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2017-12-15 New to Me Knee status update


Last October 13 2017 I got a new-to-me-knee. Thought I'd share some thoughts for those of you debating this option. It's now been 8 weeks. In no particular order:

  1. I underestimated this surgery. Hell, I've had broken back, femur, Achilles, multiple ribs, foot, knee & calcified hematoma kidney surgery. Replacement knee hit harder and has taken longer than any of the above.
  2. Mine was outpatient. In and out same day. Surgeon says less anesthesia, chance of staff infection (I work on healthy people with bad joints!) and being home leads to faster recovery.
  3. Physical therapy consists of two parts. Getting 'flat' e.g. extended and flexion (bending). Good flexion is 120 degrees. I'm at 130 and flat 8 weeks later. The second part is strengthening the quads, calf, ham strings. 
  4. The hard part is going downstairs, not up.
  5. I built a ramp from my stairs at the front door and glad I did. Yes, could have used stairs even when first arriving home but the ramp has been very helpful later in learning again how to walk downstairs.
  6. Quad muscle shutdown. The PT's and surgeon all stated that even a bit of water or swelling in the knee and the quad muscle will shut down, be unresponsive even though your brain is sending the signal. Yes, the quad is an important muscle to have working. When I came out of surgery the first thing I checked was the quad and my was firing, but only a twitch, not a clinch.
  7. It's not unusual for local swelling at knee to last 3 - 6 months AFTER surgery. 
  8. Most insurance will not cover a 'Cold Rush' machine that's essentially an ice bucket with pump, hoses and pad to circulate ice water to the knee. Insurance says an ice pack is just as good. True. But, no wetness or mess using the machine. I rented for $28 per month. Then I found out they can be purchased for ~140 all day long on Amazon. I'm not projecting to return the unit after 90 bucks or 3 months.
  9. The first 2 weeks are in home PT for wound dressing, staple removal, exercises, monitoring. After 2 weeks, in town PT. Of course you still have to do homework too.
  10. Percocet first, Norco second. Don't get opioid addicted. I can see why peeps do.
  11. Getting an implant is like buying shoes off the rack. The cut you open, then try to find the closest correctly sized implant. I recall before getting knocked out looking at 8 feet of table with beautiful titanium implants of various sizes sitting in nice glass cases. Here's the point. If your a 'half-size' the surgeon and implant specialist (who is surgery with you) have to choose loose or tight which:
  12. If you get set up tight you'll have trouble with your flat and flexion degrees..
  13. If loose, you most likely will have the 'Click-Clacks'. As you extend and retract the knee, you will hear and feel clicking or clacking. In my case 3 clicks on extension, one louder clack, almost a pop, on retract. I'm told that this too will go away as the joint is stabilized by muscle, tendon, connective tissue development and local swelling reduction At 8 weeks out, I'm still Click-Clacking although *some* times for short periods it's noticeably reduced  if not quiet. 
  14. Time line.
    1. Initially, post surgery, you'll be dancing in kitchen. You'll feel GREAT. Then.. Then the surgery cocktail and more importantly, the nerve block will end and you'll find out what's in your future.  P A I N. So don't get behind on the meds. Pain management is much better than pain retreival.
    2. Two weeks... swelling, ice, walking with a cane, wound maintenance. Staples out soon. In home PT.
    3. Four weeks... swelling, ice, walking w/o cane. Staples are out, PT in town, can drive a car. 
    4. Four to Eight weeks... at 6 weeks was back to riding a DL650. At 8 weeks, now considering the FJR. My issue is 3 miles of (soft) dirt road. All surgery swelling in quad and calf gone. Local knee inflammation still exists. PT changed from flexibility to strenght. Now at PT I get sweaty instead of just crying to mama as the Physical Terrorist makes your knee bend in positions it doesn't want to be in.
  15. Driving. My right knee was replaced, different if left. I decided to remove camper from truck so I had an automatic transmission. Good choice. Problem is the truck is 3500 Dodge dually e.g. high seats. So I got a milk crate, tied a rope to it... hold rope in hand, use crate as a step, use rope to fetch crate back into truck. It worked!
  16. Riding. See above. But..
    1. some leg motions still hurt, most don't. Lifting bike to center stand no problem.
    2. Off CS no problem either. Problem areas are mounting the bike while on CS e.g. 'swinging' the leg over the top case loads the inside knee with boot, riding gear weight and the leg no likee this.
    3. On side stand, I still can't clear the seat with my boot heal; and I have to use this dismount as no way in hell is that leg clearing the top case.
    4. No problem with not trusting the knee to hold the weight of bike or doing a 'foot stomp' should the boot hit sand or slippery surface. Factually, the joint is at max strength almost immediately after insertion into bone ID. Surgeon must use a fast-set epoxy..
    5. On the DL650 I can post up using passenger pegs.. Which puts me into the perfect position to sit, raise, sit, raise, work the muscles. On a local ride a rider asked what the hell was I doing.. I replied getting both my phyical and mental therapy exercises done!
  17. I can feel the implant, tell I have metal in there. Sleeping... the left (good) knee got bruised when I was having a nightmare and slapped it with the bionic knee. Cold weather actually feels good, keeps the swelling down. Haven't had rain or hot weather to experience yet.
  18. Jacuzzi. I'm in now every morning. While there I do PT.. flat and flexion, flat and flexion. Afterwards, ice for 20 minutes. 
  19. Ice - no more than 20 - 30 minutes per session per the PT doodes.

I hope this helps someone somewhere down the line..

Here's some video..

Right knee replacement video 2 hours after surgery..

Walking1 from dcarver220b on Vimeo.

Walkin2 from dcarver220b on Vimeo.

That's it for now. I gotta go work on Naomi's gas tank.

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