Racing after a knee replacement
 

Got a grim diagnosis from my orthopedic surgeon after he's already put my knee back together again a couple of other times

he is recommending a total knee replacement. I have not found many examples of anybody returning to racing after such a procedure. I realize that you can return to recreational cycling as I do know a handful of people but they are senior citizens and primarily interested in getting around the mountain bike trails in a gentlemanly fashion

im a trackie for the most part but due to location, i do a fair amount of criteriums, but havent been able to in a couple of years. Anything out of the saddle or standing start hasnt been possible for a while

i've seriously considering a second opinion because my doctor doesn't really differentiate between just riding an exercise bike for rehab or taking a cruiser down to the local pub versus an actual race, whether track or road

but just am in research and question mode now

I know a guy. He was just as fast after as before. Anecdotal evidence is the bomb.

Maybe tell us a little more about yourself?

Age
Gender
Years racing
Disciplines races (ever)
Racing category in said disciplines
Racing goals long term

Would all help forum users assess the situation and offer advice.

Orthopedists routinely recommend recumbent or stationary bike use after knee replacement but I've never read of anyone approve competitive cycling, and for good reason. First off, artificial knees can withstand injury but damage to your knee area can be catastrophic because multiple operations can leave you with permanent damage to muscle cover and structural bone / quad support. Second, while biking is generally seen as a low impact activity, peddling while standing can place tremendous stress on the knee due to a combination of lateral bike movement and constant weight shifts. I don't do criteriums but would guess the risk of injury is significant; I'll leave evaluation of the risk to others. It may be, though, that knee replacement and criteriums don't mix well.

Maybe tell us a little more about yourself? Good call

Age : 48
Gender: Male
Years racing licensed for 31 years - had some inactive spells so roughly 20 years actual experience
Disciplines races (ever) Track, road, mtb
Racing category in said disciplines 2 track, 3 road, 2 mtb (both XC and gravity)
Racing goals long term compete at track Masters Nats and not be laughed out of the park is goal 1. Dealing with injuries has taught me patience so I know this likely wont happen overnight

Im a stocky guy so i gravitate towards my strengths (track events, crits and other short course road events, and downhill on the MTB side ) I dont fantasize about entering events that last over 2 hours in duration as i dont have time to train for anything with any significant distance - but since my last surgery for a meniscus repair, my riding has primarily been just cruising around solo and rarely getting above tempo pace. Even with the meniscus repair , i dont trust the knee to track properly out of the saddle.
Currently going through physical therapy for a rotator cuff surgery from earlier this year as well -- its been a fun year

I have a track racing friend who was about 8 years older than me who raced with one and then two knee replacements. At age 70-74, he did a 2:37 2k pursuit and 38.5 500 meters in Manchester to win both events at Masters Track Worlds and BAR. He had great leg speed before and after surgery. And one cannot do a sub 39 500 without a great standing start.

The problem with anecdotes and third hand info is well, it is very unreliable and may not be applicable to your particular situation and may be extreme outliers. If you need the surgery, then you have to go for it and if you are highly motivated to race post surgery, then you will figure out what it takes to achieve that goal.

Existence proof is the bomb. If it worked for one guy, then its worth getting a second opinion from a sports ortho that knows something about cycling. That is assuming cycling is pretty important to the OP.

48 is very young for a replacement. Is a partial applicable in your case? At 48 a replacement would mean another one in your lifetime.

Yes -- this is alarming to me . Since I started this thread , I sought another physical therapist who is a bit more aggressive and more used to working with people with athletic aspirations and I will be gathering all applicable xrays and medical documents and getting the input of another surgeon . Not that my surgeon was bad - he has performed procedures on prominent national pro motocross athletes as well as kids from the college (Oklahoma football) ----- but those folks are in their early twenties, not late forties -- and I think something as potentially as serious as this necessitates having 2 or 3 different sets of eyes on it

I have a right knee replacement, which failed, then it led to a massive infection, I became septic, had to have a PICC line an IV pump. I was RE-replaced in 2 weeks,

Since the replacement, ive done NO exercise, but for work.

Im in pain on the operated side constantly. I just re-started cycling and noticed I do OK, but now that Im racing and upped the hours on bike and watts, IM in even more pain.


I personally feel, Im wearing out my replacement faster and im in MUCH MUCH more pain now, but am having more fun than ever. I will continue, but feel due to pain, I'll have to limit my training and always be a cat 5.

My surgery was done in So Cal by Dr. Phillip Meritt. Boo.

I know this is an older thread but my comment might be useful for people reading this thread in the future.

I am 46, male and had a total knee replacement in 2019.

I bought a mountain bike to give something to do during the covid lockdown. I can easily ride the bike up hill and bomb down. I have zero pain, in fact since I rehabbed from the surgery I have been able to surf again, run again, use weights in the gym (squats, deadlifts) and I plan on returning to snowboarding.

My friends are taking me on some proper decent mountain bike trails soon and I expect to have zero problems (apart from a lack of talent).

I made sure that I prehabbed prior to surgery to keep mobile and rehabbed properly afterwards, which is essential for a positive outcome.

As far as racing goes, I'm not a bike racer but since getting on a bike, it has crossed my mind. I will see how it goes but not because of the knee but more of do I have the talent for it. However, I did complete a zwift 40 minute FTP test the other day with zero issues.

One final thing. The knee replacement changed my life for the better, before I couldn't even walk without pain, and if I did any sport I couldn't walk for 3 days. Now I can do whatever I want.

Good luck to you.

First off -- yeah, I wouldn't race with an artificial joint. Not built for crashes, and one is in less control of crashy future in a race than solo.

I also want to say that the danger of bad crashes in crits is probably overstated in comparison to road races (unless someone has data). Generally I've low-sided in crits and been fine other than skin, but I have crashed in three crits and only in one RR. It seems I'm most likely to crash in a corner in a crit, and low-siding. Road race crashes can be really messed up when its a lot of dudes jammed into a single lane and the back wants to go fast and the front doesn't -- I've seen more ambulances show up to road races than crits, and I've probably race 10x more crits than RRs. I'm open to being swayed the other way with some actual data, but generally saying we should question the notion that crits are crash-happy ICU festivals.

How did it go?
 

Hi, late reply i know but i was wondering how you went if you had it done? I had a knee replacement last year at 39 and have found it impossible to ride as i was before (and i was D grade at best before). I have had multiple surgeries before the replacement though (I've had 13 all up - my knee replacement was no. 11).

Had it done in November 2020 -- so a year ago. I was riding a bike within a few days (just around the block - nothing serious) - in early January, i bought a 29'er BMX bike to mess around on pump tracks and bike paths and things like that

I dont have any issues with riding , although --- I have to admit , that i have had some severe depression that started with the knee pain - lack of exercise and general malaise and "I dont give a S anymore" attitude caused me to gain quite a bit of weight that i am now trying to work off
But from a mechanical standpoint, if the knee will hold up to light use at the pump track and some mountain bike rides, i think it will hold up to some competitive aspirations. But i have told myself i will re-focus on those when i get about 50 pounds off (a factor which is also really hard on an already compromised knee )
My procedure was really physically painful to me for about a month -- i literally used all the harsh painkillers they gave me, and then started on 800 mg Naproxens and the like afterwards for about 2 additional months. (Important note: not everybody has this reaction - some people have little pain and are back at work in a couple of weeks )

So yes , it sucked -- but i am most definitely thankful i had it done- my life is better for it . Since then , i have also been made aware of another Masters trackie who performs at a Very high level who has had both his knee and hip done Karl Baumgart is a multi time national and world champ and has done a 1:04 kilo on a knee and hip replacement - Amazing and inspiring !

what did you decide to do?
oKC cyclist 50, considering knee replacement

I basically just copied and pasted my reply from above - but one of the ortho's i saw said that my knee was in the Top 5 of worst he has seen all year regardless of age -- but yes i went for it - I havent tested it, but as i have noted, i have had some weight gain and i almost feel like just walking is a test - LOL.
I have done enough playing around out of the saddle that a return to track cycling would be a do-able thing. Im not coming back until im in a bit better shape though . Thankfuly, its the off season and i have a handful of months to work on it


Had it done in November 2020 -- so a year ago. I was riding a bike within a few days (just around the block - nothing serious) - in early January, i bought a 29'er BMX bike to mess around on pump tracks and bike paths and things like that

I dont have any issues with riding , although --- I have to admit , that i have had some severe depression that started with the knee pain - lack of exercise and general malaise and "I dont give a S anymore" attitude caused me to gain quite a bit of weight that i am now trying to work off
But from a mechanical standpoint, if the knee will hold up to light use at the pump track and some mountain bike rides, i think it will hold up to some competitive aspirations. But i have told myself i will re-focus on those when i get about 50 pounds off (a factor which is also really hard on an already compromised knee )
My procedure was really physically painful to me for about a month -- i literally used all the harsh painkillers they gave me, and then started on 800 mg Naproxens and the like afterwards for about 2 additional months. (Important note: not everybody has this reaction - some people have little pain and are back at work in a couple of weeks )

So yes , it sucked -- but i am most definitely thankful i had it done- my life is better for it . Since then , i have also been made aware of another Masters trackie who performs at a Very high level who has had both his knee and hip done Karl Baumgart is a multi time national and world champ and has done a 1:04 kilo on a knee and hip replacement - Amazing and inspiring !

You could look up the details, but a couple of little known guys (Peter Sagan, Julian Alaphillipe, Tyler Phinney, et al) have successfully raced after knee surgery.

FWIW, I absolutely would not rely on strangers on a bike forum, and I wouldn't depend on a doctor who doesn't understand the difference between crit racing and a coffee ride. At the very least, get a second opinion from a doctor who does sports medicine and understands both the demands you put on your knee and the level at which you're racing.
Good luck!