Knee Replacement :(

[Basscat]

Well, I guess I knew it, but my first appointment with an orthopedic surgeon resulted in a diagnosis of "your knees suck". So did he, but the second opinion from a much more professional Doc still means I will have my first knee replacement in a couple months, and the other as soon as I can. He says I can still dive, which is encouraging, just wondering about what I should expect. Anyone out there with new knees that can share experience with rehab, time until diving again, etc? Thanks!

 

[Eric Sedletzky]

On man dude, sorry to hear that.
I worked with a guy who hobbled around for a few (3) weeks after his knee replacement. He used a cane and was on light duty. He was the general contracter on a job I had a part in. Then I come to the job site on a monday morning and he's walking around like nothing happened.
I asked him about it and he said that he had a little pain at first but after a few weeks it just became psycological. He stood up out of bed that monday and realized it didn't hurt, so he left his cane behind and went to work.


Kind of unrelated but similar in some ways: I'm going to need a new hip and I'm kind of wondering the same thing.

 

[Peter69_56]

Ok had my knee replaced about 2 years ago.

Rule 1 is to exercise when they tell you too as you need full bend in your knee. I got physio and deep tissue massage and it made a huge difference. Physio by itself didn't help as much as I needed.

Bending to just 90 degrees is not enough at all. I can touch my butt with left heel and within 3" of my butt with right heel.

In relation to diving its not a problem for everything except not kneeling on it hard as you can break the skin. I have to remove fins as I cant kneel and cant use a fin friendly ladder with fins on. Its more difficult to get fins on and off even with the bend I have. Also you have to take some care with twisting and impacting the joint. No running, jumping or jumping down from height as it can damage the joint.

Taking off fins before getting up the ladder upsets some dive boat owners but tough that's the way it is with me. I have spring clips on my fins so easy on and off, and always take them off before getting up on the boat.

I was off work for 4 months (because I could) but 6-8 weeks is normal.

If you don't get the bend required, they have to knock you out and force it, which you don't want as it tears adhered flesh from the bone or other leg material (which is what causes the restrictions in bending) and this then bleeds and turns to a mess in your knee slowing healing. You don't want this.

If you ever get any infection or serious cut, you MUST get onto antibiotics as the bugs can get between the insert and the bone and that's BAD kama. It may mean removing the insert for a few months until the bugs are killed before a new insert. So take care of yourself for the first 2 years.

Get used to always being scanned in airports. Easy to just tell them and go through the body scanner every time.

If you want anymore info just PM me

 

[DocVikingo]

Hi Basscat,

No specific time frame for return to scuba can be given as it is very largely dependent upon the individual situation. However, given a successful surgery and rehabilitation, it is the expectation that the majority of persons undergoing KR will be able to resume diving.

As you know, rehab after KR is intensive and has much to do with eventual outcome. It is important that the knee can bend least 90 degrees that leg muscles be adequately strong and limber to allow for all daily activities.

While time to return to full physical activity depends upon factors such as age, health & fitness, personal motivation and response to rehabilitation, it typically takes about 3 months for those undergoing KR to reach maximum recovery.

Still, some activities likely will be discouraged, such as contact sports, intense running/jogging and others that place excessive strain on the joint.

The patient and his orthopedic surgeon will arrive at a decision as to when resumption of a particular activity is appropriate based on the specifics of the case.

The diver with KR will want to be cautious not to fall on or twist the knee while on deck/performing shore entries and should doff gear in the water rather than trying to climb the boat ladder/to the shore while kitted up.

You may want to contact boulderjohn (View Profile: boulderjohn - ScubaBoard - Scuba Diving Forum - Diving Social Network), one of our board moderators, for his experience with KR.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

 

[boulderjohn]

You may want to contact boulderjohn (View Profile: boulderjohn - ScubaBoard - Scuba Diving Forum - Diving Social Network), one of our board moderators, for his experience with KR.

No need for the contact--I'll jump in.

Let me start with saying that your title of the thread is wrong. It should be Knee Replacement .

I was in pain from traumatic osteoarthritis (injury induced) in my right knee for years. I could not run a step. People could recognize me at a distance from my awkward limp. I actually got serious about diving because that activity was less painful than my other pursuits--even golf. Friends who had had knee replacements told me to get one, but my family doctor was adamantly opposed. I was too young, he said. They wear out in a few years and cannot be replaced more than once, he said. Use a cane or an off-loading brace instead, he said. I finally had the guts to stand up to that advice and get a second, third, and fourth opinion from orthopedists. He relented, and I then went ahead and completed one of the best decisions of my life by having the knee replaced nearly 7 years ago.

Nearly a year after that, I was late for my second dive in Cozumel and was running across the beach to the boat. It dawned on me as I ran--I'm running across a beach! Pain free! Today I don't even give the knee a thought.

My diving is ever so much better. Before surgery, I was pretty much limited to basic flutter kicks. A proper frog kick hurt like Hell. Today I can do all of the kicks without even the slightest hint of discomfort. A while ago I was doing a deep decompression dive, and although I did need help standing up, I walked without pain to the back of the boat while carrying double steel LP 108s on my back, two AL 40s under my left arm, an AL 80 under my right arm, and assorted other gear needed for the dive.

How long will my knee last? I asked my surgeon, and he said he had no idea. He had only been doing knees for 20 years, and only a very small percentage failed during that time. Those were the older models with inferior materials. He used the kind with the removable insert, so when those failed, he just stuck in a replacement part, and there is no limit to the number of times that can be done. I imagine things have only gotten better since then.

You have gotten good advice above about being very serious about your rehabilitation after surgery. Get yourself a good range of motion as soon as you can.

 

[bwetter]

I agree with Peter
I had my knee replaced last June '13 and was back to diving in Sept '13, the additional recommendation I received from my Doctor, who also dives, was to take the 1st couple of dives shallow - nothing deeper then 60', mainly to check for "pressure", biggest concern is possible infection from water source - so be carful

But also like Doc states - 'everybody is different', I will also add - take the medication as recommended and on the time - you don't want to get behind the pain - easier to stay ahead .....
and do what the Physical therapist says - I probably overdid it a few times but it was Summer and I was anxious about getting back to activities, but you can't rush or you can cause more damage


Bill

 

[Basscat]

Thanks for the great info and encouragement, all. This is my first big "deteriorating old fart" episode, so I'm basically just kind of pissed off. My folks both have bilateral replacements and do OK with them, but they aren't as active as I'd prefer to be, so I'm just worried about getting back to the diving, hiking, and bicycling that I'd rather be doing ASAP.

 

[gert7to3]

I joined the KR Klub last December. I'm 3 1/2 months along since surgery. I was swimming with fins in a pool at 2 months, nice therapy. By the third month I started to forget about my new knee, it just works. I don't know about climbing up a ladder with full gear just yet, but could probably manage it.

PT after surgery is paramount. I did one week in a rehab center and 5 weeks of three days per week outpatient PT. My flex at the point PT discharged me was to 124 degrees. I am still working on it and there are incremental improvements. I went through three years of steady deterioration with my original knee. I could have limped on another few years, but why bother? Check your options on the type of joint. Newer joints have better, more natural mechanics than older designs. They also have joints with insert bearings which can be replaced. The old style metal on metal joints are the ones which don't last and require total replacement should they wear out.

The prospect of such surgery is daunting. Pain? Yeah they're cutting your leg in half. The first 2 weeks were the worst. By week three I was on OTC meds; by week five it was just occasional OTC. The scary stuff? My nerve block med quit early on day three. It no longer blocked the pain much, but it did block my motor neurons. PT kept telling me to flex my quad, but I couldn't. It was six days before I started to regain real muscle control so I could do my exercises. I also discovered that morphine doesn't work for me, pain wise, but did suppress my respiration. Well, I'm a diver, so I just consciously took over breathing control and declined the next dose.

The only downside is that TSA will grope you every time. So much for TSA Pre Check.

 

[boulderjohn]

The only downside is that TSA will grope you every time. So much for TSA Pre Check.

I seek out those full body scanners whenever they are available. No more groping. the last TSA groping I went through was exactly that--a full fledged, multiple occurrence grope of critical areas, and I would just as soon not go through that again.

 

[gert7to3]

The problem is that TSA Pre puts you through the magnetometer instead of the surface scanner (aka: toaster). I understand that this way is faster because you don't have to remove your belt and shoes. Unfortunately the magnetometer will pick up metal, even sufficient amounts of non ferrous metal.

The issue with the surface scanner is that it uses radiation to scan you. You are getting a dose of radiation each scan. The claim is that this is (mostly) harmless. Just how often things go past harmless is the question.

A nine inch scar over my knee says nothing to the TSA-holes.