Reality of Skiing after Knee Replacement !? let's hear your reality

[CTR]

lot's here in various threads re knee replacement.....I don't care about your specific "going through it" experience.....How much, how hard, what can you ski or not ski after your total knee replacement is the bottom line.....let's hear what you really can or cannot do/ski after knee replacement (my docs have said up to me when do it.....I can walk around no big deal but this year can't do a second cruiser run without too much pain to get off the hill...ski mountaineering is my big passion....ugh) ....thanks, Chet

[old goat]

People might be interested to know when your operation was.

[yeahman]

People might be interested to know when your operation was.

Sounds like he hasn't had the operation yet and is wondering what his skiing prospects will look like after he does.

[t-the-east]

Sounds like he hasn't had the operation yet and is wondering what his skiing prospects will look like after he does.

True. How about Age, maybe weight, Any previous acl/mcl tears? Lots of variables In play here.

[GeezerSteve]

I had total knee replacement w/ patella button surgery on July 10, 2018. I skied 100 days (35 lift-served, 40 touring, 25 XC) 2018-19 season. First month or so mostly half days, i.e., 10-12 runs max, worked to full days by February. By the end of the season I was skiing pretty much as I did 5 years ago. I'm a geezer, so I don't jump off shit and pick my way down icy moguls. I also did 3 week-long off-trail rugged backpacking trips last year and climbed a few mountains. I have skied 20 days so far this year, feel better on skis than I have in 7 years, but I'm more cautious because I don't want to fuck up a good thing. My ROM (flexion) still sucks, but it's no worse than it was for 5 years pre-surgery. Extension is fine. TKR knee fees solid, stable and strong, moreso than non-op knee.

ETA: My TKR surgery was ligament-preserving, unlike most TKR surgeries sacrifice some or all ligaments. Might wanna talk to your OS about this.

Background: No history of ACL/MCL/PCL tears. TKR was indicated by patellofemoral OA (not by the usual medial compartment degradation), the legacy of a mountaineering injury in 1993 which (I later learned) had deformed my patella.

[old goat]

FWIW, my dentist had a single TKR beginning Sept, back to work a week later, I saw her 2 weeks later and she was not a happy camper. but she started skiing mid Dec, although she says the knee swelled a fair bit. She was very happy to be back on skis on groomers.

[splat]

ETA: My TKR surgery was ligament-preserving, unlike most TKR surgeries sacrifice some or all ligaments. Might wanna talk to your OS about this.

I find this comment very interesting insomuch as imagining how having no ligaments would affect TKR function and I'm equally intrigued on where preserved ligaments go and the benefits of this preservation. I'm doing my best to forestall the TKR the doc told me I should get 10 years ago.

[rideit]

I get mine on the 16th, y’all wish me luck, ya hear?
I have a mountain bike/surf trip in Mexico on March 21, my PT told me that there is no reason to cancel.
Maybe not shredding hard core single track, but riding with my kiddo nonetheless.
I find this to be amazing.

[GeezerSteve]

I find this comment very interesting insomuch as imagining how having no ligaments would affect TKR function and I'm equally intrigued on where preserved ligaments go and the benefits of this preservation. I'm doing my best to forestall the TKR the doc told me I should get 10 years ago.

There are studies out there comparing results of ligament sacrifice vs. ligament retention procedures, although some prosthesis designs are new, thus the long-term data is currently incomplete. Some procedures sacrifice some, but not all the ligaments. AFAIK, before 2014 or so, virtually all TKRs involved sacrificing the ACL and rely on the prosthesis to stabilize the joint. I kept all mine, which my OS said is a relatively new thing.

I recall reading one study correlating ACL preservation with slower recovery of flexion ROM, but otherwise better long-term function. FWIW, my prosthesis is the Stryker Triathlon Titanium with patella button.

Re waiting 10 years to get it done: Every skier with a TKR I've met say they wish they had gotten surgery sooner. My OS said that means they got it at the right time : )

I get mine on the 16th, y’all wish me luck, ya hear?
I have a mountain bike/surf trip in Mexico on March 21, my PT told me that there is no reason to cancel.
Maybe not shredding hard core single track, but riding with my kiddo nonetheless.

Best o' luck! Be prepared for a very painful few days post-op. My recovery was pretty good compared to some, although bicycling came late due to slow progress on flexion. YMMV, of course. I started by riding with my seat 3cm too high, switched to shorter (for me) crank arms and gradually lowered seat to normal height. It still takes me a mile or so to work the stiffness out of the knee when I ride.

[splat]

So, with regard to skiing - where is the force that would normally tear an acl transmitted instead of the knee when the titanium knee is in place and not allowing the knee injuries people get without a TKR?

[GeezerSteve]

. . . the force that would normally tear an acl transmitted. . . .

I would hope such forces are abnormal ; )

Ligament sacrificial TKR uses posterior-stablized prosthesis, which has a post and cam system to stabilize the joint. Designs vary by manufacturer. I dunno whether anyone has done research re which posterior-stabilized prosthesis would be the most robust or best for skiing.

[plugboots]

Steve, did you choose Stryker, or was that the doc's choice, or...

[CTR]

65 years old, 6'2", 200#; original injury touch football acl/mcl 1972 before scopes/reconstructions; 2005 hamstring ACL/miniscectomy/microfracture; last 5 years gel injections, last year started to affect backcountry skiing, this year second run in area too much pain to keep skiing, but I can still walk around the mall so to speak....other knee fine, scheduled end of Feb soooooo here/there we go, Chet

[GeezerSteve]

Steve, did you choose Stryker, or was that the doc's choice, or...

Stryker is what my OS uses. AFAIK, most docs stick with one brand. Triathlon Ti was the latest and greatest Stryker prosthesis, upgraded Triathlon, which has a very good track record. I got size #7 of 8, biggest one my OS had installed that year. FWIW, I met with 3 OS, picked the one most highly recommended by HC providers in these parts.

. . .too much pain to keep skiing, but I can still walk around the mall so to speak. . . .

Too much pain to ski or hike down a moderate slope was my breaking point. After diagnosis and preliminary decision to have TKR surgery, it got so bad I couldn't ride a bicycle. I have joined all the other TKR skiers I've met who wished they would have had surgery sooner. I lived with alot of pain for years and in the last few years progressively limited mobility. Getting a TKR was pushing a big reset button.

65 means you're on Medicare?

[rideit]

That’s what I’m getting.

[GeezerSteve]

That’s what I’m getting.

Cool. Stryker Triathlon and Triathlon Titanium have very good success rates.

Are you getting a patella button?

[rideit]

It was never mentioned, so I guess no? Ti for me, of course.

[GeezerSteve]

You might ask -- if you're curious

[CTR]

Yup Medicare so several K cheaper deductible and copay etc as of two months ago....only a couple of ortho's here in Denver don't take medicare, but here and there a few...one of my buddies in Chicago is trying to keep "real" insurance because he wants one of the Chi-town Rock star orthos that don't take medicare to do his surgery ?!

[t-the-east]

You might ask -- if you're curious

That thing is intense