knee replacement for cyclist

Patrick Clark said:

I am 57 years old and until recently an age group competitive

cyclist. For the

Quoted message said:

2002 season I was ranked in the top ten nationally in my age group

for bicycle

Quoted message said:

road racing in USCF sanctioned races.

<snip>

Dumbass -

It doesn't matter how 'good' (good is a relative term) you were -
anyone racing in the Masters Fattie category is a Masters Fattie.

good luck with your Masters Fattie knee,

K. Gringioni.

Kurgan Gringioni said:

It doesn't matter how 'good' (good is a relative term) you were -
anyone racing in the Masters Fattie category is a Masters Fattie.

good luck with your Masters Fattie knee,

I sure am glad you're defending whatever it is you're defending,
Henry. It's really commendable. Keep it up. You might try joining the
Knights Templar or something.

Morgan
--
Morgan Fletcher, [email hidden] Oakland, CA, USA

Patrick Clark said:

I am 57 years old and until recently an age group competitive cyclist. For the
2002 season I was ranked in the top ten nationally in my age group for bicycle
road racing in USCF sanctioned races. For the past two seasons I have not raced
due to extreme pain in my right knee. I have spoken to several orthopedic
surgeons and we all agree that I am a candidate for TKA. All of the surgeons
recommended the same prosthesis - De Puy PFC rotating platform. I have done
Medline searches for TKA in cyclists and have found no information. My main
concern is with the amount of activity that I hope to resume with my new knee.
While cycling I average about 80 rpm for a 3 or 4 hour ride. This is approx
5000 rpm per hour. I would estimate that in a typical year I am on my bike for
close to 500 hours. That is a lot of revolutions. I am concerned with the
longevity of the replacement knee. Is there a prosthesis that is designed
specifically for my intended use? It seems to me that my level of use and my
expectations are greater than the vast majority of patients who have a TKA.
Thanks,
Patrick Clark

My very limited knowledge in this area tells me that failure with
orthopedic implants is overwhelmingly the interface between the bone and
the prosthesis, not the prosthesis itself.
It stands to reason that cycling would be much kinder in this regard
than running, and activity will promote healing and increased bone
density. Beyond that, I would depend on the expertise of my orthopedist.
I know of several cyclists who have continued to ride (relatively major
miles) with prosthetic hips; one of these also had a prosthetic knee.
He ultimately lost the knee, for reasons that were almost certainly NOT
related to his cycling. He has since received another prosthetic knee,
and AFAIK he is doing well.

Good luck,
Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

"Patrick Clark" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

I am 57 years old and until recently an age group competitive cyclist. For
the
2002 season I was ranked in the top ten nationally in my age group for
bicycle
road racing in USCF sanctioned races. For the past two seasons I have not
raced
due to extreme pain in my right knee. I have spoken to several orthopedic
surgeons and we all agree that I am a candidate for TKA. All of the
surgeons
recommended the same prosthesis - De Puy PFC rotating platform. I have
done
Medline searches for TKA in cyclists and have found no information. My
main
concern is with the amount of activity that I hope to resume with my new
knee.
While cycling I average about 80 rpm for a 3 or 4 hour ride. This is
approx
5000 rpm per hour. I would estimate that in a typical year I am on my
bike for
close to 500 hours. That is a lot of revolutions. I am concerned with
the
longevity of the replacement knee. Is there a prosthesis that is designed
specifically for my intended use? It seems to me that my level of use and
my
expectations are greater than the vast majority of patients who have a
TKA.
Thanks,
Patrick Clark

I can't answer your question specifically, but I can tell you that I got hit
by a car 2 years ago and had my femur nearly severed at the femoral head.
It was toss-of-a-coin whether or not to try to repair or replace the hip.
In consideration of my cycling, they elected to attempt to repair it because
they said no prosthesis would withstand the rigors of my cycling (12,000 -
13,000 miles a year).

Six years ago I shattered my kneecap. Knee replacement was considered, but
again, because off my cycling, it wasn't considered the best option.

Unless there have been advances in technology, the prostheses aren't likely
to do as well as a normal joint. But they may be much better than what
you've got.

Best of luck!

--
Bob C.

"Of course it hurts. The trick is not minding that it hurts."
T. E. Lawrence (of Arabia)

"Kurgan Gringioni" <[email hidden]> wrote in
news:[email hidden]:

Quoted message said:

Patrick Clark said:

I am 57 years old and until recently an age group competitive

cyclist. For the

Quoted message said:

2002 season I was ranked in the top ten nationally in my age group

for bicycle

Quoted message said:

road racing in USCF sanctioned races.

Quoted message said:

<snip>

Dumbass -

It doesn't matter how 'good' (good is a relative term) you were -
anyone racing in the Masters Fattie category is a Masters Fattie.

What the heck? Give the man a break. He didn't say was as good as Boonen or
Lance or anything like that. He's just trying to say he's serious about
cycling in his age group; what's wrong with taking a little pride in his
achievement? It's not like he exaggerated it to be more than it is.

Don't look down on your elders. If you're lucky you might survive and get
to be one yourself.

On 13 Apr 2005 08:13:35 -0700, Patrick Clark <[email hidden]>

Quoted message said:

I am 57 years old and until recently an age group competitive cyclist. For the
2002 season I was ranked in the top ten nationally in my age group for bicycle
road racing in USCF sanctioned races. For the past two seasons I have not raced
due to extreme pain in my right knee. I have spoken to several orthopedic
surgeons and we all agree that I am a candidate for TKA. All of the surgeons
recommended the same prosthesis - De Puy PFC rotating platform. I have done
Medline searches for TKA in cyclists and have found no information. My main
concern is with the amount of activity that I hope to resume with my new knee.
While cycling I average about 80 rpm for a 3 or 4 hour ride. This is approx
5000 rpm per hour. I would estimate that in a typical year I am on my bike for
close to 500 hours. That is a lot of revolutions. I am concerned with the
longevity of the replacement knee. Is there a prosthesis that is designed
specifically for my intended use? It seems to me that my level of use and my
expectations are greater than the vast majority of patients who have a TKA.
Thanks,
Patrick Clark

Ask your question in misc.fitness.weights, also. Lots of smart well read
people over there. There's also alt.support.* forums that are extremely
helpful. Be sure you really need the TKR - if there's another reason for
the knee pain, TKR might not correct it.

I think your chances depend on three things:
1. you had a successful outcome (to the surgery)
2. you had successful healing (no infections, or quickly resolved)
3. you did the recommended rest and the recommended rehab.

If you do those three things the chances of being able to ride your bike
post-TKR to the level you seek is excellent.

Keep trying to find an MD that has worked on athletes. Sometimes you will
find they will have improved procedures with more durable parts to the
prosthesis.

Do you have the knee pain when just walking around, or just after cycling
for a while?

Good luck.

jj

Patrick, I am a physical therapist who has worked with hundreds of
TKAs. the bike will be an excellent rehab tool and you will likely
have some pretty quick recovery secondary to fitness and leg strength.
I have had several patients continue with moderate level cycling, but
high intensity stuff was too much for the prosthesis to take. even the
newer implants have a limited lifespan. your might get 3-5 years of
competition in it then be a candidate for a TKA revision. So, it can
be done, but there is a tradeoff in the life of the prosthesis. good
luck, andy

Patrick, I am a physical therapist who has worked with hundreds of
TKAs. the bike will be an excellent rehab tool and you will likely
have some pretty quick recovery secondary to fitness and leg strength.
I have had several patients continue with moderate level cycling, but
high intensity stuff was too much for the prosthesis to take. even the
newer implants have a limited lifespan. your might get 3-5 years of
competition in it then be a candidate for a TKA revision. So, it can
be done, but there is a tradeoff in the life of the prosthesis. good
luck, andy

I asked a couple of the orthopedic surgeons I work for and neither
seemed to think any other implant would necessarily be more durable.
Also, one pointed out that the De Puy implant seemed to allow a bit
more flexion than some others -- a big concern for a cyclist facing a
TKR. Good luck.

Quoted message said:

While cycling I average about 80 rpm for a 3 or 4 hour ride.

No wonder you blew out your knee.

One thing to keep in mind is that implant lifespan is directly related to
proper installation. You might look for a surgeon who's experienced with
IGS (image guided surgery) to perform the procedure. However, make sure you
find a guy who's done a couple dozen or so using navigation.

Navigation certainly improves the accuracy of the placement but inexperience
with the system can lead to the surgeon having to fine tune the femoral and
tibial cuts leading to a larger than necessary poly (I've seen this several
times). Once the surgeons know how to use the system they can get the cut
right the first time and avoid the fine tuning and additional tourniquet
time.

Without navigation the surgeons use rods and stuff to eyeball the placement
of the implant and while many surgeons are good at it, they simply have no
way of verifying that they made the cut correctly until the post-op x-ray
(which is a little late).

You can get some more information on navigation here:
http://www.caos-international.org/ and here: http://www.brainlab.com

p.s. I work for BrainLAB (could you tell ;^) and definitely believe in our
product (we have studies to prove it) and would be happy to answer any
specific questions you have pertaining to navigated TKR.

-Andy B.

"Patrick Clark" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

I am 57 years old and until recently an age group competitive cyclist. For
the
2002 season I was ranked in the top ten nationally in my age group for
bicycle
road racing in USCF sanctioned races. For the past two seasons I have not
raced
due to extreme pain in my right knee. I have spoken to several orthopedic
surgeons and we all agree that I am a candidate for TKA. All of the
surgeons
recommended the same prosthesis - De Puy PFC rotating platform. I have
done
Medline searches for TKA in cyclists and have found no information. My
main
concern is with the amount of activity that I hope to resume with my new
knee.
While cycling I average about 80 rpm for a 3 or 4 hour ride. This is
approx
5000 rpm per hour. I would estimate that in a typical year I am on my
bike for
close to 500 hours. That is a lot of revolutions. I am concerned with
the
longevity of the replacement knee. Is there a prosthesis that is designed
specifically for my intended use? It seems to me that my level of use and
my
expectations are greater than the vast majority of patients who have a
TKA.
Thanks,
Patrick Clark