Hiking after Knee Replacements

[Sugarfoot]

I had to abandon my thru-hike this year because of my knees. It's the culmination of knee problems going back to 1997, primarily patellofemoral osteoarthritis. Subject to confirming MRIs, I am looking at total knee replacements if I want to hike again or engage in any leg activity more strenuous than going from the sofa to the bathroom and back. My orthopedic surgeon is very open to my resuming hiking, even long-distance backpacking, after the surgery, physical therapy and rehab, but he avoids any promises and cautions that I might find limitations.

I would like to hear from some WhiteBlazers who have been through total knee replacements and what your hiking has been like since, especially if you have thru-hiked. I haven't given up my dream yet. 20 years of section hiking haven't cured me of wanting to thru-hike.

Please trust me when I say that I have tried many, many alternatives to total knee replacements, and if possible, try to restrain from suggesting use of sticks (I do), lightweight pack (I do), stretching (I do), various Glucosamine formulations (been there and done that), proteolytic enzymes (ditto), straps and braces, etc. I really want to hear from hikers who have been through total knee replacement(s) and what your experience has been like!

Thanks!

[Kerosene]

I met Five Stones in North Carolina in May 2011. He had had a double TKR 2-3 years prior and was attempting a thru-hike. His journal shows that he made it to mid-PA. You might try to contact him through his journal to have him share his experiences.

We'll see how long I can put off TKR.

[peakbagger]

Silverfox on viewsfromthetop.com had both knees replaced and reclimbed all the NH 4000 footers in the same year. His replacements have some sort of replaceable wear insert that the doctor can check remotely and replace with minimally invasive surgery if he wear them out.

[max patch]

I have a friend who could only hike with pain. Needed both knees done. Had the first one done and was one of the 1 in a 100 with side effects. He is in worse shape now that before the replacement and his hiking days are over. He is not getting the other knee done. After seeing what he is going thru I wouldn't get the TKR either.

[atmilkman]

I have a friend who could only hike with pain. Needed both knees done. Had the first one done and was one of the 1 in a 100 with side effects. He is in worse shape now that before the replacement and his hiking days are over. He is not getting the other knee done. After seeing what he is going thru I wouldn't get the TKR either.

I am seriously considering this procedure in Oct. after years of the same thing the OP has gone through in his last paragraph. I've heard more good than bad but it is this 1 in 100 that you speak of that has me prolonging it. I hope many others get on here and share their experiences. I'm seeking out the best in their field and will get many second, third, and more if necessary opinions before I pull the trigger. My biggest fear is not being able to hike again. I can hike now anywhere from 50 to 100 miles depending on terrain, but I do pay the price with weeks of recovery. I do long so for the ability to keep going and going. One side of me says go for it, take the risk, 1 in 100 ain't bad odds. The other side says it's not worth it.

[Sugarfoot]

Thanks, guys, for the good feedback. There was a poster in the Asheville Airport when I flew back from the Trail, advertising the orthopedic services of the University of North Carolina healthcare system. On the left was a photo of a hiker. The tagline on the right read, "Joints are replaceable; hiking is not." That pretty much sums up where my head is. For "activities of daily living," I don't need new knees. But to do what I love, I do. It's a quality of life issue for me. My doctor understands, but in line with Max Patch's friend's experience, he can make no promises. The joint he prefers has no detectable nickel content, which at least minimizes the potential for allergic reactions.

[4Bears]

I had a TKR 3 years ago in July, I have 95+% of the flexibility of my natural knee. I will say it took about a year to get that far, lots of therapy on my own. I hike and bicycle with out any problems. You must be persistent about getting the flexibility back, it hurt sometimes while pushing the limits, but no pain no gain, all worth it in my opinion.

[atmilkman]

I had a TKR 3 years ago in July, I have 95+% of the flexibility of my natural knee. I will say it took about a year to get that far, lots of therapy on my own. I hike and bicycle with out any problems. You must be persistent about getting the flexibility back, it hurt sometimes while pushing the limits, but no pain no gain, all worth it in my opinion.

4Bears, do you think your knees would hold up to more than 500mi. and what do you think your daily mileage limit is?

[roxylem]

Hi!! Mariposa here. I'm a 69 Y.O. woman who abandoned my thru-hike of the AT in July, after Mt. Moosilauk, when I heard it was the gentlest of the giants in the Whites. Knees were being supported with velcro supports, poles, and Vitamin I, and still hurt. However, the issue was more fear of them giving out and causing me to crunch my head on a rock. OK, I admit I was out of enthusiasm as well, with about 380 miles to Katahdin, and a flip-flop to pick up 500 miles in the middle. I'm scheduled for bilateral new knees in 6 weeks, and very excited!! Was planning to finish the AT starting this coming July (5 1/2 mos. post surgery) but after reading others' experiences, am having 2nd thoughts. I'm super-motivated to recover well, but realize that's not everything! I plan to keep reading this thread and hope to gain more knowledge through your experiences. Happy Trails!!!

[Hosh]

First find a competent, experienced surgeon. One who does lots, and lots of replacements. The techniques, technology and knowledge base is growing exponentially.

Example, I had a posterior hip replacement in 2004, recovery was brutal. I had a anterior hip replacement 10/2016, off a cane in 11 days. I went downhill skiing, greenies & groomed blues on day 53.

My golf buddy just had his left knee replaced. Surgery at 1:00pm, home watching the Bronco's Monday night game at 6:30pm, same day, drive thru. He immediately started movements, stretching, exercising. Nearly fully recovered after 2 months.

Secondly, get a competent PT person and do what they tell you over and over and over.

[orthofingers]

I have a friend who was very active, rollerblading, running and especially skiing. He was a great skier. At 67 yo, he had both knees done, stopped skiing for one season but worked on the treadmill and elliptical machine and resumed skiing the next season . . . As graceful as ever!

There is a well respected orthopedic group near me that does a ton of knees and hips. Based on the number of their patients I know, I'd say that if you can get by with a partial knee replacement (PKR) for now, do that. They use a proprietary robotic surgery system called Makoplasty that seems allow minimal pain and quick recovery for PKRs. If you need a total knee replacement (TNR), that involves a longer recovery time.

Nationally, the satisfaction statistics are high (>95%) for people that have had total knee replacements. I imagine they'd be even higher for partial knee replacements.

[Sugarfoot]

I started this thread back in 2013, when I had to abandon a thru-hike because of knees that had been giving problems for 17 years. I've since moved to Vermont and the knee problems only got worse, and "activities of daily living," like walking, stairs, and even standing still were painful. Even bicycling more than a few miles hurt. I was ready for total knee replacements and consulted with the orthopedic folks at the University of Vermont. They required a physical therapy evaluation, which no orthopedic surgeon had done before. I was skeptical. Two months later, I've been released by the physical therapists and my knees feel better than they have in years, both feeling hikeable again. Walking up and down hills (lots of them here), stairs, sitting and standing -- all are pain free now. I do their suggested exercises daily and will even when hiking. If I find that I still can't hike, then I'll return to the surgeons. On the other hand, if hiking goes well in 2017, I'll try a thru-hike again in 2018. Whoo-hoo!

[Greenlight]

Sugarfoot, would you mind posting the pages of exercises your physical therapists gave you? Might help out a lot of folks on here (like me). Also, though I'm not even close to needing knee replacements, I probably will in the future. My wife has had one done (partial) and her dad has had both done. Father in law in particular, has regained such quality of life it is unbelievable. As a bonus, every year the hardware gets better, and the doctors learn more from feedback from trial and error. They're at the point now, with some of them, that you can replace wear pads laparoscopicly, so the darn things should last a person his or her lifetime. My FIL is 72 now, and he walks around like a fifty year old.

I started this thread back in 2013, when I had to abandon a thru-hike because of knees that had been giving problems for 17 years. I've since moved to Vermont and the knee problems only got worse, and "activities of daily living," like walking, stairs, and even standing still were painful. Even bicycling more than a few miles hurt. I was ready for total knee replacements and consulted with the orthopedic folks at the University of Vermont. They required a physical therapy evaluation, which no orthopedic surgeon had done before. I was skeptical. Two months later, I've been released by the physical therapists and my knees feel better than they have in years, both feeling hikeable again. Walking up and down hills (lots of them here), stairs, sitting and standing -- all are pain free now. I do their suggested exercises daily and will even when hiking. If I find that I still can't hike, then I'll return to the surgeons. On the other hand, if hiking goes well in 2017, I'll try a thru-hike again in 2018. Whoo-hoo!

[Sugarfoot]

I could post the exercises, but I think it would be a disservice. My recommendation would be to start with an orthopedic surgeon, getting the X-rays and/or MRIs so that you are starting with a good diagnosis. Then get the referral to a physical therapist who based upon his or her evaluation will provide you with exercises and training. Form is everything! They started with simple things and progressed, also adding in a foam roller and ankle weights. They also modified the leg routine that I was doing at the gym and then allowed me to add back exercises one-at-a-time so we could determine if any were detrimental. The last one added back was leg extensions, and only with minimal weight. If you want specific info, PM me and I'll provide it!

[Gramps]

I plan to have my left one done this summer and the right one the following one the next summer. I then hope to section hike the whole AT over 3-4 summers following. My concern is kneeling as in getting in and out of my tent. I belong to a FB group on TKR and most say you can or should not try to kneel on replaced knees, either through personal experience or on their doctor's advice. PT isn't going to help me as I am already bone-on-bone.

[Sugarfoot]

Gramps, please let us know how your knee replacements go! If your main concern is the kneeling to get into and out of your tent, you might consider hammocking instead. I've persisted with the PT exercises and plan a month on the trail this spring as a test. If my knees can handle that, then I'm thinking about doing the Long Trail again in the fall. The north end of the LT is a good final exam for knees.

[BuckeyeBill]

Gramps, If you should not kneel with artificial knees, I would recommend going with a hammock set-up. When hung correctly, you can sit in it and it would be like sitting in a chair. Hopes this may help. Best of Luck.

PS My knees make it difficult to kneel as well, but they are both still my natural knees. I have found that kneeling onto a pillow helps.