Knee replacement surgery

[Orthoski]

Valli - it's going to be tough to answer that definitively. I looked up his article published in 2010 in the British version of the Journal of Bone and Joint Surgery (a very reputable journal), and he reported success in his patients, but there wasn't a control group. Thus, it's tough to tell what percentage would have had total knee replacements had they not undergone a meniscal transplant. I'm not sure that other studies have confirmed that it's so easy to regrow cartilage with a local paste created during the initial surgery (there are other more involved methods such as "ACI" that are very involved and with narrow indications), and it may just be the microfracture that he's doing at the time of surgery.

Thus, in summary, it's tough to draw any real conclusions from one case-series study. Dr. Stone is certainly a very skilled surgeon, but one has to be careful drawing widespread conclusions from a case series without a control group.

[valli]

Thanks orthoski. I met with Dr. Stone recently when I was deciding where to go for my ACL/LCL/meniscus surgery, and I have a friend who did the Bioknee replacement with him. I had surgery with Dr. Robert LaPrade 12 days ago at the Steadman Clinic, and he was able to stitch together my meniscus without removing any tissue. My cartilage is still in good shape for someone my age (44), but I've read having an ACL recon means you are more likely to need a knee replacement later.

[Moeghoul]

Wife had her surgery last Wednesday, came home Friday, started rehab Saturday. So far so good, she can manage on her own going up/down stairs, uses a walker right now to get around, and will go for daily rehab until this Friday. Insurance for rehab runs out after this week. We're weighing the options right now: is it feasible to go to our local gym and I'd stand in as trainer to get her through the current routine of exercises she is doing? Is there a good DIY source for those that want to go it alone for continuing rehab to work on ROM and strengthening? Is this a stupid idea?

[steelhead]

Moeghoul - after getting my replacement, I thought I could go it alone and continue my therapy based on what I had learned from the therapist. Progress definitely slowed after trying this so ended up going back to PT. My view is to stick with a therapist for as long as you can afford it but go it alone if you have to financially. Just don't stop until she has her full range of motion and strength back. Best wishes to both of you for a speedy recovery.

[dcwinton]

Just weighing in here...new member, looking for fellow travelers. Thought I'd share my knee replacement experience.

I had TKR on right knee July 15, 2014. Skied my old favorite haunts at my home mountain, Squaw Valley (more accurately, the ones that are open..snow stinks) today. 5.5 months post op. Biggest challenge? Weak quads. More gym time needed. No problem at all with knee. Ironically, I tried to cross country yesterday as I thought it would be a better trial. But because I'm not very experienced at xcountry, I fell twice. Doh.

So today I got back on a more familiar horse. Reluctantly. My wife pushed me a bit, and for that I am grateful. Quads burned, but no loss of control. Skied bumps well, but tentatively.

At time of surgery, I was 54 years old. Former ski patroller. I was bone on bone for a few years, but did manage to put in 30 days last season, with braces. Hurt to sit for long. Post surgery I adhered tightly to the physical therapy regime until discharged in October. Then went lazy. Bad move but not permanent.

Knee prosthetic was custom manufactured with 3d MRIs and X-rays by Smith and Nephew. Ask your doc if he knows about it. I believe it requires special training. I was preparing to do it with a very experienced and well reputed 70 year old ortho who does about 100 of these years and actively works with the US Ski Team. He was 't sure what brand he would use. Nothing wrong with being 70 yo, but I was concerned that maybe he wasn't up on the latest tech.

So we did more research. A friend who's had both knees done recommended that I find someone who does 200 a year. So we went looking. After a handful of calls by my wife (who is in medicine) to several docs, when she asked who, if they or a member of their family, had to have their own knee replaced, to whom would they go. We live in the San Francisco Bay Area and there are a lot of great orthopedic surgeons here. Amazing, but there was a very clear consensus.

I have no regrets whatsoever. Not even that I waited too long, as I have read a bit. But everyone is different.

The athlete in me is back, and for that I am very grateful. Now it's up to me to work together back to where I should be.

[rod9301]

Thanks for sharing. Which doctor did you use?

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[dcwinton]

Dr. Peter Callander @ California Pacific Orthopedic and Sports Medicine. Offices in San Francisco and San Rafael. He is very very good. And a really nice guy too, with a great bedside manner.

[skinipenem]

Thanks for sharing. Which doctor did you use?

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Find the best physical therapists in your area and ask them which orthopedists have the best results. Fwiw.

[dcwinton]

On its face, that would appear to be a great idea. Except that a lot of the best physical therapists--at least around here--are either part of an orthopedic practice, or are in the "same [health insurance] network" as an ortho practice, which may mean that their exposure is limited at best, and may be biased at worst.

[skinipenem]

On its face, that would appear to be a great idea. Except that a lot of the best physical therapists--at least around here--are either part of an orthopedic practice, or are in the "same [health insurance] network" as an ortho practice, which may mean that their exposure is limited at best, and may be biased at worst.

Not too get into a full blown pissing match, but I'm bored so I'll bite...

PTs see good and and bad outcomes. Other orthopedic docs see the re-dos. Other docs 'see' reputations. Obviously, everyone has bias.

OP: I hope it works out well for u.

[SkiMom12]

I have been looking for stories about younger people with knee replacements returning to skiing (hard to come by). I found your forum and appreciate your posts.

I'm 41 and have been skiing/hiking/skating on wacky knees for many years after injuries and ++ surgeries. TKR was recommended about 3 years ago and I procrastinated and sought other opinions. I finally had my left knee replaced in November 2013 with the plan to ski (moderately) with my kids in the March break. It feels pretty good and I think I'm on track. Ive been skating and stickhandling a few times already and keeping up with my strengthening program.

I don't mind cruising the blues as its all I've been able to do for several years... I'm just looking for a few days of pain free skiing.
Are there any other 40 year olds out there in a similar situation? I'd love to hear how you've returned to skiing and how you plan to "preserve" your new knee against future revisions.

[Shredhead]

I know a bunch of good skiers with TKR's. One female bilateral, late 40's pro patrol in Aspen, skis and works at a very high level.

I've had a bad right knee for years and have been favoring it while skiing. Caused my left hip to deteriorate some much, I had THR last year. Still skiing at a high level one year post op, but I need to get the knee replaced before I wear out my hip again. So you might want to get it addressed, sooner than later.

[dcwinton]

I had my right knee replaced on July 15, 2014. Skied for the first time exactly 6 months later. Have skied 14 days so far this season, however rarely more than 2 to 3 hours at a time. The knee isn't the problem, but the muscle atrophy pre and post surgery while I was not able to do much. I also ski in Northern California, Squaw Valley mostly. We had bad snow this year, and it has been heavy when we do have it. Sierra Cement we call it. So sometimes I just stop early because the conditions haven't justified staying out longer and pushing things. I baby it but not too much. My wife says I'm back to my old skiing style, but it doesn't yet feel like that to me.

I was advised by other folks to take the season off, but I couldn't do that.

I'm a 54 year old male. Have been skiing since I was 9. Was on National Ski Patrol for a couple of years n 2006 to 2008. Had meniscus repair on each knee once before. But it just got to be bone on bone and I was warned that waiting too long could jeopardize full success. I actually skied 30 days last year, but finally decided that it had to be done.

Advice:

Pick the surgeon, not the prosthetic. I was going to go with. 70 year old who does a lit with the US Ski. Team, and does about 100 TKR's a year. I was advised to find someone who does 200/year. Found a very good surgeon who is in his mid to late 40's. I found that the younger age translated into his being up on the latest technology.

Latest technology. Go with Smith and Nephew. They make a custom made prosthetic based on 3D mri's and X-rays. Means better fit and less invasive surgery.

Do all of the physical therapy you can stand. It's MAJOR and will help you beyond measure. Lots of folks whose TKR's "fail" do so because the patient didn't do the right post-op stuff.

Good luck. I was very nervous, but am immensely happy that I did it. I'm not 100% yet, 8 months out, but expect t to be.

[jma233]

I had my right knee replaced on July 15, 2014.

God I wish we had talked before March Madness began.

[dcwinton]

Okay. Oops. 7/15/13

[gibbssco]

I had a stem cell injection this week that was taken from my hip, even tho I was told it wouldn't do anything for me, I did it anyway because I am desperate and hoping for a "Miracle" I guess. My fingers are crossed and my girlfriend is already trying to prep me for snowboarding this winter but i'm gonna keep hoping. Glad to hear you are getting back to healthy yourself and I hope we get a huge, deep winter! cheers. Huzie

Any word from Huzie (OP) on how the stem cell injection worked out for him????