Total knee replacement?

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9/28/2012 8:02 AM

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!

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dont screw with me, i am old and feeling grumpy..

9/28/2012 9:25 AM

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.

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Professing to be wise...they became fools.

9/28/2012 9:36 AM

I had a knee replacement about 8 years ago and I just went in for a check up and the doc said I should get another 10+ years out of it. I race Motocross and just did a 2 hour Hare Scramble and my knee replacement feels great.

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9/28/2012 10:02 AM

You should talk to Dr. Mark Sanders in Houston,TX. He post at thumpertalk.com quite often and is great about answering questions over there. I know next time I get broke riding my bike I'm going to have him patch me up.

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9/28/2012 10:04 AM

That's encouraging! My second opinion doctor said it would not be as stable and never feel quite right plus would wear quickly but I plan to get a "sports knee" called a Zimmer High Flex Knee. Its good to hear that some one is actually racing with it. Thanks a lot guyssmile

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dont screw with me, i am old and feeling grumpy..

9/28/2012 10:15 AM

Buddy has both knees replaced. Still rides and races. No reason you cant.

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9/28/2012 10:27 AM

Do you need a total knee replacement, or could you get by with a cartilage transplant / restoration? Just had my 17 y.o. daughter to the ortho doc yesterday and she needs cartilage restoration. She's been through 3 surgeries and all kinds of problems over the last few years because of alignment issues with her knees & legs. I won't bore you with the details but I found out yesterday that even though "O-care" doesn't fully go into effect until next year, the ins cos are already denying many of these types of procedures. I was told I better be prepared to pay cash if it gets shot down and don"t make it through the appeal process. Good luck with whatever you decide to do. I know from my experience with her that knee problems are no fun. I see lots of rehab time in your future. Save up and don"t forget to vote in Nov.wink

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9/28/2012 10:29 AM

Keep the stories coming. I am also gonna need a replacement on my right knee at some point and this gives mt hope that my MX riding won't be a thing of the past. Getting tired of the pain all day, every day..............

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9/28/2012 10:54 AM
Edited Date/Time: 9/28/2012 10:57 AM

My wife has both knees done and they are holding up fairly well 8 years on. The issue is not with the knees wearing out but the implant loosening in the bone. More active people tend to have the implants loosen more often They can do a revision which is basically re-glueing the implant in place.

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[LINK TO IMAGE]

Chuck Norris is 1/8th Scottish. This has nothing to do with ancestry, the man ate a fucking Scotsman!

9/28/2012 10:57 AM
Edited Date/Time: 9/28/2012 10:57 AM

A co-worker had a full knee replacement a month ago. He stopped by and I couldn't believe how well he is doing 30 days after. He'll be back to work 45 days after surgery. He said he was up and starting physical therapy the day after surgery. Amazing. This procedure has sure come a long ways.

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9/28/2012 11:14 AM

ah jus cut the bitch off

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9/28/2012 4:39 PM

FIREfish148 wrote:

ah jus cut the bitch off

Ha! That would cost even more! I have talked about the cartilage replacement and so far I have been told its kind of experimental and did not get any kind of support but it sounds good if it could be done under ins.

Thanks againsmile

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dont screw with me, i am old and feeling grumpy..

10/25/2012 4:39 PM
Edited Date/Time: 10/25/2012 4:39 PM

I had a zimmer right knee replacemt 10 weeks ago, from SCOI Mark Friedman. every thing is looking well, not sure if i will return to work at the 12 week schedule, but its looking well so far. I would like to return to VMX racing, at age 61 i know i'm not going to be as I was 10 years ago. I'll try and repost in a couple months for an update.

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10/25/2012 9:40 PM

raddad wrote:

That's encouraging! My second opinion doctor said it would not be as stable and never feel quite right plus would wear quickly ...more

There are much better knees available. The Zimmer knee is a least 2 generations old. You need to be concerned with bearing materials and seek out Highly cross linked polyethylene inserts. Smith and Nephew makes an extremely high performance knee called the Journey 2 it's a fantastic kinematic design and has advanced bearing surfaces. Good stuff. A distant second choice would be a Biomet knee with e poly. It's not as kinematic as the Journey but it does have a good polyethylene bearing surface.

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10/25/2012 9:42 PM
Edited Date/Time: 10/25/2012 9:46 PM

TerryK wrote:

My wife has both knees done and they are holding up fairly well 8 years on. The issue is not with the knees wearing out but ...more

I'm sorry but virtually nothing you said is accurate.

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10/25/2012 9:56 PM

WORCS Racer

You seem to have some knowledge regarding knee replacements. As I said earlier I had my right knee done about 8 years ago and it is doing great, I am scheduled to have my left knee replaced on November 13th. I believe my doctor uses the Depuy knee. Do you have any thoughts on that knee?

Thank you
David

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10/25/2012 9:59 PM

What is not true about it Worcs? That was my basic understanding as well. My Mom has had both of her knees replaced and it has been the best decision for her. She waited a few years because her original Dr. told her she wasn't old enough. We basically talked her into going to someone else and they had the same opinion as us family members. Get it done and enjoy yourself now. She hasn't walked this well and enjoyed herself doing yard work and stuff like that in years. It was funny, she had a follow up appointment in Pittsburgh this week. We decided to walk around town and get something to eat. I have a little bit of an ankle injury and she was out walking me. We had to laugh a little about it.
These surgeries have come a long way as someone mentioned above. She got operated on in the AM and late afternoon was up and walking with a walker. 2 nights in the hospital was basically, sleep, theropy, eat around the clock.

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10/25/2012 10:13 PM

DavidCO wrote:

WORCS Racer

You seem to have some knowledge regarding knee replacements. As I said earlier I had my right knee done about 8 ...more

The DePuy product is being promoted heavily right now using "TruMatch". Its supposedly patient matched and in reality what happens is DePuy use a CT scan and a x ray to establish the "optimal" position for the implant based on the individual's anatomy. Sounds good right? Except it isn't nearly as accurate as its being billed. The CT scans establish the boney anatomy but unfortunately the soft tissue and cartilage can effect the placement of the blocks and it can and does result in a less than perfect situation. The DePuy product also is not very bone conserving. Probably not a huge issue for a older patient who will not be stressing the affected knee but, if you place high demands on it, it could result in a periarticular fracture and that is a very very adverse event.

Bottomline DePuy is offering a "C+" plus product and there are "A" products available.

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10/25/2012 10:23 PM

WORCSRacer

Thank you very much. I need to talk to my doctor and see exactly what replacement he uses. Are you a ortho doctor or supplier of knee replacements?

Thank you
David Clabaugh
Thunder Valley Motocross Park

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10/25/2012 10:25 PM
Edited Date/Time: 10/25/2012 10:36 PM

FlickitFlat wrote:

What is not true about it Worcs? That was my basic understanding as well. My Mom has had both of her knees replaced and it has ...more

I was referring to Terry's comments about modes of failure.

Total knee replacement can restore a patients ability to enjoy an active lifestyle. People are having TKA's at much younger ages than even 10 years ago. People want to be active however it is very important to understand that unlike hip replacement surgery where 95+% of patients are happy at 2 years, only 80% of total knee replacement patients rate their TKA experience as being satisfied or happy. That certainly indicates that there is a lot of work to do and much room to improve. Some basic things to consider is if the patient has any type of metal allergies and if the patient is FULLY COMMITTED to rehab. Even the best surgery will be for nothing if the patient won't work hard in PT.

Glad to hear your Mom is doing well.

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10/25/2012 10:29 PM
Edited Date/Time: 10/26/2012 12:38 AM

this is the worst time of year for me, weather changes in northwest Europe from dry to wet, my whole body burns, screws & plates previously injuries (broken bones) and my knees (bone on bone)
long story short

visited many doctors and all said the same
The prostheses are of very good quality persist 15 years + is no longer an exception
However, the patient is the limiting factor not even think about it when you are young, 50+ minimum even better 60 +
when you are young your muscles are too strong and basically kicks out the prosthese, all advised me to wait as long as possible

years ago I was informed as well, that Developments in the field of knee reconstruction went fast, I would miss all kind of experimental treatments if I went for Total knee replacement
Happy I waited, cartilage transplant etc are no longer science fiction

http://www.leuveninc.com/event/36/818/Publication_of_ChondroCelect_pivotal_trial_results_honoured_with_prestig/

http://www.tigenix.com/en/page/149/chondrocelect

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10/25/2012 10:43 PM

FlickitFlat wrote:

What is not true about it Worcs? That was my basic understanding as well. My Mom has had both of her knees replaced and it has ...more

WORCSRacer wrote:

I was referring to Terry's comments about modes of failure.

Total knee replacement can restore a patients ability to enjoy an ...more

Thanks, She definitely put in the work in PT. I was really proud of her. She has taken care of me enough through numerous surgeries, I think she got the idea of that is how it is done. Even our therapist said that he knew where I got it from now. She was proud of herself as well. I'm glad she beat the odds because she had both knees done and couldn't be happier with the results. Her Doctor was amazing as well Dr. DiGioia and Dr. Hamlin with Womens Mcgee Hospital in Pittsburgh. I don't think she could have had a better team for her and her procedure.

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10/25/2012 10:45 PM

WORCSRacer

I looked at the Depuy site and I think the Knee replacement I am getting is the rotating platform knee. The reason I say that is when I was in for my last visit I asked what the advances were in knee replacements since I got my first one and he described how the plastic cartledge piece rotates to help with the wear.

Are you familier with this replacement?

Thank you
David

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10/25/2012 10:57 PM
Edited Date/Time: 10/25/2012 11:00 PM

DavidCO wrote:

WORCSRacer

I looked at the Depuy site and I think the Knee replacement I am getting is the rotating platform knee. The ...more

Well the RP has been out for quite a while and certainly there are surgeons who swear by them. I don't. I could literally bore you to tears about why it's designed the way it is. Believe me the ideas have sound merit however IMO, Depuy fell short on the execution of the RP knee in terms of bone conservation and actual function. There are no studies or long term follw up available that prove the RP design functions any better than a fixed bearing knee. However they do experience complications that fixed bear knees don't like the tibial bearing surface "spinning out". Spin out is when the bearing spins around 180 degrees. This condition more often than not requires a revision of the knee to resolve the underlying morbidity that allowed this to happen. It's not a common occurrence but it does happen.

Bottom line IMO it s a long run for a short slide.

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10/25/2012 11:08 PM

Wow I own Thunder Valley and promote the national there so I am on my feet alot and I still race and want to continue doing that. So bottom line you would recommend the Smith and Nephew replacement? I want the best I can get. I am still young Ok not that young I am 50 but my knees just wore out from racing Motocross since I was 10.

Thank you
David

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10/25/2012 11:27 PM

DavidCO wrote:

Wow I own Thunder Valley and promote the national there so I am on my feet alot and I still race and want to continue doing ...more

I would explore Conservative treatment first;

Joint fluid replacement therapy
Make sure you aren't overweight
Use management tools like Celebrex
Cycling to maintain range of motion

Now If you've done that and you still find yourself in unremitting pain or your knee feels unstable and you experience regular swelling then yes go ahead have the surgery. Yes the Smith Nephew Journey 2 knee is a very impressive design and displays fantastic function. Considering what youve described as your expectations and goals for having the tka it seems like a good fit to me.

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10/26/2012 12:11 AM
Edited Date/Time: 10/26/2012 12:13 AM

FlickitFlat wrote:

What is not true about it Worcs? That was my basic understanding as well. My Mom has had both of her knees replaced and it has ...more

WORCSRacer wrote:

I was referring to Terry's comments about modes of failure.

Total knee replacement can restore a patients ability to enjoy an ...more

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

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10/26/2012 3:26 AM

the parts manager at our local dealerships still rides and races with both knees and hips replaced. i think he is in his 50s and in good shape. he was a hero when he was in rehab. then on the other hand my 78 year old grandfather hates his. and my friend's overweight wife hates hers. neither of them put in much effort at rehab.

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10/26/2012 4:13 AM

@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?

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10/26/2012 5:12 AM

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.

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The Journey is the Destination