Replacement Knees

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Replacement Knees
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Posted: Jun 16, 2019 at 8:53 Quote
Hi - I'd be interested to hear from anyone out there still riding on artificial knee joints. I'm not there yet but it's definitely getting closer (painful most of the time - even when sleeping). However I've never met anyone with a replacement knee joint (I only know of four tho) who has been able to carry on with any kind of vigorous activity...is that the norm?

Posted: Jun 16, 2019 at 9:05 Quote
You may have better responses in the Health, Fitness forum down below. That being said, I’m almost 50 and know of a couple guys who had to get away from BMX but still ride MTB XC, Enduro.
I’d be interested to hear from others first hand as well.

Posted: Jun 16, 2019 at 14:07 Quote
Probably best to ask in a general fitness/health forum and see if anyone is doing any sort of sport at all.
I´m not a medical pprofessional, but given your leg regains normal functionality i don´t see a huge problem. Best ask your doctor what can be expected in regards to normal function in everyday use and normal sports activity as most people will judge downhill wrong. They´lll most likely tell you "extreme sports" are out of the question, but honestly downhill only is extreme if you´re really pushing it. At the level 90% of people ride, it´s realistically about the same level as many other recreational sports. So that´s what i would aim for. Ask if any sport will be possible at all.
If so, most likely you will be able to ride given enough preparation.
Imho it should be possible to ride park as long as you wear a good brace and don´t overdo things too much.
You most likely will have to stay away from the big drops and heavy compressions, but i don´t see why some mellower trails at reasonable speeds should be a problem as long as the knee is properly supported.
There´s people riding bikes with prostetics and such, and they get along just fine.
10 years or so ago, there was this guy in the "Ultimate Freeride Challenge" video series who only had one arm and still did huge gaps and drops.
I´d say it´s much more dependent on how hard you work on making things work for you. Train your legs, make sure to compensate for the lack of stability through muscle, get a good sports coach who can help you build the necessary muscles to make things stronger and so on.
Invest in a good bike with proper suspension bits to help out your leg.
Test some bikes to see which works best with your new limitations. Maybe some geometry lends itself more to taking off weight/pressure of your leg.
Given how many supercross racers ride with some sort of major wrist injury simply by using the proper brace, i don´t see why a kneebrace shouldn´t also help you keep your leg safe on a bike.
Given that normal function should be possible, the biggest problem would be lateral force on the knee, which a brace would take care of.
You just gotta do things right and put in a little thought to make things work and accept there will be some limits of some sort.

Posted: Jun 17, 2019 at 16:03 Quote
I work for an orthopedic implant company and have heard testimonies from patients with total knee, hip, shoulder replacements that said they totally regained mobility and have little to no pain anymore. Of course every case is different and everyone's body heals differently but the potential is very high to have a much better "quality of life" after surgery with as much pain as you say you have now. I would say chances are high that you would be in a better place post surgery with the right physical therapy and staying active. I would definitely discuss options with your Dr./surgeon but advancements in surgery over the last decade are unbelievable.
Just my .02 hope it all works out for you.

Posted: Jun 24, 2019 at 0:58 Quote
1. You need to know what specific damage you have to your knee via an MRI (and that of course also means an orthopedic evaluation).

Basically 3 areas to consider concerning knee cartilage: a) Medial meniscus b) Lateral meniscus and c) patellar (
Chondromalacia patella).

2. Need to determine if you only need a Partial vs. a Total Knee Replacement.
Partial is the medial or the lateral meniscus alone, or either with patellar damage. Some people are erroneously told they need a total knee, when in fact they only need a partial knee. There's significant difference between the healing of a partial vs. a total knee.

Here's a 1st hand success story:

Lateral meniscus damage/arthritis started before age 40. Medial meniscus and patella cartilage is pretty good. Avid snowboarder. Condition progresses to point that steroid injections/synvisc injections no longer help, to far gone for any cartilage transplant (bone on bone). Also, this would be way to damaged to consider stem cells/PRP. By late 40's Snowboard on weekends, to rid swelling during workweek in order to keep 100% weight off of swollen/painful knee I used crutches full time and used the electric elderly shopping carts in stores. Then I would snowboard again on weekend and then have to do the same thing with crutches to get fluid out during the work week. Ironically despite my bone on bone in one part of the meniscus, I could actually downhill (picked up about age 45) going every summer weekends without significant issues that I attributed to the slight bend position in knee and good suspension absorbing impacts (and I'm now taking pretty decent sized jumps and keep up with much younger riders). At this point, due to my knee, I can't run or walk any long distances on knee.

At 48, got evaluated by a surgeon who works with major professional athletes. Advised only viable option is partial knee replacement, specifically advised MAKO (robotic assisted) surgery. This surgeon wanted $15K over my insurance and this did not include the facility charge (and anestheologist) figure probably another $5k. Found another surgeon that was an expert in the MAKO procedure having done way more cases than the 1st surgeon (more is good). My insurance covered all of it (asides from any deductibles one may have).

Surgery 1st week October. Able to walk around same day (sure some pain/discomfort), start PT in couple days. PT that week including self work running up stairs/riding bike for 1 week. Go back to work, no time for further PT allowed. 1st week December, back on snowboard. About 5 yrs later, 1st f/u since surgery/healing complete. No appreciable wear on implant/spacer and no pain in knee related to surgery/implant over that period. Last 3 of those yrs including 50-70 days/year of hard snowboarding (not groomers). https://youtu.be/SPeIpoXBBzo
Have other orthopedic issues I deal with NOT related to my operated knee (can't run/walk long distances) BUT THE KNEE IS NOT THE ISSUE. NO issues for snowboarding or biking (xcountry/dh) and long wakesurfing rides on the operated knee. Sounds melodramatic, but it was life changing. Impact sports such as running/racketball will put more risk of wear on the implant. I was trying to stress that the knee is great and would allow me to run, but I deal with other non-knee issues (including my ankle in my other leg). Probably shouldn't have included that detail, other than to note that over the 5 yr post surgical period I was not putting impact wear (from running/racketball type sports) on the implant because it may sound confusing on my successful knee partial replacement.

Advice:
a. Don't settle for anything but the MAKO procedure. Utilizes a 3-D CT scan along with a robotic assisted computer guided precise remove of the minimal amount of bone (less invasive/less risks) with PRECISION alignment. Think of mm fine alignment/misalignment concerns that cannot be matched when even a very experienced surgeon has to "eyeball" things. There are youtube video's on the procedure. Just hard to find "younger" people (well call under 50 younger) who can talk about the results on line.

Realize, the MAKO procedure is now in lots of places, but the technology costs extra and thus not all surgical facilities are going to invest with that equipment. I had to travel a state over to get it done.

Also, total knees have come along way, but more risk than a partial. Surgeon's don't rush into those for younger individuals.

You can always lower the risk of implant wear by avoiding sports that have lots of impact (and I'd say downhill biking isn't doesn't cause that much impact). Uncertain how long an implant will last, but 10-20 yrs is not considered unreasonable. If a spacer wears out in the implant, it doesn't mean the whole implant must be redone, one just may need replacement of the plastic spacer. Mine at about 5 yrs showed no wear.

I also personally witnessed a 70+ yr old undergo same procedure/same surgeon who was active and golfing within the 1st month. (Actually stayed at our house in AZ so I saw his recovery personally. He went out to dinner 1st night).

If you're in the states, specifically AZ, you can PM and I can give you the surgeon's information. (I believe they have an cash pay price).

Posted: Jun 25, 2019 at 6:58 Quote
Robotic assisted surgery is the only way to go for something like that. I work in the spine division for my company I've seen first hand the difference robots make for complex and delicate operations such as spine, knee or hip surgeries. The precision accuracy of them makes the surgery faster, safer, and recovery much faster/less painful.

Posted: Jun 26, 2019 at 15:31 Quote
kwcpinkbike wrote:
1. You need to know what specific damage you have to your knee via an MRI (and that of course also means an orthopedic evaluation).

Basically 3 areas to consider concerning knee cartilage: a) Medial meniscus b) Lateral meniscus and c) patellar (
Chondromalacia patella).

2. Need to determine if you only need a Partial vs. a Total Knee Replacement.
Partial is the medial or the lateral meniscus alone, or either with patellar damage. Some people are erroneously told they need a total knee, when in fact they only need a partial knee. There's significant difference between the healing of a partial vs. a total knee.

Here's a 1st hand success story:

Lateral meniscus damage/arthritis started before age 40. Medial meniscus and patella cartilage is pretty good. Avid snowboarder. Condition progresses to point that steroid injections/synvisc injections no longer help, to far gone for any cartilage transplant (bone on bone). Also, this would be way to damaged to consider stem cells/PRP. By late 40's Snowboard on weekends, to rid swelling during workweek in order to keep 100% weight off of swollen/painful knee I used crutches full time and used the electric elderly shopping carts in stores. Then I would snowboard again on weekend and then have to do the same thing with crutches to get fluid out during the work week. Ironically despite my bone on bone in one part of the meniscus, I could actually downhill (picked up about age 45) going every summer weekends without significant issues that I attributed to the slight bend position in knee and good suspension absorbing impacts (and I'm now taking pretty decent sized jumps and keep up with much younger riders). At this point, due to my knee, I can't run or walk any long distances on knee.

At 48, got evaluated by a surgeon who works with major professional athletes. Advised only viable option is partial knee replacement, specifically advised MAKO (robotic assisted) surgery. This surgeon wanted $15K over my insurance and this did not include the facility charge (and anestheologist) figure probably another $5k. Found another surgeon that was an expert in the MAKO procedure having done way more cases than the 1st surgeon (more is good). My insurance covered all of it (asides from any deductibles one may have).

Surgery 1st week October. Able to walk around same day (sure some pain/discomfort), start PT in couple days. PT that week including self work running up stairs/riding bike for 1 week. Go back to work, no time for further PT allowed. 1st week December, back on snowboard. About 5 yrs later, 1st f/u since surgery/healing complete. No appreciable wear on implant/spacer and no pain in knee related to surgery/implant over that period. Last 3 of those yrs including 50-70 days/year of hard snowboarding (not groomers). https://youtu.be/SPeIpoXBBzo
Have other orthopedic issues I deal with NOT related to my operated knee (can't run/walk long distances) BUT THE KNEE IS NOT THE ISSUE. NO issues for snowboarding or biking (xcountry/dh) and long wakesurfing rides on the operated knee. Sounds melodramatic, but it was life changing. Impact sports such as running/racketball will put more risk of wear on the implant. I was trying to stress that the knee is great and would allow me to run, but I deal with other non-knee issues (including my ankle in my other leg). Probably shouldn't have included that detail, other than to note that over the 5 yr post surgical period I was not putting impact wear (from running/racketball type sports) on the implant because it may sound confusing on my successful knee partial replacement.

Advice:
a. Don't settle for anything but the MAKO procedure. Utilizes a 3-D CT scan along with a robotic assisted computer guided precise remove of the minimal amount of bone (less invasive/less risks) with PRECISION alignment. Think of mm fine alignment/misalignment concerns that cannot be matched when even a very experienced surgeon has to "eyeball" things. There are youtube video's on the procedure. Just hard to find "younger" people (well call under 50 younger) who can talk about the results on line.

Realize, the MAKO procedure is now in lots of places, but the technology costs extra and thus not all surgical facilities are going to invest with that equipment. I had to travel a state over to get it done.

Also, total knees have come along way, but more risk than a partial. Surgeon's don't rush into those for younger individuals.

You can always lower the risk of implant wear by avoiding sports that have lots of impact (and I'd say downhill biking isn't doesn't cause that much impact). Uncertain how long an implant will last, but 10-20 yrs is not considered unreasonable. If a spacer wears out in the implant, it doesn't mean the whole implant must be redone, one just may need replacement of the plastic spacer. Mine at about 5 yrs showed no wear.

I also personally witnessed a 70+ yr old undergo same procedure/same surgeon who was active and golfing within the 1st month. (Actually stayed at our house in AZ so I saw his recovery personally. He went out to dinner 1st night).

If you're in the states, specifically AZ, you can PM and I can give you the surgeon's information. (I believe they have an cash pay price).

Posted: Jun 26, 2019 at 15:34 Quote
Thank you so much for taking the time to submit such a detailed reply. I too have found snowboarding tough on my knees (pistes are just for getting to the next bit of freeride!). I made a spring loaded knee brace which helped a lot but bulky to wear. V interesting to hear your success story - will take all that info and see what is available here in the UK. Again - thank you.

Posted: Jun 26, 2019 at 20:12 Quote
Was curious about the UK healthcare options. Did a quick search and mako's there:

https://www.hcahealthcare.co.uk/about-hca/technology-at-hca/mako-robotic-arm-assisted-surgery

This particular one is a private hospital, what does that mean for those in the UK?

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