Total knee replacement?

dirthead1 wrote:

Do you have a prosthetic suggestion for THR? I'm scheduled at the end of November for the surgery and it seems you are involved, or extremely...

Do you have a prosthetic suggestion for THR?

I'm scheduled at the end of November for the surgery and it seems you are involved, or extremely knowledgeable, in orthopedics. I'm not a candidate for resurfacing from the existing joint damage and nature of the previous ball to femur pinning.

Thanks

Shenzi wrote:

Great thread. Thanks for all the info WORCs. At 45 I have a 75 y-o arthritic knee (due to a love affair between an XR600 and...

Great thread. Thanks for all the info WORCs. At 45 I have a 75 y-o arthritic knee (due to a love affair between an XR600 and an XT650) and been told that TKA was the solution by some, others told me to wait as long as I had no constant pain and was still able to walk and cycle. I am just frustrated at times, after long days on the floor at trade shows or when my abilities are limited due to my range of motion not exceeding about 85 degrees on that knee.

How long after a TKA can you walk and travel again. Although I guess I'll wait till 50 probably.

The Fast Guy wrote:

@WORCSRacer What is your opinion of cartilage regeneration or replacement (is there such a thing)? I had major knee injuries with MCL tears 2 yrs ago...

@WORCSRacer What is your opinion of cartilage regeneration or replacement (is there such a thing)? I had major knee injuries with MCL tears 2 yrs ago, got scoped and left the MCL to heal on its own. I had serious cartilage damage and my Dr said after surgery that I will be a getting knee replacements at 60 (45 at time of injury). I still have swelling and some pain. I still don't have complete range of motion either. Thoughts?

burn1986 wrote:

How do you know so much about knee replacement WORC SRacer?

lumpy790 wrote:

I have had a bad knee since 85 and went to see a specialist years ago and he told me to hold off as long as...

I have had a bad knee since 85 and went to see a specialist years ago and he told me to hold off as long as you can as they are constantly making technology advances......maybe its time?

To sleep every night I have to take 2 advil and 2 aleve ...one is for pain and the other for inflammation.... been doing this for 30 years and yes my Dr freaks out about it but his alternative? Prescription drugs that contain the same thing.

I am in constant night aching / pain and have been waiting till 50 to get a new knee .... hit 50 and decided to race the 50+ class instead of getting the knee.

dirthead1 wrote:

Do you have a prosthetic suggestion for THR? I'm scheduled at the end of November for the surgery and it seems you are involved, or extremely...

Do you have a prosthetic suggestion for THR?

I'm scheduled at the end of November for the surgery and it seems you are involved, or extremely knowledgeable, in orthopedics. I'm not a candidate for resurfacing from the existing joint damage and nature of the previous ball to femur pinning.

Thanks

WORCSRacer wrote:

With the advances in Hip Arthroplasty there are many outstanding implants. Do not get a ceramic on ceramic hip because they can shatter when impacted. This...

With the advances in Hip Arthroplasty there are many outstanding implants. Do not get a ceramic on ceramic hip because they can shatter when impacted. This is a real concern to guys who ride because crashing is a common occurrence. Metal on Metal bearing surfaces are fantastic however they must be implanted within a very small window of alignment because otherwise they are subject to excessive wear and that causes the implant to release excessive metal ions into your body. That is not something you want. So IMO, neither of these options are worth the risk. You can get a wonderfully functioning implant with metal on poly bearings.

Find a Surgeon you trust then The important thing to consider as an active person is the surgical approach. ABSOLUTELY AND WITHOUT QUESTION find a surgeon who uses the a Direct Anterior approach. It's very soft tissue friendly and has almost no complications from dislocations. It's not a new approach but for what ever reason most surgeons in the USA and Canada were trained to use either a posterior and or anterior lateral approach. While both of those approaches make the case easier for the surgeon, they are suboptimal compared to the DA. Surgery takes about an hour, you'll be up walking by the afternoon. 1 week post op you should be getting around pretty damn good and I've seen patients playing golf in 3 weeks. The biggest thing you'll be managing post op is the soft tissue insult from the approach dissection.

Good luck

lumpy790 wrote:

I have had a bad knee since 85 and went to see a specialist years ago and he told me to hold off as long as...

I have had a bad knee since 85 and went to see a specialist years ago and he told me to hold off as long as you can as they are constantly making technology advances......maybe its time?

To sleep every night I have to take 2 advil and 2 aleve ...one is for pain and the other for inflammation.... been doing this for 30 years and yes my Dr freaks out about it but his alternative? Prescription drugs that contain the same thing.

I am in constant night aching / pain and have been waiting till 50 to get a new knee .... hit 50 and decided to race the 50+ class instead of getting the knee.

WORCSRacer wrote:

What other conservative treatments have you tried? JFT can effectively give you more time on your native anatomy however you don't want to go for the...

What other conservative treatments have you tried? JFT can effectively give you more time on your native anatomy however you don't want to go for the single shot protocol. 3 to 5 injections over three to five weeks is best.

If I offered you the option of a damn good knee today or one that's 5 to 10 percent better 5 years from now which would you choose?

lumpy790 wrote:

degenerative joint disease ..... I have just dealt with it.

dirthead1 wrote:

Do you have a prosthetic suggestion for THR? I'm scheduled at the end of November for the surgery and it seems you are involved, or extremely...

Do you have a prosthetic suggestion for THR?

I'm scheduled at the end of November for the surgery and it seems you are involved, or extremely knowledgeable, in orthopedics. I'm not a candidate for resurfacing from the existing joint damage and nature of the previous ball to femur pinning.

Thanks

WORCSRacer wrote:

With the advances in Hip Arthroplasty there are many outstanding implants. Do not get a ceramic on ceramic hip because they can shatter when impacted. This...

With the advances in Hip Arthroplasty there are many outstanding implants. Do not get a ceramic on ceramic hip because they can shatter when impacted. This is a real concern to guys who ride because crashing is a common occurrence. Metal on Metal bearing surfaces are fantastic however they must be implanted within a very small window of alignment because otherwise they are subject to excessive wear and that causes the implant to release excessive metal ions into your body. That is not something you want. So IMO, neither of these options are worth the risk. You can get a wonderfully functioning implant with metal on poly bearings.

Find a Surgeon you trust then The important thing to consider as an active person is the surgical approach. ABSOLUTELY AND WITHOUT QUESTION find a surgeon who uses the a Direct Anterior approach. It's very soft tissue friendly and has almost no complications from dislocations. It's not a new approach but for what ever reason most surgeons in the USA and Canada were trained to use either a posterior and or anterior lateral approach. While both of those approaches make the case easier for the surgeon, they are suboptimal compared to the DA. Surgery takes about an hour, you'll be up walking by the afternoon. 1 week post op you should be getting around pretty damn good and I've seen patients playing golf in 3 weeks. The biggest thing you'll be managing post op is the soft tissue insult from the approach dissection.

Good luck

dirthead1 wrote:

I've been told that I'm not a candidate for DA. Is that possible?

Torco1 wrote:

I think most surgeons are still recommending metal on poly hip replacements the most because like WORCSRacer said, the ceramic on ceramic have been know to...

I think most surgeons are still recommending metal on poly hip replacements the most because like WORCSRacer said, the ceramic on ceramic have been know to crack and the metal on metal are starting to show some undesirable affects as well. I had a THR about 10 years ago when I was 26 right about the time metal on metal was becoming the "new and improved" design but my surgeon refused to use that because poly on metal was still the only real proven method. I'm glad I went that way, I did get the newer "crosslinked" poly design though. I've been riding on it for about 10 years now and beating the hell out of it, I have it x-rayed yearly and it still looks and feels great.

I will say something about the recovery, they are not all the same. I sure as hell wasn't up walking around that afternoon. My surgery lasted about 8 hours and I was in the hospital for 8 days, they didn't even try to get my out of bed until the 3rd or 4th day. It was the most brutal thing I experience in my life. They had to sedate me the night of the surgery when they put me up in my room after the recovery room. I was in by far the worst pain I've every experienced in my life when I woke up from the surgery and they finally had to sedate me after I broke the railing of my bed off. This wasn't in some shitty county hospital or shitty doctors either, and I'm not trying to scare people from having these things done.......in fact the reason my experience was so bad was because I waited so long. It hurt like hell for almost 2 months after the surgery and then one day it just stopped and has never hurt since. All that pain was worth it now, but it really really sucked while it was happening. I know my recovery wasn't the norm, but these can happen and I wish I knew instead of everyone telling me ahead of time that it was basically painless and that I would be home that day or the next, cause I sure as hell wasn't prepared for happened next.

lumpy790 wrote:

degenerative joint disease ..... I have just dealt with it.

burn1986 wrote:

How do you know so much about knee replacement WORC SRacer?

WORCSRacer wrote:

I stayed at a Holiday Inn Express last night.

PaleBlue wrote:

Worcs, I much prefer the friendly and helpfull guy posting in this thread to the guy who was just the opposite in the listing of contents...

Worcs, I much prefer the friendly and helpfull guy posting in this thread to the guy who was just the opposite in the listing of contents in food thread.

P.S. my brother's experience with his recovery from his hip replacement(s) was the same as Torco's. Scared the hell out of him as he was beginning to think the pain would never stop. He needed to have is done under a local anesthetic too - not something I'd relish!

WORCSRacer wrote:

Torco your experience is in the vast minority. It also sound like you had some sort of tissue or part of the capsule impinged or incarcerated...

Torco your experience is in the vast minority. It also sound like you had some sort of tissue or part of the capsule impinged or incarcerated. It not normal or expected. Wtf, did they do anything to investigate what was going on?

PaleBlue wrote:

Worcs, I much prefer the friendly and helpfull guy posting in this thread to the guy who was just the opposite in the listing of contents...

Worcs, I much prefer the friendly and helpfull guy posting in this thread to the guy who was just the opposite in the listing of contents in food thread.

P.S. my brother's experience with his recovery from his hip replacement(s) was the same as Torco's. Scared the hell out of him as he was beginning to think the pain would never stop. He needed to have is done under a local anesthetic too - not something I'd relish!

Torco1 wrote:

Yeah, they did x rays and MRI's the days after the surgery because I was bitching so much about the pain. And in the month that...

Yeah, they did x rays and MRI's the days after the surgery because I was bitching so much about the pain. And in the month that followed I went to the surgeon probably a few times a week because I was in so much pain and really pale and on the verge if passing out all the time. All the test and x rays and stuff came back perfectly normal and it almost seemed like they were getting annoyed at me that I was complaining so much.....but trust me, I'm the type of person that doesn't complain about shit.....I just couldn't take it anymore. Anyway, they figured that it was because my original injury happened when I was 13 and avascular necrosis set in a basically destroyed the ball and it worn down to nothing. Over the next 13 years all the muscles, ligaments, nerves and everything probably shortened and tightened up to adjust to my leg and during the surgery they had to stretch them out really far in order to get the implant to fit and line up and to make sure both legs where the same length. So they assumed the pain was from constant pulling and stretching from the muscles, ligaments, nerves, etc.... until they finally "settled" into place. I guess it makes sense and the front part of my ankle burned like it was on fire for a long time, so that would explain the nerve pain.

DavidCO wrote:

WORCracer Thank you for your insight into knee replacements. I have another questions as a rule do knee replacement doctors just use one type of implant...

WORCracer

Thank you for your insight into knee replacements. I have another questions as a rule do knee replacement doctors just use one type of implant. Or can I say I would like xxx Implant vs the Depuy that he normally puts in? I am gettting close to surgery and would hate to have to find a new doctor.

Thank you
David

Torco1 wrote:

Yeah, they did x rays and MRI's the days after the surgery because I was bitching so much about the pain. And in the month that...

Yeah, they did x rays and MRI's the days after the surgery because I was bitching so much about the pain. And in the month that followed I went to the surgeon probably a few times a week because I was in so much pain and really pale and on the verge if passing out all the time. All the test and x rays and stuff came back perfectly normal and it almost seemed like they were getting annoyed at me that I was complaining so much.....but trust me, I'm the type of person that doesn't complain about shit.....I just couldn't take it anymore. Anyway, they figured that it was because my original injury happened when I was 13 and avascular necrosis set in a basically destroyed the ball and it worn down to nothing. Over the next 13 years all the muscles, ligaments, nerves and everything probably shortened and tightened up to adjust to my leg and during the surgery they had to stretch them out really far in order to get the implant to fit and line up and to make sure both legs where the same length. So they assumed the pain was from constant pulling and stretching from the muscles, ligaments, nerves, etc.... until they finally "settled" into place. I guess it makes sense and the front part of my ankle burned like it was on fire for a long time, so that would explain the nerve pain.

WORCSRacer wrote:

It's certainly a plausible explanation except for your observation that it resolved it self overnight. It could be that your Sciatic Nerve was ensnared by a...

It's certainly a plausible explanation except for your observation that it resolved it self overnight. It could be that your Sciatic Nerve was ensnared by a lesion and it finally let go relieving the nerve.


How much longer was your leg post op?

superglue wrote:

I had both knees replaced last year. I haven't returned to riding only because of financial reasons. I asked my doctor what my limitations were and...

I had both knees replaced last year. I haven't returned to riding only because of financial reasons. I asked my doctor what my limitations were and he said whatever I can stand. I asked ,what about dirtbikes, and he said to just wear braces. I've had knee problems since I blew my first acl 30+ years ago playing soccer. I have (or had) that active lifestyle also and was concerned about how long the replacements would last (15 yrs +-). My doctor said at least I would have 15 good years. At the time I could hardly get off the couch. I was the poster child in rehab, which is an mf-er, and now they feel great. No pain. With knee replacements its all about the rehab. Good luck.

raddad wrote:

Have any of you that race MX had a total knee replacement and returned to race competitively again? I have a knee replacement scheduled for November...

Have any of you that race MX had a total knee replacement and returned to race competitively again? I have a knee replacement scheduled for November but after getting a second opinion from another surgeon saying that its not such a good idea for me because of my active lifestyle I may change my mind. Its bone on bone and hurts like hell all the time when riding or after words but I can get along OK when doing normal activities.

If you or anyone you know has input that would be great, thanks!

raddad wrote:

Well tomorrow at 5:30AM CST I'm getting my knee replaced! After hearing how good its working for some of you I decided to go for it...

Well tomorrow at 5:30AM CST I'm getting my knee replaced! After hearing how good its working for some of you I decided to go for it. See ya on the track in the spring