Knee Replacement – are my hiking days over?

All original equipment here, but I know a number of folks with single or double replacements that are just as active hiking and biking as before.

Getting there took some time – as in a couple of years for 95%. They worked at it. But most have no regrets.

Fitness, attitude and luck.

I've hiked and backpacked with people who had knee replacements. I'd imagine it's like anything, part luck and part diligent rehab. If you've had spinal surgeries I'm sure you know the rehab folk and how a good knowledgeable therapist can be a blessing.

Fret not.

I had one of my knees replaced in '97 with a lightweight titanium model. Compared with the pain of hiking on the old, damaged, one, the metal knee is a delight. Zero pain. Keep your pack and body weight down and you're good for miles and miles of hiking.

Thanks for the replies, sounds like my chances are good as I know I have the drive & determination to get it rehabed and back in shape. I sprung back quicker then expected from my spinal surgeries when the doctors did their part (which was not always the case)and spinal surgery success rates are not the best. It took 10 years to get all my ceverical & lumbar spinal issues resolved so I can do another year, just wish it would have lasted me through this summer.

Find a really world.class knee replacement specialist. Even if it means having surgery out-of-town. The top docs do as many in one day as some would do in a month. The old saw, practice makes perfect, applies to joint replacement in spades. Also buy yourself one of the igloo cooler icing units. You fill the cooler with ice and a submersible pump sends chilled water to a cuff around your knee.

Get a second opinion, and get the surgery done by the best doc you can. That'll give you the best chance of keeping your hiking days.

I haven't gotten to that stage yet, but I know quite a few people who have.

In addition to the suggestions re the surgeon, do plan to work closely with your physical therapist. Also, be really clear up front with all your medical team exactly what you expect to do with your new knee, so that they work with you towards that end. Most people who get knee replacements are happy if they can just walk around the house or to and from their car without pain, so make it clear that your goal is quite a bit more ambitious. I had to have one knee reconstructed 25 years ago due to tearing up everything inside in an X-C ski accident, and I made really sure that everyone knew I wanted to get back on the hiking trails (although I did give up skiing afterwards). My surgeon, especially, was quite enthusiastic about supporting my goals! I also happened to luck out in that the best orthopedic surgeon in the area was on call that weekend!

Be sure to ask how many they have done, how many they do in a day and what their infection rate is…this is all supposed to be available to the public anyways. Partials are usually not as successful long-term as totals, and almost all will eventually be converted.

I'm sure you have talked about it with your doc, but ask how long the replacement should last and how many revisions they are able to do.

I've had many patients that have gone through total knees and probably >90% are ecstatic about it. All-in-all, rehab from a total knee is probably nothing compared to your spine rehab. Be diligent and find a PT that is willing, able, and will push you (and be wary of PTAs taking over your rehab).

Besides having a good Doc do the surgery the one aspect you will have to think about is mileage. Knee replacements done in your 50s will likely have to be replaced again so you just have to think about how many times you want to go through this over your lifetime.

I am going to one of the best, if not the best, Bone & Joint clinics in Houston and I agree that choosing the right doctor is everything. The doctor that did such a good job on my back and who specializes in knee & hip replacements will not do a partial knee replacement – only full replacements because of problems he has had with partials in the past. All of the Sr. doctors in this group, the ones with the gray hair, the fame & the awards, do not do partials. Apparently on the newer members, the younger doctors with this group, are doing partials. I trust the older guys much more then the younger doctors out trying to make a name for themselves or trying to make bank while they can; I have run into them before and one was trying to schedule me surgery and install a Lumbar "cage" after my first appointment. People with those "cages" make up about 75% of the patients at my pain specialist and it rarely used anymore from what I am told because of all the problems; if I had folowed his advise blindly I would be in bad shape today. It seems these various metal devices come & go and pressure is put on docs from the makers to push these products, kick-back are given and its all about the money. Flying magazines in the office waiting room are never a good sign for me if the doctor is young; I prefer older doctors who already own their own airplanes and are not looking for an upgrade paid with my surgery.

I started "visco replacement" injections yesterday, one a week for the next three weeks and this is my last chance at putting off the surgery and I don't have much hope for it. It increased the pain level by a large margine but I won't know if it works until a month after the last injection.
Thanks for the advise of picking the right doctor, I will research others in my area outside this group, but as of now I am thinking a full replacement is my best option even if only a partial is needed. After just completing 10 years & 4 major surgeries and many other procedures to get my spine back in shape the last thing I want to drag this knee problem out for another decade; just cut the bad one out and replace it with the latest titanium model. I just can't believe this happened literally weeks after a 10-year journey that finally resolved my spinal issues.

To those of you who have sons, don't let them play football! I loved playing the game and got a lot out of it, but I have paid dearly for it and the real pain & suffering is not on the football field while playing the game but shows up years after you have played your last down. It's a brutal sport and now I wish I had never touched a football.

Yeah I tell patients all the time to never let them put hardware in your spine. Virtually 100% if the disabled people I have treated over the years have has cages in their spine.
I was a gymnast for a long time so I know where you're coming from. Daily battle with my body.

Im mulling over the idea of a doctor reccomended meniscus transplant. The doc says with as much mileage as I do hiking the PCT, it may give me a many more years before we finally have to go to a knee replacement. And he says every replacemnt is more difficult… But around 50 years old is the cutoff for the transplant, before it wont help. Maybe it is something you should look into???
sandy b.

Make sure you get a good therapist, too. There are some pretty bad ones out there…all they do is put hot packs and ultrasound and estim on you and bill you a fortune. Work diligently on your range of motion IMMEDIATELY after the surgery, walk IMMEDIATELY after your surgery, and do as much rehab as your insurance (and your psyche) will allow. Some knees do great, some do awful, and honestly after 10 years of seeing people with new knees I can't even remotely predict who will fall into which category. But the amount of effort the patient puts forward in their rehab does make a HUGE difference. And expect it to be very, very hard…people underestimate just how painful and how hard a good rehab program will be.

And don't fret too much about a full replacement vs partials – I see a lot of great docs here in Chicago doing fulls and partials with equally good results. It honestly depends on your knee, what's wrong with it bone-wise, your alignment pre-operatively, and your muscle strength/motor patterns pre-op.

If you've found a surgeon you trust, go for it. But do not go to just any PT, and be careful about who your surgeon refers you to. A lot of orthopods own their own PT practices and those are exactly the places that rip you off with wasteful interventions that cost you a fortune and do absolutely nothing to get you any better (ultrasound, e-stim, hot packs…).

Good luck – and happy hiking! You have many more years ahead of you for that…

My brother-in-law who is my hiking companion had his knee replaced and he said it was the best thing he ever did.

It ruined his golf game, but he said he's never felt better hiking. He has none of the pain that use to slow us down.

Twenty years ago I was up in Alaska for four months of driving around, camping, and backpacking when, thankfully towards the end of my stay, my foot started becoming more and more painful to the point that I could barely get out of the van. I thought I would never hike again. After seeing a great ortho surgeon who didn't believe in cutting, who prescribed PT, arch supports, and his own foot exercises, I was off and up the mountains again. Over the last five years, I have had chronic knee problems and worse achilles tendon problems, and four acute episodes. All these ills are directly related to a childhood injury. During each painfully acute episode, I thought my hiking days were at an end, but great doctors and great PTs got me up again each time. At 64 years old, every one of my old hiking buddies and gal pals have pretty much hung up their boots for anything but an easy dayhikes. Not me!

In large part through lightening my load viz. BPL and through determined efforts with the PTs, I have made it up to all my favorite summits time and again, including summiting Adams and Jefferson, the second and third highest mountains in the Northeast, just five weeks ago and twice last winter on snowshoes and creepers. I'm about to retire and want to head out west and up into the Rockies and maybe out to my old haunts in the Northern Cascades. I am willing to invest serious $ in the lightest equipment and serious time into the exercises that the PTs have given me. At some point I will need a new knee and I can only wish they could replace my achilles tendon. But I will not give up until there is absolutely no alternative. I love being out there. I especially love being up there in the alpine zone–I don't know why, but I feel so at home there. Don't give up.