 3 before making my decision.

    Not sure if that falls into the same level of professionalism that Cuyuna is referring to but if your active and outdoorsy for any length of time you end up knowing either first hand, or by name and reputation, all the players: surgeons, nurses, PTs, etc. The medical device reps not so much.
    Surgeons donít generally refer to specific physical therapists, whereas their relationship with device reps is far more personal and interdependent, especially orthopaedists and orthopedic device reps. In the case of device reps, if a surgeon got word that one was recommending patients not see him/her...that would not bode well for that repís job, even among the surgeons he was recommending. It would be seen as very unprofessional by both the surgeons and the device repís boss.

    In the case of physical therapists, most orthopaedists are very involved in the PT departments they use. A PT shooting his/her mouth off about the qualifications of various surgeons they work with is generally seen as unprofessional and is very likely to be counterproductive to job security.

  55. #255
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    Quote Originally Posted by Cuyuna View Post
    Surgeons donít generally refer to specific physical therapists, whereas their relationship with device reps is far more personal and interdependent, especially orthopaedists and orthopedic device reps. In the case of device reps, if a surgeon got word that one was recommending patients not see him/her...that would not bode well for that repís job, even among the surgeons he was recommending. It would be seen as very unprofessional by both the surgeons and the device repís boss.

    In the case of physical therapists, most orthopaedists are very involved in the PT departments they use. A PT shooting his/her mouth off about the qualifications of various surgeons they work with is generally seen as unprofessional and is very likely to be counterproductive to job security.
    I suppose so but the feedback I usually got was something along the lines of "don't use that guy for you knee, he's much better with shoulders" or whatever. The PTs are generally independent from the two main orthopaedic offices in town. You have the choice of going to see whomever you want. I don't see how getting a recommendation from a PT is counterproductive to their job security. Facts are facts. If a surgeon is lame you should be able to ascertain that knowledge somehow. Or, put another way how would you recommend going about finding who you want to saw your joint apart? It's a big decision.

  56. #256
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    Quote Originally Posted by rockman View Post
    I suppose so but the feedback I usually got was something along the lines of "don't use that guy for you knee, he's much better with shoulders" or whatever. The PTs are generally independent from the two main orthopaedic offices in town. You have the choice of going to see whomever you want. I don't see how getting a recommendation from a PT is counterproductive to their job security. Facts are facts. If a surgeon is lame you should be able to ascertain that knowledge somehow. Or, put another way how would you recommend going about finding who you want to saw your joint apart? It's a big decision.
    Fact are facts, but more relevant to this situation, opinions are opinions and opinions are not facts.

    Sometimes it's unprofessional and unwise to share one's opinions.

  57. #257
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    Quote Originally Posted by Cuyuna View Post
    Fact are facts, but more relevant to this situation, opinions are opinions and opinions are not facts.

    Sometimes it's unprofessional and unwise to share one's opinions.
    I understand your POV but as someone about to face a potentially life changing operation you don't bury your head in the sand either.

    If a device rep is recommending a surgeon because they use the product he reps then that is indeed unprofessional. No argument there. As for PTs, I would call it an 'educated opinion' and I think they should be able to share that information without fear of reprisal. Apparently you don't which I find a bit disturbing but to each his own. You didn't answer the question either.

    I'm a geologist and I have no problem recommending which firm in town to use to drill your well to find water on their property. In your case, you are in the medical field. If you were looking for the best surgeon how do you go about it? So far, we've covered device reps, PTs, or referrals from other surgeons.

    Opinion is one end of the spectrum and first hand knowledge at the other end. Guess the answer is somewhere in the middle but I'm sure glad I chose wisely instead of poorly. How do you get to that choice is the question that is relevant to this thread.

  58. #258
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    Quote Originally Posted by Wherewolf View Post
    Had both replaced five years ago. My 63rd birthday ride:

    Attachment 982391
    Hell yeah! You my friend are an inspiration to me.
    Ride

  59. #259
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    Quote Originally Posted by Biohazard74 View Post
    Hell yeah! You my friend are an inspiration to me.
    Well shyte, Wherewolf passed away in a car accident a couple of years ago. I rode a couple of times with him on long epics in Arizona. He lived in continual knee pain even with his TKRs which didn't give me much confidence. But he was out there doing it, living for the long ride. RIP Wherewolf!

  60. #260
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    Quote Originally Posted by rockman View Post
    Well shyte, Wherewolf passed away in a car accident a couple of years ago. I rode a couple of times with him on long epics in Arizona. He lived in continual knee pain even with his TKRs which didn't give me much confidence. But he was out there doing it, living for the long ride. RIP Wherewolf!
    Oh damn !!! RIP Wherewolf. That post inspires me more now. He's not forgotten.
    Ride

  61. #261
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    Quote Originally Posted by rockman View Post
    I understand your POV but as someone about to face a potentially life changing operation you don't bury your head in the sand either.

    If a device rep is recommending a surgeon because they use the product he reps then that is indeed unprofessional. No argument there. As for PTs, I would call it an 'educated opinion' and I think they should be able to share that information without fear of reprisal. Apparently you don't which I find a bit disturbing but to each his own. You didn't answer the question either.

    I'm a geologist and I have no problem recommending which firm in town to use to drill your well to find water on their property. In your case, you are in the medical field. If you were looking for the best surgeon how do you go about it? So far, we've covered device reps, PTs, or referrals from other surgeons.

    Opinion is one end of the spectrum and first hand knowledge at the other end. Guess the answer is somewhere in the middle but I'm sure glad I chose wisely instead of poorly. How do you get to that choice is the question that is relevant to this thread.
    Facts are indisputable (except by politicians). Opinions can be shaped by many factors that have nothing to do with professional competence.

    I have no clue what constitutes professionalism in the geology field, nor do I have a clue about the professional landscape in your town. I'm not making comparisons. I do have a very clear concept of professionalism in the health care field and clearly understand how lack of it can and should affect one's job.

    I'm glad you chose wisely too, and certainly wouldn't fault you or anyone for trying to obtain advice from any avenue available to them.

  62. #262
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    Quote Originally Posted by Cuyuna View Post
    Facts are indisputable (except by politicians). Opinions can be shaped by many factors that have nothing to do with professional competence.

    I have no clue what constitutes professionalism in the geology field, nor do I have a clue about the professional landscape in your town. I'm not making comparisons. I do have a very clear concept of professionalism in the health care field and clearly understand how lack of it can and should affect one's job.

    I'm glad you chose wisely too, and certainly wouldn't fault you or anyone for trying to obtain advice from any avenue available to them.
    Sounds to me like we need more people like you in your field. Glad we can keep this discussion civil and I appreciate your integrity and professionalism. But you as a surgeon are on the inside looking out. Most of us are on the outside looking in. You obviously had what might be considered privileged insider knowledge as to which surgeon to choose for your bilateral unicompartmental knee replacement. Or, did you simply go with the guy in your practice because it was the right thing to do?

    I thought about this more and asked my brother who is a Phizer rep. Actually he is a manager for reps in several states doing mostly medical devices. Device reps are a solid source of information but have a possible conflict of interest like you stated. He thinks what other surgeons have to say is important knowing that it also is unprofessional to throw a colleague under the bus. But more importantly, with relevance to this thread he suggested looking at message boards and also to research lawsuits.

    Good luck out there future TKR recipients!

  63. #263
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    In my case, having been advised by an orthopaedist partner of mine that a unicompartmental knee replacement was an option for both knees (I had had no clue that that was an option), I opted to skip him and go to the surgeon who literally wrote the book on uni knees, an orthopedist at one of the premier joint replacement programs in the country, Mayo Clinic in Rochester (about a 3.5 hour drive from here). My orthopaedist partner that I originally saw is an excellent orthopaedic surgeon, a good friend, and does a great joint replacement, but heís a Fellowship-trained Sports Medicine specialist, not a joint specialist. I picked my joint surgeon not based on any inside information, but by looking for the guy with the best credentials and training in unicompartmental joint replacement. I started by doing a literature search and finding the surgeons with the largest number of publications, then reviewing their training from online sources. The only perk I got from the guy I ultimately chose was that I asked him to replace both knees at the same time and he agreed.

    I went through the same process as many here....what kind of prosthesis? Lots of internet research and a review of medical literature, thought I had a well thought-out rationale. It turns out that despite my many resources and my ability to interpret medical literature, I actually had no clue about what was best and why, and having raised the issue with the surgeon, and telling him what I thought was my preference, he patiently explained why I didnít know WTF I talking about. Thereís a lesson in there...pick a surgeon with the best credentials and training you can find and take his/her recommendations. Nothing you read on the internet, even in a mountain biking forum, is going to give you better information that youíll get from a good, well-trained orthopaedic surgeon that has examined you, and knows your medical history. In that regard, you should looking for someone that has post-graduate Fellowship specialty training in joint replacement, not the guy/gal who, on a typical OR day, has three carpal tunnels, a trigger finger, two ORIFs and one total knee replacement. Pick the surgeon that does 20 joints a week.

  64. #264
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    Quote Originally Posted by Cuyuna View Post

    ...

    Your recommendation about checking with one is a good one, but their accessibility to the general public is generally poor, and if they are truly professional then they will keep such opinions to themselves. I canít think of anything a device rep could do that would sabotage his/her job or reputation more profoundly than rendering opinons on surgeon qualifications to the general public. Iím surprised that an experienced Ortho rep would make such a recommendation.

    Re-reading my original post I guess I could have been more clear. I wasn't suggesting calling sales reps out of the blue. We give advice freely to friends and family, but like you said... providing these opinions to the general public would be unprofessional.

    The chances of knowing someone in the industry are small, I'm aware of that and probably shouldn't have posted anything about it in the first place. Just saying if you happen to know anyone in the business, they could be helpful.

  65. #265
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    Quote Originally Posted by Cuyuna View Post
    you should looking for someone that has post-graduate Fellowship specialty training in joint replacement, not the guy/gal who, on a typical OR day, has three carpal tunnels, a trigger finger, two ORIFs and one total knee replacement. Pick the surgeon that does 20 joints a week.
    This is great advice and something I don't think the general public thinks about. A lot of people seem to think that if they are seeing a surgeon for a procedure, that surgeon probably does those procedures regularly. People don't realize they may be seeing a surgeon for a complicated procedure that the surgeon only does a couple times per year.

  66. #266
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    Joint replacement, any joint, is a big deal. The consequences of it being done anything less than perfect are at best annoying and at worst devastating. One should seek out the most qualified surgeon with the best credentials that they can find. There are many general orthopaedists out there that don't have specialty training (Fellowship training) in joint replacement, and doing a few joints a month. Prospective patients should look at their surgeon's credentials, training, and experience very carefully.
    Last edited by Cuyuna; 01-07-2019 at 05:53 AM.

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    two years ago I had both knees replaced three weeks apart. The one thing that I learned is that no matter what anyone says your body heals differently than others. My first surgery went without a hitch. I was walking with one crutch 5 day after and in physical therapy. The second went somewhat ok but staggered a little on the rehab and full range of motion. Three months after the second surgery I developed a leak which required a revision and a much longer rehabilitation time. At this point I am perfect and I could not be any more happier with the out come. I did a lot of research and asked a lot of physical therapiest which Dr had the least amount of patients with complaints and set backs. Thats when I choose the physician to do my surgery. Expect a good year to really feel like your knees are yours. Good luck!!

  68. #268
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    I'm now eleven days before my first knee replacement! My second will follow in three months. Going through both dread of the rehab, and excitement for being able to ride after recovery without as much pain.
    Hey everybody, ride my wheels! They ride good, real good.
    I'm a wheel builder. SRLPE Wheel Works. Send me a PM.

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    Quote Originally Posted by 4slomo View Post
    I'm now eleven days before my first knee replacement! My second will follow in three months. Going through both dread of the rehab, and excitement for being able to ride after recovery without as much pain.
    Good luck and with only 11 days work on your core, which will help after surgery. I think mine were done 6 or 7 weeks apart and rehab gets old the second time around, but is a necessary evil. Keep us posted.

  70. #270
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    After knee replacement surgery, what did your rehab consist of?

  71. #271
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    Quote Originally Posted by Cuyuna View Post
    After knee replacement surgery, what did your rehab consist of?
    Been awhile, but I know I went to PT 3 days for 6 weeks. Got home on a Thursday with both surgeries and started PT on Monday. I know getting knee motion back was number 1 importantance with therapist and myself. Sat on exercise recumbent bike and would go back and forth as much as I could bend it. Therapist and I would do knee exercises laying on table and over the edge of table. PT would also lay me flat n table and push down on knee to get it to go straight. I know with my first one I had my trainer setup in the garage and I would work it back and forth everyday. Then all of a sudden going back to the top my leg did a full rotation, which I was not expecting and man did that hurt. I did walk a lot as well. I did have a CPM machine at home for both knees, which I think helped me get my motion back. Most surgeons donít use these anymore, I think itís more insurance reasons.

    And a little bit of worthwhile information on crutches for all. Once you get down to one crutch put the crutch on the opposite side of the surgery fixed knee. Sounds weird, but makes walking much easier. So if itís your left knee that had surgery use crutch on right side. One more thing is to remember ďheel toeĒ when walking. Tell your spouse and friends to remind you of this as well. When you walk your heel should hit the ground first then over to toe. Sounds easy enough doesnít it? But it will take time to get there.

  72. #272
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    I had bilateral unicompartmental knee replacements 6-7 years ago. On the morning of discharge, after the femoral blocks had worn off, they had me do some OT to show me how to get up and down stairs with a walker, and stuff like that. I asked the surgeon about PT, he shrugged and said "sure, if you want". I went to one PT session when I got back home...they measured my ROM, showed me some exercises, and told me get a stationary bike. I came back a few weeks later (after I was off the walker) and they said.."good to go, come back if you need us". Never did.

    After a knee replacement, intensive PT might be helpful but mostly it's to make sure the patient is doing his/her exercises and that knee mobility is moving along nicely. The days of the CPM machine are long gone now in the days of (almost) outpatient TKR.

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    I have read through a majority of the thread replies here, all have value to what everyone has stated. Educating yourself on such a life changing event to your body, especially one that you will change your life with till the day you die, is paramount.

    With that said, I did my research, found the best device on the market, matched it with the best surgeon that performs dozens per week. Results have been outstanding.

    I was 45 and had 5 previous cleanlout surgeries, when I was told I had no repairable cartilage left in either knee, prolonged replacement for another 5 years by riding on a regular basis. This mostly by gravel trail and mountain biking.

    Age 50, could not take the burning from simply walking around for any length of time. Asked the questions, researched, then researched again. Found what I considered my best options. Had the bilateral TKR's on the same day. Was on stationary bike one week post. On a gravel bike little over two weeks post. I held off putting any resistance to the joint for three months, but continued to ride almost daily. Started mountain biking earnestly again at the the three month juncture and never looked back.

    I am 55 and almost at the 5 year post surgery point and I have not had one single regret or issue. I am a very strong rider and can ride with those half my age. Riding is a non impact activity, great for leg strength, lubrication of your joints and stretching of your muscles. My surgeon even said to ride over the rehab, just restrain till the muscles healed.

    I encourage those that are at that point of needing one or both replaced, do not hesitate. It is a small hurdle that you quickly overcome. Just complete your research and be informed. I will not not knock companies or devices on the market. Most are good, some are better, but all can be crap in the hands of the wrong surgeon. Choose wisely, and ride on!!!

  74. #274
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    Hey Turk, say someone who is knocking on the door of 50 and rides at a high level/aggressive descending (Whistler big hits for a month every year) but is in need of a partial KR. Does your advice still hold? What are the stress limits of TKR's?

  75. #275
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    Quote Originally Posted by EatsDirt View Post
    Hey Turk, say someone who is knocking on the door of 50 and rides at a high level/aggressive descending (Whistler big hits for a month every year) but is in need of a partial KR. Does your advice still hold? What are the stress limits of TKR's?
    I'm not Turk but at 57 I do still ride aggressively and compete in enduro racing albeit for fun. I don't think the stress limit is mechanical it's more about impact with your kneecap now residing on top of a hard metal and plastic implant. I worry more about shattering my kneecap than anything else. Hopefully others will chime in but it becomes a risk-reward dealio.

    Total Knee Replacement-hot-shots.jpg

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    Impact to riding is virtually negligible, unless you want to test them by going over the bars. I ride a single speed rigid, and I can guarantee they have been stressed as much as possible and I've never experienced any discomfort. Total over a partial any day. Longevity of the devices won it over for me. I had the option to a partial, but the devices at the time had half of the lifetime to my total hardware

  77. #277
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    Thanks guys, that is encouraging. I'd suspect a rigid SS is prob worse on knee then having full squish at nearly any speed/terrain... and good to see you're still getting after it Rock!

  78. #278
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    How to prepare

    Quote Originally Posted by Cuyuna View Post
    The only perk I got from the guy I ultimately chose was that I asked him to replace both knees at the same time and he agreed.
    Cuyuna, thanks for posting your path and details of finding your surgeon and recovery. I am basically in the same boat, probably waited a bit too long and now looking at the same option as you had done. I really want to knock them out at the same time and having problem convincing the Docs to do it.
    I had micro fracture on one and meniscus resection on both at the same my last round 10 years ago and it worked out well for me, was off of pain meds day 2 and fully mobile on crutches day 3 (expect for micro-fracture side). But, this is a lot different and I have no sense how I could get along the first month. Can you comment on how you manged the first few days and weeks? What did you find you were not prepared for and what you had wished you knew if you did it again. I ask the all with respect to recovery, including showers and other nitty grittys. For example, on a separate occasion I had a pretty tough surgery and shaved my head just prior to be able to skip a week of showers. Would be happy to take this to a PM if needed.

    Thanks and cheers,

  79. #279
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    I've had one total knee replacement (1/22/19) and the other one scheduled for 4/16/19. My Surgeon recommended three months apart for me (in my mid-60s), to minimize the possibility of blood clot complications. I had a month of PT, 3 times a week, and found it very helpful to begin to get my range of motion back. My knee is presently at 126 degrees of bending (3/5/19). You can't drive until 1) you're off the narcotic prescription (get off as soon as you can tolerate it), and 2) you have sufficient range of motion to be able drive safely and move between brake pedal and accelerator pedal with your foot (clutch pedal too if a manual transmission). I resumed driving 3 weeks post-surgery. I started out with a walker for several weeks, before graduating to walking unassisted. Couldn't shower for a week, until the compression dressings were removed, but could do sponge baths. It's pretty easy to leave a walker outside of the shower, especially if you have a bar in your shower to grab onto. A Polar cooler is wonderful for controlling the swelling, it pumps ice water through a plastic pad you place over your knee, I think most hospitals are providing them, although I have experience with only one hospital. I'm presently riding my road bike on flat bike trails around my neighborhood, and just about ready to do longer rides. I've found that the consensus is you will want to ride your mtb with knee pads, and know that your femur is most likely to break if you fall on your knee, as the bone is weaker than the joint. I was recommended to dial back my riding style, when I'm eventually ready to mtb ride again late summer/early autumn.
    Hey everybody, ride my wheels! They ride good, real good.
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  80. #280
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    Quote Originally Posted by Tommybees View Post
    Cuyuna, thanks for posting your path and details of finding your surgeon and recovery. I am basically in the same boat, probably waited a bit too long and now looking at the same option as you had done. I really want to knock them out at the same time and having problem convincing the Docs to do it.
    I had micro fracture on one and meniscus resection on both at the same my last round 10 years ago and it worked out well for me, was off of pain meds day 2 and fully mobile on crutches day 3 (expect for micro-fracture side). But, this is a lot different and I have no sense how I could get along the first month. Can you comment on how you manged the first few days and weeks? What did you find you were not prepared for and what you had wished you knew if you did it again. I ask the all with respect to recovery, including showers and other nitty grittys. For example, on a separate occasion I had a pretty tough surgery and shaved my head just prior to be able to skip a week of showers. Would be happy to take this to a PM if needed.

    Thanks and cheers,
    I was off work about 3 weeks. I spent a lot of time on a stationary bike in front of the TV. First week or so I used a walker around the house, then used a cane because the walker was a pain. Showering a day or two after surgery. I was driving after about 7-10 days, but I drove my wifeís car since my car is a very low sports car (hard to climb down into) and has a manual transmission, and my truck is big and hard to climb up into. Working the clutch on the sports car was no big deal, but I was concerned about working it well in an urgent circumstance. Once back at work, I used a cane until I shortly realized I was carrying it more than walking on it. I didnít really have any pain. They prescribed 120 oxycodone tablets on discharge...I think I used about 6 of them....still have some sitting around in my medicine cabinet. I didnít really do any PT. They showed me some ROM exercises before I left the hospital, and OT showed me how to go up and down stairs with a walker or cane, stuff like that. The surgeon kind of shrugged when I asked about PT at home...said ďsure, why not?Ē. I went once, learned some ROM exercises but otherwise didnít really find it helpful, although I did pick up a goniometer while I was there instead of buying one off Amazon.

    Bear in mind that my knee replacement was bilateral unicompartmental. Thatís less intrusive than a TKR. Although I will say that a close friend was able to talk the orthopod into a bilateral TKR. His recovery experience wasnít that much different than mine, although it did take longer...Iíd guess his recovery was about 125% of mine. I do recall that he was out on his tractor mowing his lawn on about postop day 10. He was in the hospital 2 1/2 days, but usually unilateral TKR patients here go home on the day after surgery. Theyíre guessing that outpatient TKR will be commonplace for some patients very soon.

    It can be hard to judge experiences from one TKR patient to the next. The joint specialist here is a pretty remarkable guy. He did his joint Fellowship at Mayo Rochester, trained by the same guy that did my bilateral Uniís. It takes him about 20 minutes to do a TKR and the staff he has for the Joint Center is remarkable. He does 4-6 joints a day typically. Itís a very elaborate and sophisticated system. He sees a lot of patients from other surgeons around the area for TKR complilcations. I review those revisions monthly. It has certainly reinforced for me the importance of having a Fellowship-trained joint replacement specialist do your joint replacement.

  81. #281
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    Quote Originally Posted by BEETROOT View Post
    I am a sales rep/consultant for a company that sells the instruments and implants for these procedures. If anyone is considering surgery and doesn't have a trusted surgeon, if at all possible I recommend talking to a device sales rep in your area. We are in the unique position of being in the OR and watching dozens if not hundreds of these cases with multiple surgeons. We usually have a pretty good idea of who the most skilled surgeons are and who you might want to avoid.

    Just a thought.
    I recently retired, but I owned a distributorship and have been in on over 5000 joint cases, along with a couple hundred spine cases in Southern California.
    Ripping trails and tipping ales

  82. #282
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    Quote Originally Posted by BEETROOT View Post
    This is great advice and something I don't think the general public thinks about. A lot of people seem to think that if they are seeing a surgeon for a procedure, that surgeon probably does those procedures regularly. People don't realize they may be seeing a surgeon for a complicated procedure that the surgeon only does a couple times per year.
    Most patients don't have a clue what implant brand the have. I'll also add (to the other posters) that there are industry standards and brands can be used together. An example would be a hip revision where they use my cup and head, but since the femoral component is solid and has the same 12/14 taper as my head, it gets left in.
    Ripping trails and tipping ales

  83. #283
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    Quote Originally Posted by Vader View Post
    Most patients don't have a clue what implant brand the have.
    I don't know if that's true or not, but probably is. Of course the other side of the coin is the patient, non-medical, who finds out that they need a new hip or knee and then researches brands and models of prostheses all over the internet and bases their surgeon decision on finding one that implants the one that their internet search has told them is best.

  84. #284
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    Quote Originally Posted by Cuyuna View Post
    I don't know if that's true or not, but probably is. Of course the other side of the coin is the patient, non-medical, who finds out that they need a new hip or knee and then researches brands and models of prostheses all over the internet and bases their surgeon decision on finding one that implants the one that their internet search has told them is best.
    I always ask people what implant company they went with because I'm genuinely interested. Most never bothered to ask. I worked for three top docs who only used my stuff and were loyal to me, but sometimes a patient had did their research and wanted what they thought was best, or in one instance, saw a commercial for a "womens' specific" system and another rep would step in. That works both ways. Id sometimes travel to a distant hospital for a spacer or liner exchange.
    Ripping trails and tipping ales

  85. #285
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    Ok Liz I can provide a less than perfect case scenario. First and foremost get this book on Amazon- "Total Knee Replacement & Rehabilitation" by Brugioni and Falkel. I wish I'd had it before surgery instead of 3 months later when things were not going well. Read and prepare now. Get that leg moving immediately after surgery. If possible arrange for a machine that moves your leg in the hospital bed. It hurts like hell but get out of bed and move. Within first few days of surgery If you miss a day poop do everything you can get that thing to drop including an enema or else you will experience pain like you could never imagine. Physical therapy- Make sure you have it set up in advance to occur right out of the hospital. Read that book and follow the advice in it. I hope you don't have as rough a time as i I did. 3 months before I could do stationary bike pedalling. 6 months for a real bike ride. 9 months and 78 miles on the road. 14 months later and I'm mountain and road riding at least 3 time a week. In a few weeks will try for another century ( would be 20 straight years except for missing last year).BTW I'm 70. But in some respects my leg is not better than before surgery.

  86. #286
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    Quote Originally Posted by just4thefunofit View Post
    Ok Liz I can provide a less than perfect case scenario. First and foremost get this book on Amazon- "Total Knee Replacement & Rehabilitation" by Brugioni and Falkel. I wish I'd had it before surgery instead of 3 months later when things were not going well. Read and prepare now. Get that leg moving immediately after surgery. If possible arrange for a machine that moves your leg in the hospital bed. It hurts like hell but get out of bed and move. Within first few days of surgery If you miss a day poop do everything you can get that thing to drop including an enema or else you will experience pain like you could never imagine. Physical therapy- Make sure you have it set up in advance to occur right out of the hospital. Read that book and follow the advice in it. I hope you don't have as rough a time as i I did. 3 months before I could do stationary bike pedalling. 6 months for a real bike ride. 9 months and 78 miles on the road. 14 months later and I'm mountain and road riding at least 3 time a week. In a few weeks will try for another century ( would be 20 straight years except for missing last year).BTW I'm 70. But in some respects my leg is not better than before surgery.
    Wow! In this day of almost-outpatient TKR, you must have had a terrible experience.

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