Post-knee replacement hiking ?

[Peakbagr]

After decades of pounding my knees running, racing, hikes, one of my knees keeps crying "Help". I've been seeing one of the best sports medicines docs in the area. He isn't a surgeon so a good choice instead of a doc who's quick with the scalpel.
MRI shows knee has to be replaced but timing depends on my tolerance for discomfort that might last over a few years. Over 5 months I've had a cortisone shot, needles to break up tight tissue, injection of synthetic lubrication and weekly PT.
He tried me with one of his neoprene braces with small metal hinges but he gave me a prescription for a larger, heavier and more sophisticate brace. He's offered to refer me for a surgical consult but is trying to follow my desire to forestall surgery as long as possible. There's a suggestion that a possible next step is an injection of my blood platelets ($$).

With any previous medical procedure, I've always felt that if it's inevitable, get it over and done and cut short the number of bad days. But I'm afraid that I won't be able to do the type of off trail bushwhacking I enjoy. This knee has been scoped 3x over the last 20years and the MRI says another would not accomplish much.
Hoping the avid hikers here who have had a knee replaced can offer advice and how much their new knee has changed what they were able to do.

Thanks

 

[Ken MacGray]

A little something I wrote last year about this subject:

https://sectionhiker.com/hiking-after-knee-replacement-surgery/

As a postscript to that article, I had what what was probably my busiest hiking season ever last year due to the amount of field work required for the WMG. I was all over the place and doing a lot of miles at once. The replaced knee wasn't an issue at all.

Currently, I'm just about three weeks into rehab after getting a TKR on my left knee on 5/25/2022, and am a bit ahead of "schedule" as far as recovery goes. Feel free to ask away.

 

[dottie]

Here’s my story:
April 2021 I had a TKR, as bone-on-bone was horrible. Found an excellent surgeon who listened to me describe my hiking goals: to complete the 67 Four Thousand Footers in New England. I completed the AT in 2016, so I’ve been hiking for a long time!
Immediately after surgery I began home-PT, then found an excellent PT. I described my hiking goals to this young lady. I now live in MD so I wasn’t sure she would comprehend what I needed. This young lady listened & said “I grew up in Millinocket ME.” WOW. She indeed knew what I needed, so “aggressive PT” she gave me.
Additionally, I used a cycling trainer in my basement until I had enough rotation and transitioned to outdoor cycling, 10-20 miles every few days. I’m a former competitive swimmer so I did workouts 3-4 times a week designed to help my knee strengthen & bend.
And 4 months after surgery I completed my final 3 peaks: Hamlin Peak, North Brother & Mt Redington!
Peakbagger, I wish you well on your decision & hope you get back to your beloved trails soon.

Dottie “.com” Rust

 

[Peakbagr]

Reading and mulling. Right now there isn't an urgency as I'm using a special stabilizing brace. Just looking for other opinions and stories as I know it's coming. Thank you.

 

[BISCUT]

Same situation for me. I recently had a PM talk with Ken who posted above. It helps to hear from others with the same plight. About 50 and in need of a TKR of my left knee due to bone on bone. The left side and knee cap are where the pain presents most. For me, the "real" pain is while descending. I do not experience much if any discomfort on the up. I have 3 hikes remaining for the 4k club (Isolation, Owl's Head, and The Bond's) and working toward that goal. I'm trying to get it done before the AMC lists reach 15k persons. I've been receiving Visco shots and they have worked well. With that moderate success, I am in a holding pattern for now. I've been doing hikes in the Catskills as it not far of a drive for me. But not the same as the Whites. I've been training on a treadmill with 5 miles/day and some 7 and 10 mile walks. Frustrating as I can't jog so I'm learning to walk faster I set the speed to about 3.7 and the incline at 5.5/7% throughout the walk. Next step is loading a pack and doing a 10mile with pack weight to see how that goes.

Stem cell treatment for knees is a subject I keep looking for more on but not a lot out there yet. I'm hopeful there could be positive results on this end before I have to make the final decision for TKR. Good luck PEAKBAGR and thanks for posting this. I'm sure there will be many responses.

 

[Peakbagr]

I went from a neoprene knee brace with internal metal hinges to something much better. My Sports med doc proscribed the Ossur Unloader brace. Weighs next to nothing, clamps on shin and knee, lots of straps but it really seems to work.
Downhills are also my issue. I've done all the longer and higher 'list peaks'. I enjoy the off trail, off trail 'whacks. Lots of unexplored terrain with ledges and steeps. Coming down those is an issue. The MRI showed lots going on so I know the TKR is waiting, but trying to figure whether to bite the bullet and get it done, or eke out months of discomfort then having it done anyway. If you haven't checked out the Ossur brace, it's worth a look.

 

[Ken MacGray]

Before my recent surgery, I'd been using an unloader brace for the last few years. It did help a lot, but I can't say I'll miss it.

 

[Peakbagr]

Ken, pls check your messages.

 

[Ken MacGray]

Ken, pls check your messages.

Sent you an email ...

 

[Bernerbabe]

After decades of pounding my knees running, racing, hikes, one of my knees keeps crying "Help". I've been seeing one of the best sports medicines docs in the area. He isn't a surgeon so a good choice instead of a doc who's quick with the scalpel.
MRI shows knee has to be replaced but timing depends on my tolerance for discomfort that might last over a few years. Over 5 months I've had a cortisone shot, needles to break up tight tissue, injection of synthetic lubrication and weekly PT.
He tried me with one of his neoprene braces with small metal hinges but he gave me a prescription for a larger, heavier and more sophisticate brace. He's offered to refer me for a surgical consult but is trying to follow my desire to forestall surgery as long as possible. There's a suggestion that a possible next step is an injection of my blood platelets ($$).

With any previous medical procedure, I've always felt that if it's inevitable, get it over and done and cut short the number of bad days. But I'm afraid that I won't be able to do the type of off trail bushwhacking I enjoy. This knee has been scoped 3x over the last 20years and the MRI says another would not accomplish much.
Hoping the avid hikers here who have had a knee replaced can offer advice and how much their new knee has changed what they were able to do.

Thanks

I'm scheduled for TKR end of April. I use Bauerfeind brace. It's comfortable and keeps knee stable. Hoping to do Long Trail with my daughter in August 2024.

 

[Beckie and Prema]

Good luck to everyone! And thanks to everyone who shared their wisdom (I read Ken's contributions, emailed Hiker Ed, who graciously responded). Turns out my horrible pain was considered mild/moderate by my doctor, according to the xrays. PT followed, was encouraged to keep up with those exercises, as they will build up the leg muscles and keep the stress off my knees. I didn't do much last year due to pre and post surgery for bilateral inguinal hernias. One theory is my leg muscles were weak as a result and my knees took more of a beating.

 

[peakbagger]

A friend of mine had two knees done with a fairly short period. He mentioned that his doctor was a big advocate of pre surgery physical therapy. Not sure what specifics is done but its his description is that its strengthening the muscles that are going to be called upon post surgery to take up the slack. BOth his replacements went very wel

 

[WhiteMTHike]

I'm scheduled for TKR end of April. I use Bauerfeind brace. It's comfortable and keeps knee stable. Hoping to do Long Trail with my daughter in August 2024.

I also use a Bauerfeind brace, not only for the knee but also for the back. I agree about the comfort and stability.

 

[loanshark]

I didn't have much choice with my TKR. I could no longer even perform simple yard work. My knee was getting a bow in it from lack of Cartlidge. I'm very pleased with my choice of surgeon and hospital. I have full extention and about 140 degrees on flexibility. Hiker Ed recommended his PT. He was right on with that choice. I'm at the gym 4 days a week with alot of stationary bike and leg presses. off gym day includes 3-4 mile walks. The progress is slow but steady. It's not something that is better every day. It's more like a little better each week.

 

[Beckie and Prema]

Keep up the good work!

 

[CaptCaper]

I had both knees done. One was done 2 yrs apart. I was hiking lightly at 3 1/2 weeks. And built up from there. It takes at least a year to get to the point one might forget they had it done. Each TKR was different in healing which was odd and different in feeling to this day around 8 yrs later.
The the guy who wants to do the Long trail I would allow for lot's of resting. It will swell up and give off pain galore. If you try to push it mileage wise.
Since I've hiked many hundreds of miles in all types of conditions and they still are working great. Had a xray follow up this year and still tight. But you always know you have fake joints. They make noises and give weird feelings off and on.

 

[SherpaWill]

I'm almost 15 months post op from bi lateral partial knee replacement. I had no cartilage left in the medial compartment in both knees and it was getting to the point where the day to day stuff was getting laborious, never mind hiking. I was hiking locally after 6 weeks and hiked Zealand at around five months. I did a handful of 4 Ks last Summer/Fall without any complications. It's been great not being laid up for days post hike. I'm looking to do a 3 day Pemi Loop this summer, something I definitely could not have done without the surgery.

 

[Bernerbabe]

Curious why you did partial rather than full replacement--from the gal planning to do Long Trail 15 months out.

 

[SherpaWill]

Curious why you did partial rather than full replacement--from the gal planning to do Long Trail 15 months out.

I did the partials because the medial compartment was the only one in both knees that was damaged enough to replace. It’s a little easier to recover from and I still have 2/3 of both my knees. The partial is easy to transition to a full if I ever need that in the future.

The first pic is my left knee about a year before surgery and the second is both about six months post op.

 

[Beckie and Prema]

Since I only have mild (according to the x-rays and my dr - I wouldn't say it feels mild sometimes) knee osteoarthritis, I haven't had the challenges you folks have had, but I thought I'd mention Mt. Roberts as a good place to get back into the swing of things. We went yesterday and so far no pain the last 24 hours. I think because there was so much gradual ascent, ridge walks, no rough climbs.