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    Is intense activity possible after TKR?
    mfullmike posted:
    I couldn't find this question answered less than 2 years ago, so maybe the state of the art or opinions have changed. I feel there's a TKR in my future and I'm wondering what level of activity is possible post surgery. Specifically, might I still be able to climb mountains? I'm 58 years old (male) and I've had three arthroscopic surgeries on my knees for torn meniscus repairs, the last one about 10 years ago. I did not injure them in accidents, but may have worn them down through running. I figure I just don't have good "genes" for healthy knees. I have no other significant health conditions and do not take any medications. I stopped running after the third surgery. After intense physical training for months, I recently attempted to climb Mt. Rainier (14,410 ft.) and got about three quarters of the way up the mountain, but it required being roped for safety and going at the guided pace, without stopping for up to 1 hour, 40 minutes. To make a long story shorter, my body wouldn't cooperate and I was turned back. I now know how to train more intensely and specifically for that climb, but that will stress the knees even further. I had no problem with the knees climbing up, but I know it's stressful nonetheless. But after coming down the mountain my knees were screaming and after three days of intense up and down climbing, I was in considerable pain and felt like a much older man. I should also add we carried 45 to 50 pound packs to our high camp at 10,200 feet and then lightened the load to about 20 to 25 pounds for the summit attempt. So now I have to go see the doc to consider my options, but I'm wondering if one of those options is a TKR, can I reasonably expect to climb mountains again or will I have to give up the big ones and stick to flatter trails? Thanks for any info.
    arbob5 responded:
    Everyone is different, but I would think that being pain free after the surgery should be your main goal. If being able to comfortably climb a mountain is in your corner, sobeit. You are obviously in pretty good shape, so that is going to help you tremendously.

    Let us know how you're doing. I say go for it, and prepare yourself for pretty intense therapy after the surgery. This is to be expected for everyone. You, it appears, are a step ahead because of your conditioning for climbing. But I don't think anyone can truly tell you what you can or can't do afterwards. That's an individual thing. Good luck.
    georgia888 responded:
    I admire the shape you are in, mfullmike, & also your desire to continue to be active & adventurous! However, I don't think "intense" activity of any kind should be pursued after joint replacement therapy. Your doctor may advise otherwise, however, you are relatively young for this procedure & the replacement joints at this point in time are made to last for some where between 10 to 20 years.

    I can fully relate as I am 57 years old & my exercise of choice for over 25 years was jogging. Over the years, I climbed a few of the high peaks in the Adirondacks & always loved hiking of any kind. Unfortunately like you, I've inherited some bad genes predisposing me for degenerative joints throughout the body. I am adjusting to this by replacing previous activities with gentler ones. My daily routine now consists of swimming & water walking, various stretching & yoga routines & land walking.

    My intention is to manage my condition while hopefully slowing the inevitable progression of the osteoarthritis.

    It was a tough transition but I did re-invent my exercise routine & love the new one almost as much as the old one.

    Best of luck to you!

    JudithKi responded:
    This is only my opinion but I had a hip replacment at 50 and a knee at 51 and I wouldn't do anything to make me have those operations again, as it is I am looking at having the knee and hip done again in 15-20 years as thats as lng as they last and that scares me, I know how awful the opeation and recovery is so I would give it all a miss or risk stuffing up your new knee .. good luck
    arbob5 replied to JudithKi's response:
    I was 66 when I had my first hip replaced and 67 when I had my knee replaced. And now at 74, I have had my other hip replaced just recently, July 16 of this year. I can only relay my personal experiences...the hip surgery is easier than the knee surgery, BUT, neither one ever made me say I wouldn't have the surgeries again if necessary. And when I say the hip surgery is easier, it's not the pain, but the knee did seem to take more time to heal and make me more mobile. I was able to put full weight on the hip immediately, and I was able to drive after 2 weeks. As I recall, after the knee surgery, I think it might have been a day or longer before I could put full weight on it. Or maybe longer, to the point where I felt comfortable with it. Driving I believe, was about 3-4 weeks. Therapy was different too....different exercises with the hip than with the knee. That's understandable.

    I can only say we're all different in how we adjust to certain things. If I were told my other knee required replacement surgery, I would go ahead with it.

    Let us know how you're doing. God bless.
    mfullmike responded:
    Thanks for your input everyone. You've given me a lot of good advice and things to think about. This bulletin board seems to indicate there are many people that experience complications from knee replacements. It causes me to pause and consider it only as a last resort. Maybe I'll never climb the big mountains again, but I'll explore all the possibilities and options before I consider surgery to be the solution.
    georgia888 replied to mfullmike's response:
    When the surgery is elective, it should always be the last resort. One comment with respect to the negative stories concerning knee replacements, for the most part, these bulletin boards tend to attract more negative than positive stories.

    In reading your last statement, I feel confident that you will make the right decision about your treatment.

    Good luck,
    JudithKi replied to arbob5's response:
    Hi, funny I found the hip much worse because I had blood transfusions and I can't sleep on my back ,the knee was a longer recovery but what ever way unless I die I will have to have them both done again in 15 to 20 years when I am 65-70 so I wouldn't do anything really physically demanding to hasten the process, I do need my other knee done but they want to wait as long a possible because I am young . Hope all goes well for you too..
    sabrina94 replied to JudithKi's response:
    had blood transfusion myself too and i do feel back pain at time
    KevinHilton responded:
    After knee replacement, the activities you describe are certainly possible, however they wouldn't be considered normal by any means. I've personally treated patients who have skied moguls and rock climbed after surgery, although again these would be considered exceptions and not the rule. It's always surprising when I receive pictures from patients or letters from patient's about some of the crazy or more adventurous things they do after knee replacement. I do have one reservation however. Most knee replacements are cemented. With severe stress I worry about the bone/cement or cement/prosthesis interface failing leading to premature loosening of the prosthesis which leads to knee revision. There exists cementless implants for TKA, however these are usually used much less commonly in the United States because on average they even have more problems with loosening than the cemented varieties. There are newer versions of knee replacements that have entered the market recently that use the concept of metaphyseal fixation -- meaning they are fixed within the bone similar to hip replacements rather than traditional knee replacements which are glued onto the bone. These metaphyseal fixation variety replacements are being used most commonly in cases of revision -- or in the worst possible scenario. I often wonder however if using this type of knee replacement would be beneficial in the initial setting as well as the revision setting to diminish the risk of premature loosening. I know some surgeons have used these "revision" parts in the primary setting, but I have not seen any long term studies (>5 years), that would prove they are indeed better in terms of decreasing the loosening rate.

    Sorry to take over your discussion

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