Total Knee Replacement

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Apologies for the off-topic post.

Does anyone have any experiences with total knee replacement and continued high-mileage cycling? (female cyclist, 49 years old,
competitive masters rider, knee-injury from early 70's that is horrific - docs recommend total knee replacement...we're seeking more opinions)

Also, does anyone have experience with Synvisc Hylan G-F 20 knee injections?

Any off-list responses would be greatly appreciated.
Again, sorry for the off-topic post.
pedalhome@earthlink.net

regards,
Jenny & michael

I'd suggest visiting this site -
http://www.kneeguru.co.uk/cgi-bin/KNEEtalk/YaBB.pl

I got a lot of good info there for my knee issue.

I highly recommend you get lots of opinions from lots of Dr.'s before you get the TKR done. Apparently there is a lot of work going on trying to develop a TKR that will last a persons lifetime under the stresses you are likely to inflict upon it. You need to find out who the people are at the forefront of this research.

good luck,
Tim

I ride 5000 miles a year and like you have an injury from the 70's, am looking at tkr in March. These artifical knees are great for somebody who goes from the couch to the bathroom and back. My doc, when I told him how much I ride said people like me scare the hell out of him, not a good sign. But I have no choice, will keep this page posted of results

Originally posted by pedalhome
Apologies for the off-topic post.

Does anyone have any experiences with total knee replacement and continued high-mileage cycling? (female cyclist, 49 years old,
competitive masters rider, knee-injury from early 70's that is horrific - docs recommend total knee replacement...we're seeking more opinions)

Also, does anyone have experience with Synvisc Hylan G-F 20 knee injections?

Any off-list responses would be greatly appreciated.
Again, sorry for the off-topic post.
pedalhome@earthlink.net

regards,
Jenny & michael

Jenny,
Have you gotten any more information on knee replacement and
cycing? I am a masters racer (53) in fact a national champion. I had surgery on my knee for meniscus tears a year ago & there was no change in the pain and swelling. A sports med. doc. has
recommended total knee replacement because I have very little
cartilage left on the lateral side of my knee. I told him I would like to wait awhile before having the surgery and he recommeded that I wear an unloader brace when I ride, workout or walk a lot.
I've been using it for about 2 weeks. It helps a bit, but its not a cure all.... Anybody have any input before my fitness level is totally trashed?

Sue

Originally posted by leesm
Jenny,
Have you gotten any more information on knee replacement and
cycing? I am a masters racer (53) in fact a national champion. I had surgery on my knee for meniscus tears a year ago & there was no change in the pain and swelling. A sports med. doc. has
recommended total knee replacement because I have very little
cartilage left on the lateral side of my knee. I told him I would like to wait awhile before having the surgery and he recommeded that I wear an unloader brace when I ride, workout or walk a lot.
I've been using it for about 2 weeks. It helps a bit, but its not a cure all.... Anybody have any input before my fitness level is totally trashed?

Sue

Hi, I had a TKR about two years ago. As part of my recuperation I took up road biking and really got into it. I am 52, 6' 3", 180lbs and ride 150 to 200 miles a week typically at an average of 18 to 20mph. My knee is holding up fine but I am concerned about long term wear. Now that biking has become such a big part of my life I am concerned about what kind of wear I am doing to the knee and how long I can expect it to hold up. I have not seen my doc in about a year but he was aware that I was riding pretty agressively and didn't seem to be overly concerned. I will probably go in for some Xrays in the next month or so to see what kind of wear I am experiencing.

I would be interested in anything you are learning about TKR longevity for active cyclists. If you are considering a TKR I would strongly recommend that you focus on post operative flexibility. I did not regain enough flexibility after my surgert to be able to ride comfortably and was told by my surgeon that there was nothing that could be done to improve thing other than PT. I went for a second opinion and found a doc who said he could get me 20 more degrees of motion through arthroscopic debredment. Thank God I found him since I went ahead with his procedure and was able to get to 115 degree range of motion. A lot of the surgeons who only do TKRs are not fully up to speed on post op arthroscopic remedies. You really need to focus on range of motion and make sure your doc understands how important it is that you get at least 110 degree range of motion post op or you won't be able to ride.

I can tell you that the surgery and recovery is really tough but worth the effort if things work out. I was in sever pain prior to the surgery (old footbally injury and over three previous operations) and could barely walk. It was worth it for me especially after I had the second procedure and got the extra range of motion. Good luck!

I had synvisc injections in the fall of 2002 which seemed to help.
In the early summer of 2003, I had synvisc again and experienced
a reaction to it. My 'pod did some research and found that hylagan
(sp) was similar but didn't have some preservatives that were in
the synvisc. I went through the series of hylagan injections in
fall of 2003 and had a very fast (for me) November. It's now
March and I'm hoping to get another set. In general, I am a
candidate for TKR; I can get bone-to-bone on either side of the
left knee. I just hoping to get another year out of this thing.
Note that I ride an hour a day at a pulse of 150 and then ride
with a fast club for 45 miles or so once a week.

Best of luck.

Ted

Ted,
Thanks for the information! Hope it works out for you. I read this week in the local newpaper that a less-invasive TKR has been developed. The incision made is 3" rather than 12" and they don't cut the quadricep muscle or tendon, so the recovery is less painful and quicker. The patient is only in the hospital for a day and is able to walk without cane or crutches in 5 days. The folks who developed this surgery, predict that 40% of the TKRs done five years from now will be this type. It is not for suitable for
eveyone. People who are obese or over 80 or who have other
nonarthroscopic knee surgery don't qualify. But for many of us this will be great news. Tria and Dr. Thomas Coon of Redding, Calif. developed this method. I know that locally, some doctors at the Mayo clinic in Rochester, MN and United Hos. in St. Paul are already using this procedure! I'm sure it is also being used in other parts of the country. Just wanted to pass the word.

Good Luck,

Sue

Originally posted by leesm
Jenny,
Have you gotten any more information on knee replacement and
cycing? I am a masters racer (53) in fact a national champion. I had surgery on my knee for meniscus tears a year ago & there was no change in the pain and swelling. A sports med. doc. has
recommended total knee replacement because I have very little
cartilage left on the lateral side of my knee. I told him I would like to wait awhile before having the surgery and he recommeded that I wear an unloader brace when I ride, workout or walk a lot.
I've been using it for about 2 weeks. It helps a bit, but its not a cure all.... Anybody have any input before my fitness level is totally trashed?

Sue

Some people are getting meniscal transplants (cadaver) now and the results have been really good. Unfortunately the waiting list is long apparently. There is also work going on with synthetic menisci which looks promising.

In your case Sue, I'd look into some extra PT to help stabilize the knee and control the laxity that's beating up your meniscus. Tell the PT that you need to work on your "propreoceptors". You might find some OTC products like glucosamine+chondroitin+MSM and some sam-E helpful - I have for what's left of my knee!

Good luck,
Tim

Tim,
I've taken glucosamine+chondroitin daily for about 4 years. I also take 800 mg ibuprofin a day. The unloader brace seems to help. I can stand longer, walk longer etc. but it just takes one twist, or awkword step to cause shooting pain. The the rest of the day I have discomfort, swelling and more sharp pain. I can be at the library and stoop down to look at a book... or
twist it getting out of the car... it doesn't take much, but I still
can walk. It's not like I can't put any weight on the knee at all.
The doc says I have a fair amount of arthritis too. I really don't think I'll be able to compete in sports any more, but I think I still can ride both on and off road.

Sue

I bought my first 10 speed bike in 1964. Rode on and off for a number of years. I was doing 30-50 miles on weekends last summer.
I had a TNR (Genesis II) at Thanksgiving. Had operation at 7:30 am. Was walking using a walker that afternoon. Was walking using a cane the next morning. Relased from hospital the 36 hours after the operation. Began riding my bike on an indoor trainer later in the week. Rode consistently 30-45 minutes at a crack. Now riding 6-12 miles a day (trying to take it easy). I have promised myself a new bike if I can do 30 miles in 2 hours by this summer. Yes, it's painful -- but no more painful than prior to the operation -- and I now have the oportunity to improve my situation. My orthopaedist had gave me only two restrictions -- no running, no jumping. I'm 54.
Look to see if the othopaedist can do a MIS (minimally invassive) TNR--the latest and greatest. Ask lots of questions.
dale

Originally posted by leesm
Tim,
I've taken glucosamine+chondroitin daily for about 4 years. I also take 800 mg ibuprofin a day. The unloader brace seems to help. I can stand longer, walk longer etc. but it just takes one twist, or awkword step to cause shooting pain. The the rest of the day I have discomfort, swelling and more sharp pain. I can be at the library and stoop down to look at a book... or
twist it getting out of the car... it doesn't take much, but I still
can walk. It's not like I can't put any weight on the knee at all.
The doc says I have a fair amount of arthritis too. I really don't think I'll be able to compete in sports any more, but I think I still can ride both on and off road.

Sue

Hey Sue,

I'd go out and get some more opinions before you have the doc do a TKR. I ended up going to 5 orthos before I was satisfied - and I got a disturbing range of opinions by the way! The first doc was an idiot - literally!

There is a lot of stuff that can be done with arthritis before you go TKR. TKR is last resort, especially for someone as young and fit as you!

I strongly suggest you go here -

http://www.kneeguru.co.uk/index.html

and spend some time reading up and posting ?'s about your knee. There is a lot of really good info to be found there.


Tim

Thanks Tim,
I plan on holding off on the TKR for as long as I can. I've already been to 3 ortho docs. The first did arthosopic surgery on the knee then some cortizone shots and anti-inflamitory drugs.
Next I went to a sports medicine knee specialist & had viscosuplimentation. Then to another sports medicine knee specialist who wanted to do partial or total knee replacement. I told him I just didn't want to go through that just yet. So he recommended I try wearing an unloader brace. So that's where I am now.

Sue

Originally posted by pedalhome
Apologies for the off-topic post.

Does anyone have any experiences with total knee replacement and continued high-mileage cycling? (female cyclist, 49 years old,
competitive masters rider, knee-injury from early 70's that is horrific - docs recommend total knee replacement...we're seeking more opinions)

Also, does anyone have experience with Synvisc Hylan G-F 20 knee injections?

Any off-list responses would be greatly appreciated.
Again, sorry for the off-topic post.
pedalhome@earthlink.net

regards,
Jenny & michael

I think it's interesting that everyone comments on the wear and tear on a TKA but not the wear an tear on a knee that is not letting a person fully function. Definately get multiple opinions, but make sure you are seeing orthopedists who have experience in Sports Medicine, because you are not an average patient.

You will need a doctor for any therapy or procedure that understands your goals. Range of motion and level of Strength that is considered functional for an average housewife whose major concern is climbing 1 flight of stairs with minimal pain is not appropriate for pretty much anyone who reads this forum.

Check out another thread here that has additional info (& opinions!):
Cycling Forums> Bike Racing> Health,Nutrition and Supplements> knee replacement