coffeesnob

The wife had a total Knee replacement 5 weeks ago and is itching to get back on the trail. Anyone have any timelines they can share?

canklecat

Depends on age, fitness before the injury and surgery, ability and willingness to participate in post-surgery rehab. Being active before and after surgery seems to translate to quicker and better recovery.

That's based on observing results my granddad, mom and longtime friend got from knee replacement and other joint surgeries.

Granddad was always a big, strong guy but never "exercised." He did physical work and puttered around the house and their 3 acre property tending the garden, etc. With age he got grumpy and uncooperative with rehab after knee replacement surgery. The joint never set properly because he wouldn't do the physical rehab, and his knee would pop out occasionally. He lost the ability to walk much and developed congestive heart failure earlier than he might have with regular moderate exercise such as walking.

Mom was a lot like granddad. Her first knee surgery (repair, not replacement) was very young, in her 20s back in the 1960s -- mom developed rheumatoid arthritis very young. The surgery was crude and she didn't do much physical therapy. Over time that knee enlarged nearly double normal size, stiffened, and she couldn't bend it even to get in and out of a car without help. Many years later she had joint replacement surgery for that same knee, which helped a little but, again, she wasn't very cooperative with PT.

So when mom's other knee needed replacement, around 2007, I made sure she did her PT. I visited her every day to be sure she did her PT, which included a motorized device that worked the joint. It was strapped to the leg and articulated the knee joint. She hated it and every moment of PT, complained and sometimes yelled. But she did it and the knee healed properly and without chronic pain. When she saw how well that worked, she didn't need much prompting from me after her shoulder replacement surgery in 2010. By then she was more willing to put up with temporary discomfort for long term gains.

In contrast, my longtime friend was always physically active and recovered quickly from her various joint surgeries -- knee, hip, maybe one or two others. She wasn't an athlete by any means, but she was physically active, played tennis several times a week. walked a lot, did her own yard work until she was in her 70s, and still does most of her own housework now in her 80s. I've never heard her complain about chronic pain. I complain enough for both of us -- I've never had any joint surgeries, but my back, neck and shoulder are busted up from being hit by cars twice, along with injuries from many sports activities from boxing, cycling, climbing, etc. I've been able to avoid joint surgery so far, including for a 2018 broken and dislocated shoulder when I was hit by a car, due in part to having good overall physical fitness and muscle tone to support the broken coracoid process (a very small bone) without surgery. I wore a sling part time. The dislocated and winged scapula took about a year to recovery, though, and might have done better with surgery.

coffeesnob

Thanks, my wife has always been active and she has followed her PT advice to the letter. I am sure surgery is quite a bit more advanced now than when your mother had it.

MoAlpha

Wife had #1 done in Feb and is scheduled for #2 next week. She was on the trainer with no resistance at two weeks and is slowly dialing it up now, but is not clipping in, doing any "smart trainer" stuff, or riding outdoors. She told me to arrange to have our sailboat launched about 4 weeks after the second knee. That involves maneuvering around on a heavily slanted, constantly moving, surface and climbing up and down a ladder many times a day, so I think she's pretty confident. Advice from her surgical and PT teams has been to go slow and that's what she's doing.

What does "the trail" involve?

Juan Foote

My mother had one knee rebuilt years ago and had a pretty hard time with the recovery. She went in to have the other knee done as a full replacement late summer of last year IIRC. She was supposed to be able to walk out of the surgery center, you know how they make it sound like you are getting up right away with little trouble. She had to go into a care facility for a couple of weeks and work with physical therapy some. I went and stayed with her for about a month to help out. She has stairs every way coming into the house, so I installed a couple of grab bars for her.

Her recovery from it has been slow and by her own telling if she could go back in time, she would not do it again. I very much think that there are a couple of factors in her case that are important here. She hasn't really been in "go for a walk" shape in some years now. She hasn't followed up on her exercise/therapy the way she should on her own. And lastly, she cannot tolerate pain medications at all. I think that due to the pain she is moving around even less, is drinking less water, eating less good food in types that require prep, and is suffering the health consequences for it.

One of our friend's neighbor had his done a couple of years ago. He showed extreme promise at first, but his condition also deteriorated on a level of tolerable pain such that he walks on a cane and had to quit his car hobby.

It is an amazing procedure now. They really have it down to a science (lol) and it is amazing that it can be done as an outpatient procedure. I wish your wife well with a quick recovery and hopefully less pain moving forward than what led to the decision.

StanSeven

My wife used a recumbent trainer bike at the PT clinic starting in the second week. At first it was only for 5 minutes with no resistance. They gradually increased the duration and resistance where she’s doing 15 minutes plus walking on a treadmill. They are basing intensity on her feedback about how she feels and reacts. So as long as she’s not suffering and the knee isn’t swelling, they tell her to gradually add more each time. It’s really up to her under their watch.

jamesdak 

Ugh, I'm in here right now looking for info/insider views, etc. Had my first one done Monday and released the next day. Did ok walking on it a few hours after surgery and then the next day. But now I'm struggling. Before they released me I could dress fine, get socks on with only a little work. But now in my house I realize the limitations of high high my bed and chairs are compared to the hospital stuff. Yesterday was the most pain and stiffness yet. I was trying to not use the opioid but screw that. I'm staying on the Oxy regular for at least a week now. I wish I had taken all the tools for dressing and such the VA offered me. I seemed fine in the hospital but not so much a few days in. And after today I'm on my own, my kid has to go back to work. Going to be interesting. I just hope the pain eases soon. I can normally deal with it fine but sitting all day with nothing to do and pain is bad mentally. I'll go bonkers if I can't get puttering around the house soon...

Speedskater

I'm getting one in May. A friend got on for his other leg on January 3rd. He was on ice skates on February 1st. And refereed a speedskating meet on February 25.

OldTryGuy

Almost ready for double replacements. Robotic sounds promising and need to research some more.

https://www.pennmedicine.org/for-pat...e-replacements

Had right shoulder replaced August 2016 on a Monday, Tuesday the sling was removed and Thursday I was back bicycling. Now 2023 so maybe I will be able to cycle out of surgery.

jamesdak 

Well a couple of days later now and I've been staying on the Oxycodone. That's changed everything. Pain is totally manageable as long as I keep on the meds. What's holding me back right now is that the thigh muscles still not firing. I can put full weight on that leg but without the muscles working properly I really cannot balance on it or take a step without support. PT has started and I'm hoping in a day or two I can get the quads going again.

Using the ice therapy machine religiously and sleep with it on. Also sleep with a pillow under that calf/ankle to keep the leg extended.

MoAlpha

You want robotic if it’s available. There is no downside. My wife had hers as an outpatient with regional anesthesia. Hobbled out after five hours both times and got by without narcotics, but she’s a tough old bird.

epnnf

@ 67, Ive been told I have knee replacement in my future. I only have ?s, and realize it depends greatly on various circumstances. How long after surgery can you: ride a bike (indoor machine or on your regular bike), drive a car, do steps? How long: swelling, pain, physical therapy? No crutches? Isnt PT painful?
Last February, I had joint replacement surgery in my toe. I was able to ride after 3 weeks. My podiatrist had TKR a cpl yrs ago; can only bend his knee around 90degrees. My cousin had two TKR; after painful PT, can only bend his knee 126degrees (not sure what that means).

Cgnman59

I had a knee replacement January 2020 at age 60. I had some complications with the surgery and so my recovery was much longer than normal. As an old athlete who has broken bones, tore my ACL, cartilege, etc, I know the value of doing the physical therapy. I took the PT very seriously; lifted weights and worked on the flexibility, etc. The bike was one of my best rehab exercises. Once I was able to ride, which for me was about 6 months after surgery, I gained strength and mobility much more quickly. The only thing I changed was going from clipless pedals to flat pedals. Now 3 years later I am riding 4-5 times a week, walking, hiking, etc. all pain free. The replacement has been worth it.

jamesdak 

12 day post surgery for me. Biggest problem I'm having now is still pain management. Docs want me to only use the Tylenol every 8 hours if needed for the pain now. The Oxycodone was refilled and once again only every 8 hours if needed. Reality for me right now is the pain won't stop and not getting any real sleep. The mental struggles dealing with the constant pain for outweighs the risk of addiction to me. Seems like the docs are afraid now to properly treat the pain. The ice machine is a must and I use it a lot and still have to sleep with it for any kind of relief. I'm getting new pains now that nothing seems to help, I suspect that's the nerves regrowing or whatever. The pain doc did mention switching to something else to deal with this and I'm going to call them today. For me I'm just staying on a steady diet of pain pills right now. I'm supposed to do PT sessions four times a day and the pain is just too real to not stay on the meds. I would just kill for at least 6 hours of real sleep for one night.

PT is tough and very painful to me but you've got to do it. I can pretty much straighten the leg out fully which is one positive. But the flexion is still badly limited. We got to about 80 degrees yesterday. Tried pushing through to 90 but the pain was more than I could bear. I used to be pretty mentally tough against pain and I wonder if all the years just dealing with constant pain have wore me out? On the stationary bike I can get full rotations now but only by leaning over and barely keeping my one butt cheek on the seat. Going in reverse is easier but I can go both directions. Here again getting that first full rotation around at the beginning of each session is a mind screw but it really is getting less painful and easier. I plan to really go after this on my own over the weekend as I don't see the physical therapist until Monday. My hope PT wants me at 120 degrees of flex before I switch over to the outpatient PT on the 1st of May.

I'm still using the walker but I can move now without it. The leg is holding it's own if I move slow. Leg raises are still challenging and the pain in the front is crazy strong sometimes as I lift and move the leg to sit and such. Going up and down the stairs to get out of the house is no real issue now. I take the walker up and down with me but really with the repaired leg working some now I can do stairs without any real support. I just play it safe since my one remaining knee tends to sorta give out sometimes.

I did some cleaning yesterday morning before my first set of PT and was on my feet for probably an hour and a half. Some aching but not bad. After each PT session the thigh turns into one big spasming knot for awhile. Going to start using my massage gun on the muscles afterwards to help with that. The ice machine is like great sex after each PT session too! :-)

One thing I want to point out is I figured on this surgery happening later in the year. It was an extremely long winter here where I went over 4 months with no rides outside. I barely got on the stationary bike either because I suck at being disciplined to ride inside. Don't make my mistake. Work long and hard on your legs before surgery, stretch daily and work your core. That will make post surgery life so much easier.

Anyway, I'll come back and update in a couple of days. Hopefully with good news. It would be nice to be able to transition to the Dutch bike soon so I can get out and about a bit.


This was bought as errand bike a couple of years ago but I think will be the ticket for a lot of rehab rides. 8 speed IGH, step through frame, flat pedals.

jamesdak 

Curious about one thing, did you ever go back to clipless pedals?

Speedskater

I went to physical therapy for a pre-op assessment the other day. The football player sized therapist let a young student do the assessment. I'm very small and she was about my size. So after a half century of bike riding, marathon running and speedskating I'm still in shape at age 81. She wasn't strong enough to move any of my muscles

jamesdak 

Ok, another week has gone by and the leg is stronger every day. I am still behind of range of motion though. It's like I just can't get past a certain point on my own. Quads continue to fight me but I've added on more exercises to try and get them back to norm. Pain is not bad now. Tylenol during the days and no Oxy. Been having trouble sleeping the past two weeks and that is now my biggest issue. Docs switched me to a different pain med at night that knocked me out the first night and then nothing since. I go to bed at 9ish and then just lay there forever not able to sleep and I don't know why. The knee isn't really hurting so it's not pain. Tried Sleepytime tea and even a small dose of Melatonin last night and still no sleep. The past two nights around midnight I've had to take 1/2 an Oxycodone pill just to finally go to sleep. In my book that is bad when I take it to sleep vs for pain. Using the ice therapy machine at night no longer seems to help either. Getting a bit worried as I need to get back working and need sleep to function. Glad I'm teleworking this week so at least I won't be driving without any sleep.

Both knees were so bad before this surgery that I could hardly walk for more than 10 minutes or so. Now the "good" knee is holding me back on my walks to rehabilitate the repaired knee. Bummer....

Speedskater

So I had mine done on May 9th. Luckily I wore the baggiest old jogging pants that I own. The bandage is huge, if I wore anything else I would have gone home in my underwear. The anesthesiologist said that the pain deadening nerve injections ware off in 2 or 3 days.My wife recorded much of the nurse's and doctor's instructions, because I don't remember 10& of the instructions.

jamesdak 

Good luck, push the PT as soon as you possibly can.

jamesdak 

A couple of days past a month. Sleep is still really elusive. The leg just seems to ache all night deep in the bones and without bending that much it's hard to get comfortable with it. Not really much pain in the day if I keep moving and elevate and ice when sitting. The incision is pretty much healed now.

On a positive note, I did get out on the Azor bike for 15-20 minutes today. It was slow and painful at first but near the end it was just mildly painful. Felt good to get out on a bike. Hopefully I'll be riding a road bike in another week or so.

Speedskater

update:
log
Tuesday ~ total knee arthroplasty surgery
Wednesday ~ 1/4 mile walk (with 2 crutches)
schedule
Friday ~ much of the huge bandage will come off
Monday ~ first Physical Therapy session. Will find out which of my long list of exercises, I will be permitted to do.
plus 14 days ~ follow-up doctor's appointment.
notes
after 36 hours peeing is back to normal. B.M. to be determined.
with the huge bandage, range of knee motion is only about 50 degrees. The other knee about 135 degrees.

MikeWMass

Recovery varies all over the place.
Some people are pretty functional in a couple of weeks, others not so much.
Consensus seems to be 12-18 months before back to "normal".
I had mine done 2/11/22, pain was unbelievable for the first couple of weeks even with medication, but I was diligent with PT and home exercises.
Back to work in 5 weeks.
It was several months before I was back on the bike outside, but it was much better than before surgery.
Retired in January, so with my new relaxed schedule I am working out >1 hour each morning (stationary bike, resistance, Nordic track skier).
Now 15 months postop I can still feel the difference in the operated knee, but I can do pretty much whatever I want (or need) to do, except I was told my running days are over!
Have done several rides >50 miles,
I am faster than I was before I had problems, but still not fast.
About to leave tomorrow for a week hiking in the Cotswolds with some friends.

jamesdak 

Another 10 days and things are progressing. Suddenly the knee is really bending better, I put it down to the biking and forcing it around consistently. The hardest part is the top of the stroke on the surgical side. Measured the top of the pedal on the Azor at the upstroke distance to the top of the saddle. Then compared it against my normal fit on the road bikes. Pretty much the same. Sooooooooooo....... On the 17th I put a set of flat pedals on my Raleigh Team USA and took it out. Woo Hoo, I could ride it!! I was slow but it was totally doable. So after a bit on that bike with it's CX tires I went back and swapped the pedals over to the Evans bike. I'm cooking with Crisco now! Knee is finally bending as I walk too, I'm sure part of that was me mentally. Muscles still feel tight and stiff as I move. Today I worked in the yard from 9 AM to around 2 PM with no cane. Leg was stiff and a bit achy but I swear the non-repaired knee was the worse of the pair. Light at the end of the tunnel. I can also go up stairs normally too.

So basically 6 weeks after surgery I'm back on road bikes. I'm moving slow, paying more attention to just spinning lightly and flexing the knee, not speed or power. Even able to stand up on the pedals to go over rough spots with no issue. Decent sleep is coming too. Did 7.24 miles at 9.3 mph avg yesterday. Didn't have any fatigue or soreness in the muscles but not sure how much I can push the effort right now.

Speedskater

I just had the staples removed. I was surprised that they looked like industrial metal staples!
I'm very small and the scar is 8 inches long.
The knee is a Medacta International "Global Medacta Knee". That manufacture was not on my brand list.
Day 18, 2 mile walk. First mile 22.00 minutes.

IcySwan1 

Fitness and commitment drove a quick recovery for me. Had left knee replaced at 70. Traveled to Oregon and stayed in 5th wheel. Legs in good shape before. Determined to be able to ride after surgery. Focused on scheduled PT and home exercises. Riding stationary bike at therapist at 2 weeks. Rode my bike at 4 weeks. Bought the Shimano combo pedals (flat on one side and SPD on other) to mainly reassure myself but clipped in as soon as I knew I could get on and off the bike easily and turn the pedals over.

My adult son and grandkids live in Oregon. I contacted the local club and asked for input from folks who had the procedure, who they used as a surgeon, who did their PT, and when they could ride again. They all were older than me and all had results similar to mine. The folks who may have had negative results didn’t reply.

The result was great. May yours be, too.

Mike