Knee replacement advice please

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 nigel n 18 Feb 2021

Anyone any experience of returning to the hills after knee replacement?

How soon were you able to do short walks in the hills (say 2-3 hours)?

How long before scrambling/easy rock is feasible?

And is there any possibility of low grade winter routes?

And lastly, does anyone have any experience of these things after both knees have been replaced

I've had various arthoscopies in the past so know the importance of sticking with the physiotherapy

In reply to nigel n:

Assuming you have articular cartilage issues  and need a TKR - total knee replacement - then the fact you can load bear without pain will have a hugely positive impact but with any invasive procedure there is the natural healing process of soft tissue which is normally 8-12 weeks before you should consider anything mildly taxing and much hinges on underlying fitness/health/weight etc. Your physio and carpenter will of course advise.

Of equal/greater importance is ensuring you select a good orthopod, in a good unit, using the best and most advanced implants and surgical techniques.*

*previous insider knowledge. This is my office paperweight. A knee implant, slightly scuffed.


 nigel n 18 Feb 2021
In reply to TheDrunkenBakers:

Many thanks.  The implant looks fearsome!

 Morty 18 Feb 2021
In reply to TheDrunkenBakers:

> Of equal/greater importance is ensuring you select a good orthopod, in a good unit, using the best and most advanced implants and surgical techniques.*

How does one come by this knowledge?  I need to have surgery on my ankle - either replacement or fusion. 

In reply to nigel n:

> Many thanks.  The implant looks fearsome!

It's actually quite tactile and an older design, from Newcastle, helping 1000s of oldies around the country today.

Post edited at 19:13
In reply to Morty:

My knowledge is (was) more knees and hips but some principles are universal. PM me and I'll send you my number. Best having a chat.

 Tom V 18 Feb 2021
In reply to nigel n:

Can I be very cheeky and ask how bad things have to be before you are considered eligible for knee replacement ( in terms of everyday mobility and pain/suffering)?

 Dave the Rave 18 Feb 2021
In reply to nigel n:

I’ve rehabbed many knees Nigel and can say that everyone is different.

Prehab is important, strengthen quads/hams calves prior.

Expect It to hurt post op. 
 

Bilateral TKR’s can still cope with stairs.

If everything goes well, then gentle hillwalking Should be possible at around 12 weeks.

Unless you have a bad op, then anything should be possible really. It’s the bad bone that’s being removed not the major soft tissues involved in knee stability.

Explain to your consultant your goals and hopefully they can choose an implant suitable.

There used to be a TKR called a Signature knee, where they MRI you and make the implants to measure.

Good luck

 Mike-W-99 18 Feb 2021
In reply to nigel n:

No personal experience but it reminded me that Alan Kimber had successful surgery and he documented it here - https://www.alankimber-mountaineering.co.uk/2016/04/new-knees/

Best of luck.

 nigel n 19 Feb 2021
In reply to nigel n:

Thanks all - much appreciated.  Just have to work out whether I am ready yet!

 Chris_Mellor 19 Feb 2021
In reply to nigel n:

I had both knees replaced in Sep 2018 and could go up and down stairs on crutches when I left hospital c4 days after the operation. After three months or so (and private physio) I had ditched the crutches and was walking and built up from there, now both rock climbing and mountaineering. But I'm slow and it took 12 hours to get around the Snowdon Horseshoe. Then perhaps being 70+ contributed to that.

TKRs are a big deal and need a longish and tedious recovery but I'm so grateful I had it done and would recommend it to anyone with arthritic and worn out knees; no question.

 nigel n 19 Feb 2021
In reply to Chris_Mellor:

Thanks Chris.  Any particular reason for having both done at once (I'm 64 so have a bit more time to play with hopefully!)

Nigel

 HammondR 19 Feb 2021
In reply to nigel n: thought you might be interested in this from the Uphill Athlete website 

https://www.uphillathlete.com/new-knee-running-again-total-knee-replacement/

 nigel n 19 Feb 2021
In reply to HammondR:

Can't get much more positive than that!

 HammondR 19 Feb 2021
In reply to nigel n: seems that the 30 year knee is the future! 

In reply to nigel n:

I've not personal experience of knee surgery. But I know you three people who have had total knee replacements. It took them all at least a year to feel the full benefit. Like others have said the physiotherapy is the key. Orthopedic surgeons generally love active, outdoorsy patients.

All the best for whatever course of treatment you decide on.

 David Lanceley 19 Feb 2021

Nigel has already seen these comments in an earlier PM but they might be helpful for others.

I had a total knee replacement at the end of October 2019 so about 18 months in. 

Some thoughts.

I went private for convenience and timing.  Surgery was painless and I was out of bed and eating the same day and home the following day.

The first couple of weeks are pretty uncomfortable, quite a lot of pain, crutches, difficult to sleep and I had some constipation probably due to the pain killers.

After that recovery to normal day to day life is pretty quick and I was walking a few 100 meters, shopping, driving, going to the pub etc. by early December.

By then I was also in the Gym using the leg resistance machines, cross trainer and bike.

In January I was doing gentle hill walks, around Idwal, Aber Falls, sections of the Wales coastal path etc. and tried a bit of scrambling without problems.  Also did my first post-op long haul work flight late January with no problems.

I was building on this when lockdown came along and delayed things and although I was able to do some more significant walks last summer I’m not yet climbing.

I feel that modest winter routes would probably be OK and I’m hoping to get back to gentle skiing.  My main interest these days is a cruising yacht that I keep on the West Coast of Scotland, no problem with that.

Pre-op I was really struggling with day to day stuff so had to be done but I think a last resort when you’ve tried everything else.  I’m 67 and a few other bits creaking as well.

A fell running friend has had both knees done (at the same time) and is pretty active, he’s in his early 80’s

 Tom V 19 Feb 2021
In reply to Tom V:

I'll try again:

how bad do things have to be before

1) you think you need new knees;

2) your GP agrees that you need new knees.

?

 John R 19 Feb 2021
In reply to Tom V:

Tom, no idea how typical my experience was, but I was 60 when my left knee reached a point where I could literally barely walk and realised I needed help. By the time I got to see the consultant (NHS West Cumberland Hospital) it was so bad he was unable to manipulate it for examination. Four months later he replaced it. All very low-key, two nights in hospital, but only because I took against some of the drugs. Home and moving around on crutches, physio and very soon down to sticks only. Recovery did take time and work, but brilliantly worthwhile. Started with gentle walking, moved onto the fells and managed 8/9 hour days of walking and scrambling after about five months. Haven’t looked back since and after perhaps 2 years was back to climbing no worse than five years ago. Winter climbing, paddling and cycling all now completely unaffected. Three years ago the opposite hip collapsed and the same surgeon replaced it very readily and without my needing to go through the GP. Recovery was much quicker and easier (climbing gently in Pembroke after just two weeks). Both were really bad/immobilising before replacement, but GP and consultant were very willing to go ahead. I couldn’t fault the NHS at any stage and know that, without their intervention, I would have had no choice but to give up several years ago. Hope you are able to get such effective and brilliant help, John.

 Tom V 19 Feb 2021
In reply to John R:

Thanks, appreciate the reply. 

I'm obviously not in the needy category and tbh I don't want more surgery of any sort at the age of 68: I was just seeking an insight as to how bad other people's conditions were before they resorted to knee replacement. 

 Chris_Mellor 19 Feb 2021
In reply to nigel n:

A shorter overall recovery time Nigel.


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