Knee replacement surgery, time back on boat.

[Dave_S]

Plan is to take off this time next year for 6 months +.

My knees weren't great but workable. I tore the cartilage in my knee recently and have one old snapped ACL and mid range arthritis in both knees and knee caps. They used to get a bit sore but workable. Since the tear they (for some reason both) have been getting worse and now if I step around obstacles occasionally my knee just gives way.

My thinking is to get both knee replacements done in one go.

For those old farts (meant in the nicest possible way :-) ) with experience how long until you can manage a sail boat full time after replacement surgery. I like to think I'm pretty hardy, so what is an optomistic time frame ?

Secondary question, the tear has created a large bakers cyst behind my knee, the knee guy didn't think draining it would help but it feels like part of the problem to me (based on my extensive lack of knowledge). Anyone tried draining one and how did it go ?

[JimsCAL]

My wife had one knee replaced last fall. By the fifth month she was back to snowshoeing. And she is pretty conservative about such things. If it was me, I would have been back doing most things in 3-4 months. Obviously everyone is different, and your physical condition and health before surgery is also a factor. But I would say you should have no trouble sailing at the 6 month mark.

[mjscottinnc]

I can address to the knee replacement and Baker's Cyst.

I was preparing my boat for a Bahamas winter cruise when I slipped and fell finally damaging a worn out knee beyond simple repair. I had a total knee replacement in mid-December and I was back getting the boat ready for cruising by February and left in November. If you give it 6 - 8 weeks you should be good.


The other knee, which also needs replaced but hasn't completely failed yet, developed a recurring Baker's Cyst. I found that using a elastic knee brace every other day keeps the cyst from refiling. I never had it drained, the brace alone emptied the cyst in about 2-3 days. Those cysts can be really painful if left alone.

[maxingout]

My wife had 2 knee replacements done three months apart. She did great and we are out cruising.

I blew out a hip socket and ten weeks later started cruising.

My father in law had bilateral total knees and the day after surgery had a big stroke.

I am a physician, and here is what I have observed.

You range of motion, level of activity, and muscle strength before surgery will significantly determine the speed of recovery. My wife did vigorous jazzersize five days a week for years before surgery, so her recovery was extremely rapid.
She was back to normal after 3 months.

If you have limited range of motion now with poor muscle strength and minimal physical activity, you will have a more difficult and prolonged recovery. I recommend that people in this condition get physical therapy before surgery to increase muscle strength and range of motion so that after surgery they are not starting their recovery in a hole.

The problem with getting 2 knees done, is blood loss may require a transfusion of blood. You could donate blood to yourself for storage a month before surgery and have an autotransfusion of your own blood if you need it at surgery.

If you are hypertensive or have heart problems, doing bilateral surgery is more risky.

As an eye surgeon, I never operated on 2 eyes at the same time for cataract surgery because if their is a problem with infection post op, you don’t want to have 2 eyes in trouble at the same time.

As far as I am concerned, the same principle applies to knee surgery. Sometimes there are contaminated fluids or break in sterile technique during surgery, and you would be in major trouble if you had 2 infected knees at the same time.

[gonesail]

speaking of cataract surgery .. I can attest to the miracle of getting new lenses put in an eye. this is an amazing thing that usually has amazing results

[Tayana42]

I had one total knee replacement just about a year ago. I’m now ready to get back to cruising. I was in good shape for a 70ish year old (turned 70 during that year), had fair muscle strength (the knee damage requiring the surgery took its toll on knee strength and movement over the last several years prior to the surgery), was not overweight and was otherwise in good health.

The surgery and recovery went exactly as the doctors told me it would. I didn’t believe them that it would take so long for me to recover. In summary, ice and elevation, physical therapy for three months, pain and swelling for another three months, and you will feel recovered after a year or year and a half.

I was advised against doing both knees at once by the surgeon and by my GP. I know some people do both to shorten the total recovery time but the research I did showed a slightly higher rate of complications with bilateral TKR. And it was hard enough to get up from bed or a chair or on and off the toilet with one knee. I wouldn’t want to have to do that with both knees involved.

When to do the second knee? I guess it depends on how bad the second knee is. My approach to knee surgery was and is don’t have it unless your knees keep you from doing the things that are important to you. When my knee prevented me from rowing a single scull I gave that up. When I couldn’t run I stopped running. When I couldn’t manage sailing I had the knee done because not sailing wasn’t an option. In my case I’m not going to do the second one until the new knee hurts less than the remaining old one. So far the bad knee isn’t keeping me from doing anything that the new knee would allow, so I’ll wait a while longer.

I was an athlete, cyclist, swimmer, serious fitness participant for most of my adult life (so far) and I found recovering from knee replacement to be the hardest thing I’ve had to endure. I’m glad at this point I had it done. I’m much better off than I was before the surgery. But I caution you to take it seriously. Take your surgeon’s advice about when to do the second one. Do not expect to get back to challenging sailing in a few months. If you need the surgery don’t be afraid of it. It is worth what you have to go through but don’t underestimate the recovery.

You have my best wishes for a full and speedy recovery. If you get enough parts replaced you may become your 28 year old self again. One can hope anyway.

[maxingout]

Originally Posted by gonesail

speaking of cataract surgery .. I can attest to the miracle of getting new lenses put in an eye. this is an amazing thing that usually has amazing results

The vision gets much sharper and the colors are brilliant once again. You are no loner looking through foggy yellow sunglasses.

[cichal]

After replacing the knee 6 weeks skied. I was on a sailboat before. I was 77 years old.
Evidence:

https://www.youtube.com/watch?v=_AnuJitsD0c

Take care!

[DEAN2140]

My thinking is to get both knee replacements done in one go.

I'm not a doctor but have talked to a few about my knees. Many doctors refuse to do both at the same time. I also remember a column in the Times by Jane Brody, who had both done. She said it was a huge mistake and would never recommend it. Do your research.

[SandyF]

Hi:

There are two points that have not been made in the posts so far.

1- After you get the first knee done, the other one will IMPROVE all by itself, for a while. Why? Because up till the "bad" knee had the TKR, the "good" knee has been doing all the work, and now that the bad knee has been replaced, the other one will no longer be working as hard as it was before the TKR. This was a pleasant surprise after my first TKR in 2014.

2- Had my second knee done last November. Recovery is slower than the first one (am 76 now). My lingering issue is range of motion. Gait, balance, and strength came back quickly. Recovery time for every knee is different, even for the same person.

[dannc]

Originally Posted by maxingout

My wife had 2 knee replacements done three months apart...

What he said.

My grandfather had both knees done at the same time. This was against the doctor's advice.

I don't think the surgery was a success because my grandfather did not do the PT as instructed. Why? Because of the pain. My guess is that the pain during PT with one leg was bad enough and having to do PT on both legs at the same time was just too much for him. He never walked well after the surgery. His pain level decreased but his mobility was no better, if not worse, than when his as born with knees.

Also check out the stroke rate because of knee replacement. I have read that the rate of strokes increases for some reason after a replacement. My grandfather had large numbers of strokes after his surgery.

Another family member has had a knee replacement and it has been sorta successful. They are better off with the replacement but they still have mobility issues. The surgery was not what I would call a complete success.

My two cents is that knee replacement, hip replacement, or back surgeries should be done only when the pain and/or loss of movement is so bad that surgery is worth the risk.

Hopefully, I will never need a replacement, but if I do, no way would I get both done at the same time unless there was danged good reason.

Later,
Dan

[Cpt Mark]

I think I can speak to this. I have had 6 surgeries on the right knee starting with a meniscus tear and finishing with 2 TKR's.

1st. I had a friend who did both at the same time. She was 50+ and within 3 weeks was pretty much done with rehab. She was one of the lucky rare ones.

Skipping the 1st 4 surgeries I finally had a TKR done. Surgeon put the wrong size part in and not at the correct angle. I destroyed it in 8. months. Took me years to find a Dr. who would even talk to to me. He did an exploratory, discovered the initial root cause and the the totaled TKR and replaced it. You don't want a 2nd TKR for a lot of reasons.

How long too rehab. The good Dr above hit the nail on the head. It's all about how good you are going into it. Brutal exercise but. extremely effective is to take a large plastic ball and laying down on your side hold the ball against the wall with your foot/ankle. Now move it up as high as you can and then as low as you can without dropping the ball. This will build up you muscles needed for recovery very fast.

Recovery. This is all about rebuilding the strength you lose in surgery and most importantly range of motion. Surgeons call you healed when you can bend your knee enough to climb a stair which is much less than you have now. You want to aggressively go for more than that, much more.

This is how I did recovery on all 6 surgeries. Taught to me by my brother who's had 2 surgeries. My last PT was also now teaching this. I'm not a Dr or PT, just someone with way too much experience. Do what feels right for you.

There are 2 things you absolutely need for ROM.
Get an old crappy Exercycle . Get and ice machine. If your Dr' says to use a bag of frozen peas I'd look for a new Dr. Seriously. An ice machine will knock the swelling down in record time which is huge in your recovery time. It's an ice chest with a pump, hoses and wrap around bandage. The ice water flows through and around your knee and is super effective as it lasts longer than peas and is far more encompassing. Dr. can give you an RX or you can buy one on EBAY. I've had mine for 15 years and all my friends have borrowed it over the years.

Exercise bike. DO NOT USE ANY TENSION at 1st.

Set the seat up as high as you can and barely reach the pedals with your toes. Mark the seat stem in 1/2" increments all the way from top to bottom.

When you 1st get on the bike using your good leg move the pedal back and forth. Your TKR foot will just follow along. You might only be able to get it to move a few inches and that's ok. Keep working at it and stretch it out. You should feel the stretch but not pain. Pain is you pushed it too far. You'll tire out, get off the bike and go on the ice machine. When your'e ready, go back on the bike and repeat. Within a few days you will be able to make a complete circle going forward and backward. Congratulations! Now "ride" the bike for 5 minutes. When you can do that move to the next step.

Now, drop the seat 1/2". Do the entire process all over again. Don't be dismayed, it will take you a day or 2 to be able to make a circle again.

You will keep dropping the seat until you are on the post and can't go any further. You can ride for 5 minutes in either direction. This is great ROM.

At this point now you can put the seat back to a normal riding position and dial in a very slight bit of tension finally and start rebuilding the muscle. Once in a while, drop the seat without tension and keep it stretched out.

My 1st TKR I was back to normal in a few weeks. I was very aggressive about this program and I was either on the bike or ice all day long.

[Steve Bean]

Do all the research you want, but don't assume your results will be like someone else's. No surgery is guaranteed successful.

[ohgary]

Well, After a single full knee replacement, 30 minutes after surgery I was walking. 1 month after surgery I was up and mobile. After 2 months physical therapy was over, but it took close to a year for everything to get back to as normal as it will every get.

Keep in mind most of the recovery is based on YOU!!! DO the therapy, If you doctor will allow get the CPM machine in the hospital and take it home for the first month.

Two knees is going to add complexity to early movement, but with a walker and help you can do it.. Just keep in mind after the replacement, getting on your knees and back up to your feet will be different and more difficult.

[dannc]

Originally Posted by Cpt Mark

...
Get an old crappy Exercycle . Get and ice machine. If your Dr' says to use a bag of frozen peas I'd look for a new Dr. Seriously. An ice machine will knock the swelling down in record time which is huge in your recovery time. It's an ice chest with a pump, hoses and wrap around bandage. The ice water flows through and around your knee and is super effective as it lasts longer than peas and is far more encompassing. Dr. can give you an RX or you can buy one on EBAY. I've had mine for 15 years and all my friends have borrowed it over the years...

It is AMAZING how effective cold is for pain management. With my second back injury I went to a bone cracker since the MD just had me pop pills which laid me out on the couch like a zombie. After my exam, the bone cracker sent me home to use ice and over the counter pain pills. I thought he was NUTS. He had me use a cold pack every hour I could for seven minutes. Was amazing how that reduced pain. It kept me out of the ER and off serious pain medication that is for sure.

A family member has had THREE shoulder surgeries. The doc had them use the ice machine to manage pain and it is amazingly effective. Something so simple and cheap but works so well.

Later,
Dan