Knee Replacement and Thru-Hiking

[Kerosene]

I know of several people with one or two TKRs, and have heard of dozens more who have successfully finished their PT and are pain-free. Almost everyone agrees that it was worth it. My ortho doesn't want me to consider it until at least my mid-60s, primarily because I would be a candidate to wear it out after 15-20 years of backpacking and the like. The current success rate on second replacements is not nearly as high.

[Rolls Kanardly]

She has since had her right knee done, about 7 years ago, and had the left knee replaced again about 5 years ago. She wore the left one out! Materials have changed over the years and the Docs told her it would be almost impossible to wear the newer knees out.

Again, not directly related to long distance hiking over time and YMMV. Best of luck and I bet with the right pace and light gear you'll do fine.

Before I blew out my left knee I was doing 1100 pound sitting leg presses, Doc told me to lay off the weights and no running. When I pressed him he said "I suppose you could do at least your own weight since you walk". I worked hard on the rehabilitation and it took 6 months. The scar tissue must be broken down or the joint gets stiff. I laid on the floor, wrapped a towel around my ankle and pulled my foot towards my head while bending my knee. After that I got down on my knees and let my weight go down. Hurts like crazy but it gave me more flex. As far as hiking the AT with a metal joint, if everything goes alright I will let you know next year. rolls

[Freedom Walker]

Has anyone ever thru-hiked with a total knee replacement? Can it be done? Thanks.

I have read a trail journal of a retired man who thru-hiked with both a knee and hip replacement. Alas I lost the link last year wen I lost a hard drive

[gsingjane]

I am very surprised to keep reading these accounts of people who do long distance running and marathons after TKR's. The one thing I was told, repeatedly, by orthopedists at the time I was recommended to have one (I decided not to) is that "guaranteed" I would never run again. What I was told was that long distance running, or really any running, puts undue wear on the replacement knee and that will make it more likely to have to be "revised" (a painful surgery that usually doesn't have as good an outcome as the original did). I also did a lot of research on this on the Runners World forums and there, too, people said no. more. running. ever. Has the technology really gotten that much better in the past 2 years, or are there more success stories than I know of?

[MuddyWaters]

I am very surprised to keep reading these accounts of people who do long distance running and marathons after TKR's. The one thing I was told, repeatedly, by orthopedists at the time I was recommended to have one (I decided not to) is that "guaranteed" I would never run again. What I was told was that long distance running, or really any running, puts undue wear on the replacement knee and that will make it more likely to have to be "revised" (a painful surgery that usually doesn't have as good an outcome as the original did). I also did a lot of research on this on the Runners World forums and there, too, people said no. more. running. ever. Has the technology really gotten that much better in the past 2 years, or are there more success stories than I know of?

From what Ive read, its a personal decision by some to take the risk. Usually folks that running was their life, and arent willing to give it up.
Drs are always going to err on the side of caution. Due to fear of legal actions, they cannot do anything but that.

I wonder why they dont have artificial knees with replaceable wear parts that could be done in an easy surgery. Seems stupid not to.

[max patch]

I am very surprised to keep reading these accounts of people who do long distance running and marathons after TKR's. The one thing I was told, repeatedly, by orthopedists at the time I was recommended to have one (I decided not to) is that "guaranteed" I would never run again. What I was told was that long distance running, or really any running, puts undue wear on the replacement knee and that will make it more likely to have to be "revised" (a painful surgery that usually doesn't have as good an outcome as the original did). I also did a lot of research on this on the Runners World forums and there, too, people said no. more. running. ever. Has the technology really gotten that much better in the past 2 years, or are there more success stories than I know of?

My dad asked about hiking, and the dr told him he could hike as much as he wanted to, he just couldn't use a pack. Just being conservative IMO.

Based on my dad's results, I'd stress that TKR should only be done as a last resort. He is in worse shape now than before the surgery. He was supposed to have both knees done, but he said there is no way he'd have the other one done.

[The Solemates]

I am very surprised to keep reading these accounts of people who do long distance running and marathons after TKR's. The one thing I was told, repeatedly, by orthopedists at the time I was recommended to have one (I decided not to) is that "guaranteed" I would never run again. What I was told was that long distance running, or really any running, puts undue wear on the replacement knee and that will make it more likely to have to be "revised" (a painful surgery that usually doesn't have as good an outcome as the original did). I also did a lot of research on this on the Runners World forums and there, too, people said no. more. running. ever. Has the technology really gotten that much better in the past 2 years, or are there more success stories than I know of?

No. The continued direction is to not perform such activities. (and I'm in orthopedics).

From what Ive read, its a personal decision by some to take the risk. Usually folks that running was their life, and arent willing to give it up.
Drs are always going to err on the side of caution. Due to fear of legal actions, they cannot do anything but that.

I wonder why they dont have artificial knees with replaceable wear parts that could be done in an easy surgery. Seems stupid not to.

Correct. Non-compliant patients will always do as they wish.

they do have "replaceable" parts for knees. As long as fixation remains and the metal components have not been damaged, PE inserts can be switched out. there are are several problems:
1) people that need revisions tend to be non-compliant patients. they do not heal as well.
2) people that need revisions tend to be elderly patients. they do not heal as well.
3) people that need revisions tend to have comorbidities. they do not heal as well.
4) the technology implanted 20 years prior tends to be archaic compared to the technology at time of revision. if you were in the market for a car, would you by a 1993 ford taurus if your insurance would pay for a 2013 cadillac escalade?
5) "replacements" may be hard to find - but more importantly - the master carpenter who knew how to implant that original insert is now dead, and no one knows how to do it. just like no one knows how to run MS-DOS nowadays.

[partly cloudy]

After I got my TKR, the doc told me to be careful. This may only last 20 years and I'll need a replacement. I asked him to install zerks. ( grease fittings ) Go in for a grease job every 5 years. He looked at me to say, " now, that's an idea " 3 years down the road and all is good with the right knee, total metal. The left knee is shot. No more operations, I'll live with it.

[gsingjane]

I appreciate the responses. I have been very fortunate to have been able to return to running and backpacking (I did get a second opinion on the TKR recomendation, which the second doctor felt I did NOT need), although not at my previous level. Getting the diagnosis, at age 53, that I would need a TKR was humbling and depressing in the extreme. I am glad that I sought out a second opinion and returned, albeit very slowly and carefully, to running. And I also am mindful that, had I followed the initial advice, I never would have run another step. That would have made me very sad!

[Pedaling Fool]

That would have made me very sad!

I know the feeling. It's something I've been dealing with lately due to a bum right knee stemming from an accident I had at a very young age where I tore up my patellar tendon. There are times, like over the last week when it hurts really bad, so bad I hadn't run for over a week, until yesterday, but it still hurt so I ran slowly. Ironically, it's my cycling style that does the most damage.

[pettas]

I had a total knee replacement just about 3.5 years ago. After rehab & PT I've been able to go back to my full round of hiking, biking, xc skiing, snowshoeing, paddling (canoe portages were something I wondered about initially), etc. While I haven't tried an undertaking like the AT, I feel confident that if I trained properly for it I could do it. Slow and steady would be the way but hey, I was never quick to begin with. For what it's worth, 4 months to the day after the replacement I was able to ride a 44 mile loop on my bike through northern VT & southern Quebec. I didn't do the follow up ride on day 2 of the tour but that was because I chose not to push it; not because of any pain or discomfort. The best part for me is my doctor is an outdoor guy himself so I felt comfortable going back to all my previous activities based on his guidance.

[Berserker]

I met a guy just north of Hot Springs three years ago or so.(Trail Name "hopalong <G> appropriate name, no??) who had a total knee replacement. He was having some pain at that time and I heard he got off later.
The next year, I saw he was back on the trail, but don't know if he finished an "end to end" or not.

I read your response, and it reminded me that I met this guy in 2012 (had to check my trip reports). I ran into him at the Wildcat Shelter in NJ. He goes by Hops Along, and he was a cool dude. He told me about his knee replacement, and I was impressed that he had made it that far (he was thru hiking and had started in GA).

My dad has also had a knee replacement, and even though he isn't a hiker he's still quite active at 67 (walks, cycles, hunts, etc.).