Hi everyone,
I am taking a break from my normal blogging on running to update you on my status of my knee replacement. My hope is that those folks who have gone bone on bone may wish to explore more than one option in living with a worn out knee part.
Not being a medical doctor, keniseoligist, orthopedic surgeon, or other medical professional, I only wish to convey my experiences from a patient centric viewpoint.
After years of sports use including basketball, skiing, riding, mountain climbing and so on, at age 46 my knee dislocated while playing hoops. Although the knee became compromised, and I was told not run, I used strength training, cross training, braces and guile to coax an additional 40 marathons out of my knee, mostly Boston qualifiers. Never the less, my knee continued to deteriorate and finally, at 58, my meniscus on my left medial (inside) knee was gone. I was bone on bone, unable to run, and at times, even walk. Prior to the loss of meniscus material, there are a variety of treatments increasing available. However, once gone, options narrow. There's plenty of articles on the net to educate and discuss amelioration.
1. The knee is mostly three parts: knee cap, and medial (inside) and lateral (outside) joints.
2. Most common is either part of the 'figure 8' like meniscus wearing out, whereby the cushioning qualities of the meniscus no longer exist; the joint goes bone on bone, no lubrication, only pain.
If you go to Midas, you're going to get a muffler!
3. Doctors usually offer the following choices to bone on bone:
a. Bike, wear a brace and live with the pain, stop doing all the activities that put big grins on your face.
b. Or get a full knee replacement. Basically, this is a knee amputation, and a double rodded joint replacement is added. Mobility is limited by the new appliance.
If you go to many doctors that have been doing this procedure, for advice, it's highly possible you are getting a knee replacement. I was trying to avoid a full knee replacement.
4. My attending physician, luckily, was chosen by me since he has a deep history as a record setting, and still functioning athlete. Dr. Eric Heiden treated me as an athlete, and was consultative, and did not act like a technician trying to book his calendar. Over a 9 month period, he worked diligently and personally with me to try and solve my pain, and offered alternatives. Unparalleled support by a doctor of his stature and ability in these capitated times. But none worked in helping me achieve a satisfactory result. Understanding my resolve, he offered a solution he personally did not provide, but his associate, Dr. Phil Davidson, could. Explaining the pros and cons, Dr. Heiden noted that a partial knee replacement might be worth the try, and if it failed, I could still avail myself to the full replacement as a backup.
www.heidendavidsonortho.com
tell them Fasteddie sent you!
5. A partial knee replacement is not nearly as invasive. Rather, it is a resurfacing technique, and a smaller shelf is cut into bone to accommodate the three needed pieces.
http://www.conformis.com/Patients/About-Knee-Replacement-Surgery
6. On June 2, 2010, Dr. Phil Davidson installed a Conformis partial knee replacement, up in Park City UT. I was walking stairs very gingerly, within a day or so.
My observations:
It is now the end of November, 2012. I successfully completed the Triple Trail Challenge in Park City (Steeplechase, Half, and Full Mid Mountain Marathon) almost within 3 months of the procedure.
(I don't think this is normal recovery protocol :>)) I added two more since.
To date, I have now successfully completed 5 marathons, and reached my Boston Qualifier target goal at St. George this last October of 2012. 28 months.
My own experience with Physical Therapists is they have not handled many partial knee recoveries. As a result, after a few weeks of PT, I ended up with my own recovery program, rehabbing myself.
My primary issue was that the PT folks did not seem to understand that I was not recovering as fast after PKR as FKR patients. But let me explain. FKR is an amputation, then adding a new appliance. Days after surgery these FKR folks have tremendous mobility as the joint is now mechanical. Of my 3 knee parts after PKR, my left medial was new, but my left lateral knee joint was still stage 3 arthritic, and my kneecap was still stage 2. Only my medial joint had been replaced, so I was far from new.
My guess is that over time data will confirm that partial knee replacements take longer to rehabilitate.
However, the benefits may be more overall mobility and.... YOU CAN RUN! The doc is really resurfacing a small single joint.
Add to that that a full knee replacement is still then available if the partial knee fails, and I think it's worthy of consideration.
Please note that not only was I methodical in rehab on recovery, I was also diligent in not over stressing the knee joint and attendant muscle groups in recovery. ( I walked most of the events immediately after surgery).
At 8 months, I could barely run 8 miles, and very slowly. My plan was to go slowly for a year, and just get back to a normal gait, my second year was to develop a modicum of speed. Muscle atrophy was a long time in making. First year pain during workouts abated only very, very slowly. The first 6 months were very painful. I did not consider myself a "runner" again for about a year and a half.
I did not attain speed workout status until about 20 months! But I always kept Dr. Davidson's admonitions in mind that a PKR has small parts, and I did not want the pieces to separate from bone and resurfaced joints. So I went easy, and it paid BIG dividends from months 20-26. Just my experience, and, if you read this blog, in concert with my philosophy that slow and steady is better than fast and injured. All comes to he who waits.
So the recovery period is longer, but my knee is functioning at a very high level. Feel free to comment or ask away with any questions!
Best wishes...... Fasteddie.
I am taking a break from my normal blogging on running to update you on my status of my knee replacement. My hope is that those folks who have gone bone on bone may wish to explore more than one option in living with a worn out knee part.
Not being a medical doctor, keniseoligist, orthopedic surgeon, or other medical professional, I only wish to convey my experiences from a patient centric viewpoint.
After years of sports use including basketball, skiing, riding, mountain climbing and so on, at age 46 my knee dislocated while playing hoops. Although the knee became compromised, and I was told not run, I used strength training, cross training, braces and guile to coax an additional 40 marathons out of my knee, mostly Boston qualifiers. Never the less, my knee continued to deteriorate and finally, at 58, my meniscus on my left medial (inside) knee was gone. I was bone on bone, unable to run, and at times, even walk. Prior to the loss of meniscus material, there are a variety of treatments increasing available. However, once gone, options narrow. There's plenty of articles on the net to educate and discuss amelioration.
1. The knee is mostly three parts: knee cap, and medial (inside) and lateral (outside) joints.
2. Most common is either part of the 'figure 8' like meniscus wearing out, whereby the cushioning qualities of the meniscus no longer exist; the joint goes bone on bone, no lubrication, only pain.
If you go to Midas, you're going to get a muffler!
3. Doctors usually offer the following choices to bone on bone:
a. Bike, wear a brace and live with the pain, stop doing all the activities that put big grins on your face.
b. Or get a full knee replacement. Basically, this is a knee amputation, and a double rodded joint replacement is added. Mobility is limited by the new appliance.
If you go to many doctors that have been doing this procedure, for advice, it's highly possible you are getting a knee replacement. I was trying to avoid a full knee replacement.
4. My attending physician, luckily, was chosen by me since he has a deep history as a record setting, and still functioning athlete. Dr. Eric Heiden treated me as an athlete, and was consultative, and did not act like a technician trying to book his calendar. Over a 9 month period, he worked diligently and personally with me to try and solve my pain, and offered alternatives. Unparalleled support by a doctor of his stature and ability in these capitated times. But none worked in helping me achieve a satisfactory result. Understanding my resolve, he offered a solution he personally did not provide, but his associate, Dr. Phil Davidson, could. Explaining the pros and cons, Dr. Heiden noted that a partial knee replacement might be worth the try, and if it failed, I could still avail myself to the full replacement as a backup.
www.heidendavidsonortho.com
tell them Fasteddie sent you!
5. A partial knee replacement is not nearly as invasive. Rather, it is a resurfacing technique, and a smaller shelf is cut into bone to accommodate the three needed pieces.
http://www.conformis.com/Patients/About-Knee-Replacement-Surgery
6. On June 2, 2010, Dr. Phil Davidson installed a Conformis partial knee replacement, up in Park City UT. I was walking stairs very gingerly, within a day or so.
My observations:
It is now the end of November, 2012. I successfully completed the Triple Trail Challenge in Park City (Steeplechase, Half, and Full Mid Mountain Marathon) almost within 3 months of the procedure.
(I don't think this is normal recovery protocol :>)) I added two more since.
To date, I have now successfully completed 5 marathons, and reached my Boston Qualifier target goal at St. George this last October of 2012. 28 months.
My own experience with Physical Therapists is they have not handled many partial knee recoveries. As a result, after a few weeks of PT, I ended up with my own recovery program, rehabbing myself.
My primary issue was that the PT folks did not seem to understand that I was not recovering as fast after PKR as FKR patients. But let me explain. FKR is an amputation, then adding a new appliance. Days after surgery these FKR folks have tremendous mobility as the joint is now mechanical. Of my 3 knee parts after PKR, my left medial was new, but my left lateral knee joint was still stage 3 arthritic, and my kneecap was still stage 2. Only my medial joint had been replaced, so I was far from new.
My guess is that over time data will confirm that partial knee replacements take longer to rehabilitate.
However, the benefits may be more overall mobility and.... YOU CAN RUN! The doc is really resurfacing a small single joint.
Add to that that a full knee replacement is still then available if the partial knee fails, and I think it's worthy of consideration.
Please note that not only was I methodical in rehab on recovery, I was also diligent in not over stressing the knee joint and attendant muscle groups in recovery. ( I walked most of the events immediately after surgery).
At 8 months, I could barely run 8 miles, and very slowly. My plan was to go slowly for a year, and just get back to a normal gait, my second year was to develop a modicum of speed. Muscle atrophy was a long time in making. First year pain during workouts abated only very, very slowly. The first 6 months were very painful. I did not consider myself a "runner" again for about a year and a half.
I did not attain speed workout status until about 20 months! But I always kept Dr. Davidson's admonitions in mind that a PKR has small parts, and I did not want the pieces to separate from bone and resurfaced joints. So I went easy, and it paid BIG dividends from months 20-26. Just my experience, and, if you read this blog, in concert with my philosophy that slow and steady is better than fast and injured. All comes to he who waits.
So the recovery period is longer, but my knee is functioning at a very high level. Feel free to comment or ask away with any questions!
Best wishes...... Fasteddie.
Hi: I also had a pkr and am eight months out from surgery. Although not a runner I am a hiker and mountaineer. I am still having an ongoing problem with stiffness and some pain after a four hour slow hike. At 8 months I expected more and am wondering if you could tell me if you had issues too. Thanks.
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