Knee replacement and getting back into the saddle

[Peter Holmes]

I find knees an interesting subject, by the time I had reached the age 72 I had systematically managed to destroy both of mine, mainly from sport at a very early age, and then football, road running, squash until around 40 years of age, and of course kicking over Vincent motorcycles didn't help the situation. After several surgical procedures to both knees over the years my knees were both destroyed, so replacement was the only option.

The build up to the knee replacement operations initiated some interesting conversations with my chosen surgeon, one such conversation being, when looking at the new components that were soon to be residing in my legs was "I can't see how the ACL (anterior cruciate ligament) will attach to the new knee components" I was told they don't, I thought that is very strange, apparently it is the most important soft tissue structure within the knee joint, and its main role is maintaining stability of the knee during all motions, so how can it not be re-attached, well apparently it gets discarded, along with all the other worn out parts, remaining cartilage and some bone, so how does the new knee joint maintain stability, well the replacement joint components, along with the remaining muscles and tendons and ligaments take care of that.

So back to flexion, , most of us will have in young adult life around 135-150 degrees of flexion, and 5 degrees of that can be a negative figure to start with, in other words when your leg is fully straightened and your knee locked, your leg will be straight, plus a bit more, so over straight by 5 degrees, and fully flexed 130-145, now if you can achieve that figure after knee replacement surgery you will be doing very well indeed, but you should be able to get somewhere near to that.

As far as activities go, and I do mean normal activities for a septuagenarian, my surgeon advised against taking up running again as the forces on the knee are so great, you could knock your new knee out prematurely. Exactly a year after my ops I walking on Ilkley Moor when I slipped on ice, and my legs collapsed under me, I think on that occasion I achieved the absolute maximum knee flexion that is possible, and it was extremely painful at the time, and for a few days after, thankfully it all calmed down after a while, but I was extremely worried about long term damage, thankfully that proved not to be the case, at the cost of a decent Vincent Rapide, I would prefer not have the procedure repeated.

 

[vibrac]

T. Originality is the name of the game

Originality is easily sacrificed if riding a Vincent is the most important thing, nobody checks your rivets when you are in motion. there are plenty of matching numbered stationary totems in kitchens and museums

 

[Peter Holmes]

I agree with Tim almost 100%, but having modified my Rapide in almost all departments I feel somewhat reluctant to repeat the process with my Shadow, as standard it still remains a delightful and rideable motorcycle, although my wife might not agree when riding pillion. I am not in anyway interested in entering concours competitions, I just kinda like standard Shadows.

 

[Speedtwin]

Twenty minutes after coming round following the rebuild of left knee, the torture team/physio had me walking about, was sent home that evening and told to stay on my feet all weekend, to stay active and to brush the yard.

What I want to know is how the fek did he know my yard was such a mess?
Maybe the robot for the knees has google earth also.........

 

[Gary Gittleson]

A few points. First of all, I forgot to mention that I have been an avid bicycle (yes, "push bike") rider for decades. I don't ride it so much now, having substituted hiking and my usual farm work. Not that I can't ride them, but I mostly rode a "mountain bike" in rough trails with two dogs following. Nearly every day for one hour. Somehow, it doesn't appeal to me so much and my current dogs are too small and (perhaps like me) too old. In any case, the bicycling was probably good preparation for the surgical insults that followed.

Kick backs. I've experienced more than my share of those. Greg Brillus says they're usually caused by a lean mixture, and I think he's right. I fixed that. But the kick backs never caused a problem, not in my knee or my artificial right hip. These joints have been in place now for nigh on to 10 years with no problems. One more point here. The kick backs always seem to occur when the knee is at least slightly bent. So the shock is absorbed by the quadriceps. I think. Either it's luck that the kick back doesn't happen at that exact instant when the leg is fully straight or the physics and mechanics of it make that unlikely.

Flexion. Yes, the closer to the original flexibility, the better. In my case I got around 135 to 140 degrees just three or four weeks after the operation. On more than one occasion a doctor will observe me waiting in the office chair and remark that I my replacements are obviously very good, based on the fact that my feet are comfortably tucked under the chair. Immediately after the operation, I was given a machine to assist with flexion. Later, I was told that they don't work and are no longer used but at least in my case, I think they do. Anyhow, I think it's worth it to push yourself.

 

[vibrac]

Ah! push bikes! judging by the numbers I see on the country roads there will be a lot of old men hobbling around in twenty years time at least I wont be there to be still held up behind them.
My Uncle had a push bike shop and I lived on the Chiltern hills, I can tell you about push bikes. I am proud to say I have kept that vow I made the day before I was 16 and my Tiger cub was delivered. NEVER AGAIN!

 

[Peter Holmes]

You have a rather jaundiced opinion of cycling and cyclists, I find that difficult to understand, isn't owning your own cycle a child's first taste of freedom and speed, up until that point the fastest you have ever travelled anywhere using only energy generated by yourself was by running as fast as you could, and for every sinew you strained to climb the Chiltern Hills, there was the pay back as you raced downhill, round sweeping bends, with adrenaline coursing through your veins, maybe attaining 40mph! I would not have missed it for the world, Clamp Hill, Brooks Hill, Rickmansworth Hill, Harrow on the Hill, oh the memories.

You are far more likely to see lots of old men hobbling around in twenty years time as a result physical contact sport and running rather than cycling, unless you fall of your bike that is, the whole cycling experience I found to be good, that early introduction to how mechanical components function, wheel bearings, frame bearings, brakes, gears, tyres, inner tubes, punctures, general essential maintenance, all wonderful groundings to owning a motorcycle.I still cycle to this day, and I love it, but I don't wear tight Lycra you will be pleased to hear!

 

[Peter Holmes]

Another unforeseen benefit of Bilateral knee replacement surgery was getting back straight legs after years of being bow legged, I just assumed that this came with age, I thought the long leg bones just became banana shaped, they don't, it is just the gradual collapsing of the knee joint as it wears out, and as they do, your knees kind of hinge out sideways. As I walked into the surgeons consulting office, almost his first words were "I can see by your gait and your bowed legs that you have very advanced arthritis, the good news is I can treat it" I now have straight legs, for the first time in years.

I attach a photo of Harvey Bowden and myself in Italy 2015, we both entered the Bow Legged Competition, I seem to remember that Harvey won!

 

[moto8500]

I wasn't as lucky as you Gary as the knee stuck at 55 degrees flection so had to return to theatre for a manipulation under anesthetic. I am now around 110 degrees but more needs to be achieved so I am just keeping at it with the exercise routine etc. The kick back on the BSA on a 500cc pod is considerable and enough to damage the implant so I wont be doing that any time soon. It's a love hate thing with the BSA - it spits and swears while I thrash it. I am with you on the cycle thing Peter. I often come across many of them while on jollies over the Surrey Downs so I have to remind myself that is where it all started with long bike rides across the Romney Marsh to Dungeness. I am now back on one of them but reduced to the static cross trainer - not the same.

 

[moto8500]

Didn't know bow legs and knees went together but with it hinging out sideways sounds painful. Your take on how to achieve full flexion on ice sounds an interesting one but without anesthetic I think I would be rather hesitant.