Well, this is it. My right knee has come to the end of the road. After about 25k miles of jogging over 50 years, and hiking maybe a thousand miles, it has worn down to the bone. I can no longer descend stairs without dropping quickly on the good (left) knee. Climbing a ladder hurts; descending requires a two step--use the right leg only to lower my weight.

So Thursday morning, 9 AM, it goes. I've heard several people's experiences and they are happy. One friend is still having trouble with one of his. The doctor says I can return to doing everything I did before -- except no running. It should last the rest of my life--he said 30 years!

Here are some pics:

Sasquatch's knees.


Xray: Note the lack of separation on the inner section of the left knee (that's my right knee).


Side view: Metal surface around the upper (Femur). Flat plate on top of the lower Tibia (shin bone), and a polyethylene plastic plate between, where the friction will occur.

There will also be a plastic surface glued to the back of my patella (knee cap) that will rub against the metal.

This is the Tibia part:


Here's an image from https://www.mykneeguide.com/the-knee/the-knee-prosthesis


So... I hope to be out hiking again by summer!

So, will you be awake during the procedure or is it lights out?

Semi-awake, I think. I've been told I'll get a spinal block.

I sent a post but not sure it went thru. I guess it didn't. Would you mind telling me who the surgeon is? Thanks, Fran B.

My step-mother had a knee replacement last year and she was up and walking around within hours of surgery. Within a few days we was back home and doing physical therapy. She could barely go up and down stairs without pain - now she is able to move freely with no discomfort at all.

Good luck and you should be able to be back hiking by summer no problem!

Me too! I’ve already applied for our August 15-19 permit for Emerald Peak, Mt. Henry, and Mt. Senger. Wishing you a speedy recovery so you can start hiking again. And hoping for a speedy end to the Trump Shutdown so USFS can issue our permit.

goes well, Steve

Matthew Simons. Why?

I'm guessing if you shaved that 20 pounds of leg hair that would reduce the wear and tear on your knee and ankle joints.

Those legs aren't mine! I think I accidentally stumbled onto a new Sasquatch sighting!

Best of luck Steve. Hoping for a speedy recovery!

Good luck, Steve. A family member had both his knees done and we have heard all positive things. He bikes, hikes, plays tennis, chases the grandkids etc.

Best wishes.

Just spoke with Steve in hospital. His surgery is completed, and went well, now he's floating in a wonderful haze of Oxycontin.

Looking forward to his trip report.

Very funny Bob!

Ha!! Three days out, and I've made it through the day with only Vitamin I. First round of PT tomorrow... I think I'll pop the serious meds before that session.

Hey Steve.

Just saw this thread. Yikes..... Okay, all is well?

What's your time frame for layoff before hiking again?

How's the other knee?

Getting old is the pits. I turn 70 in April.

Good luck!!!!

paul

Paul, I just got back from the first of 12 PT sessions. They tell me I'm already ahead of the average on the flexion measurements, so it's going well. I'll take a pain med before the PT, but Ibuprofen is all I will need outside of that.

I'm hoping to visit Mt Whitney maybe in June, if progress goes well. We will see...

The other knee has never even hinted at trouble.

Swelling is sure making it sore!

Bella hopes Steve is feline better.

Love the cat Steve. Short hair all black cats are my fav. I had three in a row all and I named them all the same.

Hi Steve,

How are you doing? Painful rehab?

Glad to see you on the website.

Take Care, Fran

Rehab actually helps! After the ice and (yes a bit painful) stretching, the pain is hardly there.

It's overnight and mornings that are more difficult. I'm taking narcotics to sleep through the night, but only Ibuprofen during the day. I'm back at work full time -- sitting at a desk all day is easy on the leg.

The monster bandage comes off in two days, Friday (at 2 weeks).

Here are Xrays two weeks later:



Physical Therapy and working it on my own has gone well. The doc told me I'm well ahead of the average. Walked half a mile this evening.

Sleeping is still giving me trouble. Going to try a switch from Percocet to Vicodin tonight. No meds during the day.

Wow! If this keeps up, we’ll have to do two trips this summer, rather than only one.

You must be doing great because of being in such great shape. More power to you. Please be careful regarding the vicidin.(SP?) Keep up the good work!

Regarding Percocet vs Vicodin: Made no difference. Both give me about 4 hours that I can sleep. Took the V at 2AM, P at 5AM. I'll be back to 1 P tonight -- have to be back to work at 8 AM.

Good luck with your rehab, Steve. Your MD says 'no running.' Question: Can you 'run' on an elliptical machine? Run in a pool with an aquabelt? Just thinking about how you would train for hiking the mountains....

Rowing, using an elliptical machine, bicycling and spin workouts, walking, hiking and backpacking are all OK. Just no running as a training exercise. I quit the jogging two years ago due to knee soreness, and I was still good for major hikes. It will be the same once I get back to it after this little interlude. ;-)

I appreciate your concern!

BTW: I'm 3 weeks post-surgery now. Made a looong Marathon drive to southern Cal and back, 12 hours driving yesterday. The leg did just fine, except it got a bit annoying and somewhat painful during the always-present L.A. stop-and-go traffic jams. Moving the foot often from accelerator to brake and back was like PT. I really appreciated getting out of that and back to where I could use cruise-control.

That sounds great Steve and good luck the rest of the way with your rehab.

Progress report: a little over 10 weeks after the surgery.

I've been riding my mountain bike about once a week -- can ride for 2 hours without any trouble. I can almost climb the steep slopes I did before, but not quite. There is still a little weakness in the quadriceps that is getting better.

Trying to hit the gym 3X per week, doing leg presses and knee extensions each time. The operated knee is definitely a lot weaker than the other. I can press 200 with the good leg, only 140 with the right. Knee extensions are about half the strength of the good leg. But I am able to add more weight in each of these exercises almost every week.

Going down stairs is still not steady. That leg press weakness really shows up going down. Heading upstairs is ok, but the leg is a little weak. I need to head out and try a short hike on a trail with serious inclines to see how well I can do.

I still have swelling around the knee cap area. When leg is extended and relaxed, I can move the knee cap around and it looks and feels like it is floating around in a bunch of mush. Going in to see the doctor in a week to make sure all of this is normal.

Wishing you the best Steve!

Glad surgery went well. BUT, P.T. is what makes or breaks a full recovery vs. "as good as it can get". (granted no issues in the surgery part)

I think you will treat it with the intensity it deserves!

zapanther, thanks! I went through all the PT my insurance would cover -- 12 visits over 6 weeks. I have done all that, and am pushing everything as much as I can. I got in some hike/walks this past weekend, 3 miles with some terrain, 2 miles including some sandy beach. The leg is only mildly sore from all of that.

I'll be hitting the gym again tomorrow.

That’s what I would have thought. When my wife got her first TKR, she did a ton of P.T. and used a fancy machine that slowly flexed her knee for several hours a day. She recovered fine. When she got her second TKR, there was a communications and scheduling SNAFU. It was two weeks before she finally got to P.T. They did one session and sent her home with a few exercises to do on her own. Second recovery was better than the first. Go figure.

My wife had a total knee replacement about 2 years ago, and her surgeon said something interesting: He actually encouraged her to do low-impact weight-bearing activity (walking, hiking, etc...but no running). The reason is that the weight bearing maintains or increases the leg bone density, and serves to help lock the knee replacement implants in place more firmly.

For me, the word was "you can do anything except no running". I asked about emergency run across the street examples, and that was ok. Just no jogging. I may try jogging "across the street" just to see how any emergency will work out.

Here I am at 3 months:
Workouts continue to show improvement.
Leg press is approaching the good leg's strength (150 vs 200)
Hamstring curls are almost normal
Leg extensions have a ways to go (40 vs 80)
Stairmaster until my heart can't keep up.
Rowing machine is as good as before.
Spin cycle: alternately stand at 23, rest at 13 for 30 or 60 second intervals is really helping.

When I tore my quad tendon to 90% I also found cycling really made the difference in regaining the strength in the leg. I knew I was back when I could stand up while peddling.

Steve Wow, your 3 month numbers are remarkable! You lit it on fire indeed. LOL. You may get it "better" than before with proper rest and time.

It is hard, and a disservice, to compare someone's TKR to another as there are so many different ways, procedures, materials,etc.. to do this surgery now. Let alone the each person's tendons, ligaments, bone and muscle capabilities, age, circumstance is different each person.

Bob, I'm glad the wife's 2nd knee replacement went BETTER with a scheduling SNAFU, dang. Did she keep and use the passive flexion device on her 2nd while being left in limbo?
I got the flexion device as well and an internal cooling pump after surgery. My PT appts were the same time as a firefighter that had the same surgery 3 weeks earlier. He was pissed and provided a competitive motivation to our sessions because my range of motion was better my first day. PT said it had a lot to do with the passive flexion from day of surgery on that helped the most.

Lewis is right about surgeons wanting to keep weight bearing quickly. HOI total hip or knee procedures, they want pts. woke up from sedation and getting up and walking a few hours after surgery that same day.

But all this is just anecdotal info and anyone needing a surgery should find the best surgeon and P.T. they can find/ insurance approved for. Give as detailed history, share your desire, then listen and follow your specific path for your surgery they said.

No. She was renting the flexion device and returned it when she was done with it. The second surgeon said she didn't need one. They made her buy the cooling device the first time, so she used it again the second time.

A friend loaned/gave me a "Cryo/Cuff with Gravity Cooler" ice pack system, and I sure used it for the first number of weeks. PT people said to ice it, but the Cryo/Cuff is way better.

Hey all, I see I haven't written about the knee for quite a while. Thought I'd write an update. Just wrote this as a reply to someone asking me about it, since he was considering getting one.

The knee replacement has been very good for me. Before the replacement, I could not descend stairs or a mountain trail without holding a hand rail, or hiking poles, and dropping from the bad leg to the good one -- the good leg was doing 75% of the work. Now, that is history.

I still have an arthritic ankle that is the limiting factor now. (Broke it badly in a motorcycle accident almost 50 years ago.) I had to stop training on a stairmaster because the ankle got worse and worse until I quit. When I hike, I double-wrap the ankle using two ankle brace/wraps, and so far that helps. I am hoping and planning on attempting a full JMT hike late June into July. We will see how I well I do. If problems arise, I don't think the knee will be the problem.

I use my knee probably harder than most people my age (69), because I like to push myself on a spin cycle--setting the friction to the point (23) that I have to stand to keep the pedals turning. I do that for a minute, then sit/rest go easy for 30 secs, then repeat -- for 15 minutes. Now that I can't go to the gym (corona virus closure), I ride my mountain bike on some local river bluffs, climbing and descending a number of times. The crazy thing is the crepitus (grinding noise) that comes from the knee when I straighten it under stress. It sort of sounds like I'm shaking a pepper mill. Put my hand on the knee when it's doing that, and I can feel the grinding. This all worries me, and I am not sure how long everything will hold up. I think I'm pushing it, but becoming a couch potato just isn't going to happen as long as I can keep moving. Others with knee replacements don't have my issue, but nobody works it like I do.

I know a guy my age with a double replacement, and one has been re-replaced. He's had lots of trouble and pain with his. He assures me that his experience is in the ~2% who have had lots of problems. He was still hiking on the knees, but going slowly.

Other than my snow-shoveling adventure on the Main Whitney Trail last June, I just haven't done any hiking. I took the family to Glacier and Yellowstone last summer. Only lite day hiking, which was no trouble at all. I'm keeping the idea of a Whitney shoveling trip open for this year, but we will see.


By the way, the message board software here is aging, it went down this morning, the hosting company says I have to replace things or it will fail for good in a month or so, when they do a permanent upgrade.

Be a compliant patient, Steve; follow your doctor's instructions.

Don't do what I did after 5 weeks on my back after bi-lateral toe surgery and do a day hike from Pine Creek trail-head to Italy Pass...and back...on pain meds. Idiot me. Shocked my doc.

My current doc, a retired Navy Seal, told me to "embrace the suck".

Growing old is not for sissies, eh? So, we keep putting one foot in front of the other and carry on.

The only instructions my doc gave me was "no jogging or running".
I asked about emergencies, he said running to get out of the street, something like that was ok.

I took a pretty good leader fall on the Lower Exum Ridge on Grand Teton back in 2004. We bailed off the route. I headed up to solo the upper Exum Ridge, while my partner headed back to camp. About half way up, I realized that I had probably broken my foot. Having no choice, I finished the climb, made it home, and went to the doctor. Yep, two broken bones. After 6 weeks, he cleared me to “go for a hike” as long as I wore “substantial footwear” that would protect my foot. Technical ice climbing boots fit the bill perfectly, so I brought crampons and a couple of ice tools and headed up the main couloir on North Peak. When I got done, I drove to Tuolumne for a burger. Then I put on a pair of “substantial” trail runners and did the easiest route on Cathedral Peak. It felt great to be out again. And I was compliant the whole time.