Living with a Knee Replacement: Which Activities Are Okay ?

Innovations in Total Knee Replacement offer the potential for high demand function with lower failure rates over the 20-30 year life of the components. These advanced engineered components are new to the market and the potential benefits have yet to be proven.

Even so, a 2007 survey of joint replacement surgeons show a trend to allow more activities in patients with artificial joints. 95 % of joint replacement surgeons place no limitations on swimming, golf, walking and biking on level surfaces and stair climbing. Patients are still discouraged from jogging and difficult skiing. About half of the Knee Surgeons allow doubles and singles tennis.

Patients who chose to play sports after joint replacement should train for their sport, build up back, hip and knee strength, and be aware of the potential risks (early failure of replaced joint or fracture of leg bones) of athletic activity after joint replacement.

Primer on Knee Arthroscopy

The most common surgical procedure in Orthopedic Surgery is arthroscopy of the knee. The operation is performed at a hospital or outpatient surgical center. The patient is usually administered a general anesthetic. The procedure usually takes 30-45 minutes.Patients are on crutches for a day or day, take oral pain medications for less than a week, return to desk work in 2-4 days, and are usually fully recovered in 2-4 weeks (for simple arthroscopic procedures such as menisectomy, chondroplasty, loose body removal and lateral release).

Arthroscopy outcomes vary, but can be predicted based on age and diagnosis. As a rule, if the patient is younger than 55 with only one problem (only a torn meniscus, only a loose body, only a small area of joint surface damage) tend to have a higher rate of successful surgical outcomes. Patients over 55 with more than one disease process (most common is torn meniscus with chondral damage – also know as arthritis) have unpredictable outcomes after knee arthroscopy [improved knee outcome in 60% range for these multiple disease process knees].

The best surgical outcomes are after Arthroscopic Medial Menisectomy, Arthroscopic Lateral Meniscal repair and Arthroscopic Loose Body removal. The least predictable surgical outcomes are with Arthroscopic Chondroplasty for arthritis and Arthroscopic Lateral Retinacular Release for patellar tracking problems.

A more detailed report is found on the Knee Arthroscopy page on the web site of Doctor Tarlow.

Bicycling and Knee Pain

Knee pain is a common cycling ailment. The two most common causes for knee pain in cyclists is iliotibial band (IT band) syndrome and patellofemoral syndrome. Both are overuse conditions.

Cyclists may be able to avoid these conditions by pedaling with low resistance and keeping a cadence up to at least 80-90 rpm, and minimizing hard/hill riding. Add a stretching program for legs and be sure to do core training exercises.

Be sure your bike is adjusted properly including the saddle height and position. Have an expert advise you on crank length- being too long can predispose to knee pain. Avoid pushing in high gears. Finally, be sure you have correct cleat alignment/motion.

Tom Bratcher, Physical Therapist at Center for Athletic Performance in North Scottsdale , is an expert in helping cyclist attain proper mechanics with correct bike adjustments and outlining a treatment program to improve body function, relieve pain and improve performance.

Total Knee Replacements Highly Successful in First 3 Years

A British Study looked in the National Registry to determine revision surgery rates of 80,697 primary Total Knee Replacements between 2003 and 2006. This was an observational study and a revision for any reason (infection, loosening, instability, fracture) was the defined end point of the study. Observational studies have many limitations, but the numbers in this study still have some validity and some interest.

The overall primary knee replacement revision rate was 1.4% for cemented total prosthesis, 1.5 % for cement less total prosthesis, and 2.8% for uni compartmental prosthesis at three years. Patients younger than 55 years at the time of the primary TKR had the highest revision rate and those older than 75 years at the time of primary TKR had the lowest rates. Overall, this reports shows that revision rates in the first 3 years after knee replacements carried out in the NHS in England since April 2003 were low.