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knee replacement and cycling
Until this year I have been a fairly competitive age group cyclist (55+).
I have gotten Synvisc (or similar) injections for the past 4 years. This year arthritis in an injured knee has slowed me down considerably. I am not competing and hard rides cause considerable pain and stiffness. My orthopedist says that I am certainly a candidate for a total knee replacement but he is hesitant because he does not know of anyone who has resumed strenuous road cycling after the surgery. He says that there is very little data about athletes of any kind resuming competition. I have done a PubMed search for "knee replacement atlhete" and found very little. Does anyone know of any data about competitive cyclist who have had a total knee replacement? What are reasonable expectations after the surgery? Thanks, Patrick Clark |
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knee replacement and cycling
Patrick Clark wrote:
Does anyone know of any data about competitive cyclist who have had a total knee replacement? What are reasonable expectations after the surgery? Here's a decent overview article from the American Journal of Sports Medicine: http://www.findarticles.com/p/articl...29/ai_75561140 I read another article about the young "X Games" athletes who are getting joint replacments at 30 or younger. Longer lasting materials are being used for these young, active patients. Sorry, I don't remember in which magazine I read the article. -- terry morse Palo Alto, CA http://bike.terrymorse.com/ |
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knee replacement and cycling
Terry Morse wrote:
Patrick Clark wrote: Does anyone know of any data about competitive cyclist who have had a total knee replacement? What are reasonable expectations after the surgery? Here's a decent overview article from the American Journal of Sports Medicine: http://www.findarticles.com/p/articl...29/ai_75561140 I read another article about the young "X Games" athletes who are getting joint replacments at 30 or younger. Longer lasting materials are being used for these young, active patients. Sorry, I don't remember in which magazine I read the article. -- terry morse Palo Alto, CA http://bike.terrymorse.com/ That's a good survey article, but it doesn't mention at all what is probably the best type of hip replacement for the active and athletic person. This may be because it is not through all the FDA approvals for general use although it is well past the experimental stage. Anyway this technique is surface replacement. In the standard technique the end of the femur is cut off and a large pin with the ball on the end is inserted down in the marrow of bone. The socket part attached to the pelvis is polyethylene. This contains the seeds of its own destruction, or at least the need for revision (read replacement of components). The polyethylene wears and the wear particles provoke an allergic reaction in the bone (osteolysis) which loosens up the pin in the femur. The time scale of this is usually 10 to 15 years, not a problem if you don't live that long, but a serious problem for the active athletic person. To minimize wear rate the size of the ball is relatively small compared to that of the natural joint. Unfortunately this makes it much more susceptible to dislocation that the natural joint. There have been improvements in materials, more wear resistant polyethylene, or ceramic components, but they all seem to stay with the relatively small ball diameters and the big pin down the femur. In the surface replacement technique, the end of the femur is left mostly intact except for the ball being ground down to a peg and a metal (cobalt chrome) ball is attached to it. The socket is also the same metal, so that in effect they are just replacing the worn surfaces. The metal is very hard and the part are machined and polished to quite exquisite tolerances. The wear rate is very small compared to the metal/plastic combination, and the diameter of the ball similar to that of the natural joint so it much better resists dislocation. Worst case if it were to become necessary, there is plenty of good bone left to do a standard type of replacement. My interest in this is that I have such a joint replacement. About five years ago at age 54, osteoarthritis had about done for my left hip. I did a lot of research and found out about this type of replacement. I had it done a the Joint Replacement Institute at Orthopaedic Hospital in Los Angeles. Since then I have never looked back. Range of motion of the replacement joint is as good or better than the natural one, and I have no sigificant restriction on my activities other that good sense (I don't bungee jump). I didn't go back to running because I found cycling more interesting. I have done more challenging backpack trips since the replacement than I had been doing before it was needed. I am a relative wimp compared to some of the folks I have heard of who have surface replacements, including an Ironman competitor. For anyone interested, there is more information at http://www.jri-oh.com/index.asp There is also http://www.activejoints.com/ and a Yahoo group of former and prospective patients http://health.groups.yahoo.com/group/surfacehippy/ Mike |
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