Got a New Knee today…

I love my PT place. When I was in for my foot, the assistant that massaged and iced asked how I did my foot. Told her moto. She smiled and said, "that's golden". With my TKR when I told him I wanted to ride he said uh, no... I thought, here it comes, and then I'd like get your leg stronger. When I went back I told a tech I rode but don't tell Jeff, she ratted me out. Hey, heard you went riding. Yep, Cool how'd it go? Had some discussion and he did a real deep eval, really wrenched on it and was happy enough when my PT renewals ran out.

post up any information you find on that. Doesn't sound possible to do the actual replacement that way- they literally saw your Femur and Tibia in half and take your whole natural knee joint out with you lying on your back. The alignment is strictly held in place with a big open space while they experiment with which components are the best fit for your normal anatomy. and put it all in place permanently before closing up all the tissue layers and finally skin. The only way I could envision side incision is simply to form a flap of skin and fat layer that the fold back over at the end of process. Not sure what the advantage would be with that?

FWIW: when you interview surgeons about how they do the surgery, ask exactly WHICH prosthesis the use and do they retain your kneecap. THAT actually has a major bearing on whether you can crawl or kneel down to work on stuff. I got the device that DOES include kneecap component and have been able to crawl and kneel on them but it takes some getting used to desensitizing over time.

I think it all depends on what the person wants the end result to be. 

My PT and Orthopedic both said for me to do one at a time. That way I can rehab with one strong leg. My end goal is to get back to work and riding asap. I live an active life style. 

They both also said I could do both at once but that the end result could be both knees don’t rehab as well as doing one at a time. I think if you’re a person that just plans on not being too active doing both at once would be ideal. A person may not gain full range of motion, but would have it over and done with sooner. 

If doing both at once make sure your house is wheelchair friendly.  You’ll be in a wheelchair for at least a couple weeks. My 1948 beach bungalow is definitely not set up for a wheelchair, and that would have totally screwed me if I choose to do both together. 

It's called Jiffy Knee and is a new implant and procedure that is supposed to be faster recovery, lower pain with no loss in performance.  

Find the doc that does it in your area and go see him...  It's worth a discussion.

https://jiffyknee.com/

Mayo Clinic will not do both at the same time.  That leaves you with zero Functional Ambulation.  It's a long process as it is, but I can't imagine not having 1 functional leg while trying to rehab.

Ha!

I'm pretty sure I've experienced both...  The Oxy works, but it sucks to deal with the side effects.

I went and reviewed the entire website. There is no information on how many of these have been successfully done and there are complications documented. This device and procedure is not FDA approved and Dr exaggerates the very old method of achieving entry to your joint space in the video. In modern TKA no muscles are cut as he explained. Your ACL will be lost if you still have 1 (mine was gone). Here below is part of my actual Operation notes by my surgeon. The only big incision is the 1 they make on the front of your knee through the skin/tissue to gain access. Even Jiffy patients shown have the same big incision/scar down the front. You can see in 1st paragraph of Operative Findings below they only do "minimal release" of MCL. I asked about this and it was explained the MCL is very thick and stranded material and they pull a small area on the side away from your bone (but don't cut it completely) so they can stretch the MCL out of the way and it is repaired as they close everything up and heals just fine. Everything they need out of the way to create an open working space to remove old knee and install replacement is simply done using specialized clamps to hold ligaments, tendon and muscle to either side temporarily while old knee comes out and new knee installed.

Look up Jiffy Knee.  There is a big group on FB with all different outcomes of Jiffy Knee procedures.   I know 3 people that had it done all with good outcomes. 

My PT has a client right now with me that had both done with JIffy Knee.  First one his recovery was fantastic.  Second one is on rehab now and it’s going more like mine.  Flex is coming slower than his first, but he has almost no pain.  There’s something to be said about the differences in the procedures.  You just have to decide if you are on board with what those differences are.

I know we're talking about knees, but my first hip replacement was a "Resurfacing". It was a new implant / procedure that was supposed to be the latest greatest thing and have advantages over a traditional THR.  Looked good on paper but the doctor shit the bed in more than one way. It was never right and had to be revised at the 5 year mark. I know hips are easier than knees. I'd be a little leery of being a guinea pig for a "Brand new" implant and procedure. It may look like a way better way to go but if the doctor hasn't had a lot of experience with it (because it's so new) and doesn't get it installed perfect, it could cancel out any potential advantages over a tried and true method. No matter what you decide Research the living shit out of the surgeon. You know how it's "The bike not the rider" ? Same thing goes for surgeons, "It's the surgeon, not the implant".  You want a finish carpenter, not a framer... Good luck to all of you.    

I went back and reviewed the website again, and not sure there is even new prosthetic device being offered there? The video where Dr Patel demonstrates movement of a knee with a model is the exact same model my Surgeon uses for show and tell. The biggest difference seems to be the method of opening you up he is pitching. I agree with sumdood here on getting the absolute best qualified surgeon rather than prioritizing a procedure that may sound more appealing to you in theory. Now if they come up with a single pill that cures all cancer, I may just bite on that 1...

Just got back from PT, decent day.  measured 115 and i'm 9 weeks out of surgery.  I asked how the guy with the Jiffy Knee was doing and he discharged him from PT last week, less than 6 weeks post surgery.

It may not be for everyone, but I wish I knew about it sooner.  3 surgeons in my area doing them.  I would like to have had that conversation with the doc so I could have made a decision based on that.

Jiffy is just a fancy trademarked name for the subvastus approach to the knee, where you lift off the VMO, rather than making a parapatellar arthrotomy to access the knee joint. The big issue with subvastus approaches, is difficulty with exposure -- so usually subvastus surgeons will have some extra retractors to help them out (AKA Jiffy retractors). Literature shows that subvastus approaches are more likely to have malpositioned implants, because if you can't see very well, it's difficult to operate well -- however, there are no long term clinical differences proven at this stage. I would not go to a surgeon who is new to, or or in the learning phase of this technique. I have personally seen disasters as a result of this.

Many of you have some destroyed knees, which are more complex and more difficult to balance intraoperatively. So, these aren't straight forward grandma knees. Further, you are going to be using your knee and stressing it if you ride moto-- so you need a balanced knee. Balancing the knee is effectively the entire case. If you are bow-legged or have knock knees, and we make your knee straight again, chances are your soft tissue is going to be tensioned differently, which is a source of pain and discomfort. This is how TKA's were generally done prior to robotics (aka -- they were mechanically aligned). The use of robotics helps us get a better functional alignment for each patient, and I think is decreasing the rate of unacceptable clinical outcomes -- usually due to surgeons going to fast, not having done enough cases, or just lack of foresight and a need to get to their T time, all of which is unacceptable.

If it were me having my knee replaced, I'm looking for a few things:

1) Fellowship training in knee arthroplasty, and now particularly with robotics (can be had in an arthroplasty, trauma or sports fellowship)

2) Don't let a non-arthroplasty fellowship trained surgeon revise your TKA. There are exceptions of course, but this is a good general rule. I don't care how nice they are. If they aren't doing these frequently, they should not be doing them.

3) Major 4 implant being used: Stryker Triathlon, Zimmer Persona, Smith and Nephew (Journey 2 or Legion) or Depuy (Attune). Anything else and run away. You need to ask yourself, why is this surgeon using a different implant than the above 4, which have demonstrated survivorship data and excellent clinical outcomes? It probably isn't to benefit you -- and when/if you have a complication, having a non major 4 implant limits your options for revision.

4) For me personally -- I would demand a robot and I will use one in my own practice. Doesn't matter which, just that the surgeon is trained in using it and familiar. It helps make me better and get you a better aligned knee. There is no reason aside from ego to not use it.  I prefer the Mako.

5) Avoid extra high volume surgeon-- aka the surgeons doing 8-12 joint replacements in a day. These guys are going too fast, cut corners for speed, and I've seen the downstream results in my ED. As always there are exceptions, but I think that's a good general rule.

Thank You, for posting your input. I have been monitoring this thread along with other research as I was told 5 years ago that I would need TKR eventually…. 15 year old ACL & meniscus repair, anterior bone on bone. After a poorly timed foot dab last fall while racing Mx, I thought for sure I had finished off my knee. I was doing my best to mentally prepare myself for TKR. My Ortho, who specializes in robotic TKR, wanted to try 14 rounds of rehab first….I balked some as I have been through 2 ACL repairs and know the rehab drill and I was still very active leading up to my mishap. Surprisingly after 10 PT visits and doing the work on my own, my knee has made a pretty good recovery….not totally pain free but I am riding Mx 1-2 times a week and Mtn biking in between….but I keep a close eye on this thread…..

Both of mine are Stryker Triathlon, and surgery done manually. 9 years apart. I believe it has the largest base of successful installs globally at around 3 million. When I had the 1st 1 done in 2016 the lab testing data projected possible 15–20-year useful lifetime. This 2nd 1 done 6 months ago I was told the updated longitudinal lab studies show projected possible 25-30 functional lifetime. MY expected lifetime will expire before the knees 😅

Met with my doctor today, torn medial meniscus with moderate arthritis.  Said I can scope it now and see how it goes or do a replacement.  I choses the scope.  April 24th is my surgery date.

ever had a procedure for torn meniscus before? I have. They will tell you upfront if it is a non blood circulatory area they will simply snip off the bad part and clean everything up and you go home quick and recovery is pretty easy. If they find it is an area with blood flow and they choose to repair it you have a much longer recovery and rehab in front of you including no weight bearing at 1st (at least that's how it used to be done).

I’ve had both of my knees done several months ago and my recommendation is don’t do it, put it off as long as you can. I’ve been putting them off for 7-8 years and I wish I had sucked it up longer. I have excellent insurance both health and short/long term disability. I put in extra time at therapy did everything I was told and they just don’t work worth a shit. I’ve had some pretty bad mx wrecks with bad injuries that required hospital stays and extensive therapy so I figured I knew what I was getting into….I didn’t. I can’t walk worth a shit and have constant pain.

I had my L knee total replacement done in early April 2022 so it’s been 4 years and it’s better but still have the cold wet weather aching.  

Does your new still knee snap crackle and pop just like the knee that was replaced? Mine has done that ever since it was replaced.

Even after having a total knee replacement will you still wear knee braces?

sorry to hear you're not happy- yet. IMO, you need to be more patient and go back to your surgeon to see if it's something wrong or just normal recovery that you've never experienced before so have no roadmap to judge your progress. Everybody is different. If Dr says it is on normal recovery path, then you need to up your mental game and power through it.

I just went in for my 1 year check up on my Left knee. Everything is showing perfect and I can do all my normal daily life stuff just fine. It does not meet all the measurement criteria they chart in PT and has a little pinch from time to time but that's fine for this active 68-year-old. I had my Right knee done 10 years ago (waited 40 years to get it done!) and it still took a little over 1 year to get 100% normal feel back, but it's been rock solid from 3 months after surgery- including moto. I got the same exact prosthesis both times and very qualified lady surgeons but the procedure itself has evolved over time and I'm happy with both of mine with no pain like I had for decades before replacements.

Good Luck!

Yes, mine still snap, crackle & pop just like before surgery. I figured it wouldn’t move smoothly after I felt it.

Bummer to hear Bear and here's hoping you firstly get the ol knee sorted to 100% and then go kick that docs ass so that he cant do anymore good folk in.

I'm still on my 'mission' to nail that bloody Ortho.

It will take some time. 

I get back to my basic , 100 / 120Ks a week on the bicycle, every now and then, but, then stop for a month or more, so, lose the benefit I get from it, and then 'Pile On The Porkiness'. And it take so much to get rid of that, now, at my age!

I did 5000Ks in the  year prior to the Operation  - well, it was only about 9 months, as I had to go rescue my Mum from a Vietnam Hospital  ( note, it was a Great Hospital, with Great People!)  when she got sick and they hoicked her off a Cruise Ship - the B**stards . So, I was fit and prepared,  to have an utter Mongrel Not do the Work / fit the Parts he promised. So, I seem to be only able to do my riding in fits and spurts, then the 'Black Dog' gets me. 

I can handle being on crutches  - for speed ( I can move far quicker than most can walk, and, almost endlessly ) and safety - and have been in chairs a few times over the years,  but not being able to ride my Bicycles , or Motorcycles, as I had hoped to, Plus, making my Work so difficult to do, really gets me down. 

Yoinks - only 10minutes to the start of the Seff Effrican MXGP Studio Show 😅  - thought I'd missed it, but then I remembered OZ is wiiiide, as is the Indian Ocean!

Bearuno, not sure how old you are, but may be worthwhile to see a few other orthos and a possible revision? Would suck to suffer for years when it may be fixable. Had mine done a few years ago, not perfect but pain free at 63, can mtb and ride my dirtbike, but my back is a different story

I'm 66. 

When I had the 1st knee done in 2016, I had cleared all the PT stuff and was cut loose for return to full normal activities. I had my routine 6-month checkup with my Primary Care Dr. He was a Sports Medicine Dr as well as Family care. I was with him from 1995 and very supportive of guiding me through all my bumps, bruises, and surgeries from moto. At this 6-month appointment I specifically mentioned the noisy crackling and popping sounds and he said, "that means it's working correctly"!  The surgeons aim for a sweet spot where it's not too tight and not too loose. At that point I only cared the surgery was successful and that I had no limitations and could ride and stopped even thinking about the knee.