Knee replacement surgery, time back on boat.

[JPA Cate]

Hi, Dave S,

Sorry to hear of your knees in trouble.

I had bilateral total knee replacement surgeries. It would have prolonged the recovery period to do them separately. Dave on Maxing Out does have a point about the possibility of infection, though. Doing them both at once wasn't a problem, but poor muscle preparation beforehand made the initial recovery take a long time. I had 3 months of physical therapy afterwards. (Physical therapy in US = physiotherapy in Australia) Here in Oz, get your GP to refer you to a physiotherapist for exercises to do before hand to tone and strengthen the muscles without hurting you, before the surgery. I had to have mine revised by having new inserts, and that is something you want to avoid if possible. But the initial recovery was very fast 3 days in hospital, compared to a week the first time. I didn't need the walker at all, and the muscles that had been strengthened beforehand worked great. Unfortunately, I also got septicemia (bacterial blood infection) afterwards, which was a really bad deal, and i was in the hospital so long that i lost a lot of that tone, but it will make a huge difference for the better if you do it. Talk to someone who is a sports orthopedic specialist. Just get some easy exercises and do them as if the quality of the rest of your life depends on it. It does. If you are advised to lose weight first, when you do it, plan to keep the weight off, it's not meant to be just lose it for now (which was how I took it), but it is way easier on the plastic inserts if you make yourself slender.

The guy who gave you the exercise bike instructions, his method will work, too, if you apply yourself. And I also agree about the use of some kind of ice machine to help control the pain. It really does help a lot. It is important to get yourself in the best possible total health prior to the operation, sorry for harping on it, but it is really important, and so are the exercises beforehand. I wish my surgeon had told me that. Lap swimming may be okay, but check with the physio first, because your knees may be too trashed for it.

If you're bone on bone, with arthritic complications, not much is likely to help except the surgery, unless you're among the lucky ones who have some stem cells stored that you can call upon.

Good luck with it all.

Ann & Jim
Insatiable II
Lying Eden, NSW

[inspectr]

Will have my 70th birthday this year
Had right knee total replacement in December 2016, was back doiing heavy building inspections, crawling under houses and climbing ladders 4 weeks later
Did the other knee a year later - same - 2 days in hospital, one week in rehab and four weeks outpatients, back to work in 4 weeks on the boat a few days after
I have spent many hours in rehab after both knee ops and observed that the double knee cohort recovered MUCH more slowly than me
Secret is preparation, hours on exercise bike for weeks b4 op to increase mobility and strengthen the muscles, and hard work in the rehab gym starting the day after surgery
One thing you will notice that mobility, bending etc will only get back to where you were before, with some improvements due only to hard painful work. Neglect the post op physio and your result could be a disapointment
If you don't want to kill your physio at times, they are not doing their job.
Knee replacement surgery, and I have had varicose veins removed from my legs as well, involves the cutting of many superficial nerves and you will lose much of the feeling in the knees and lower legs
Kneeling becomes difficult, crawling hard, commando crawling best rather than hand and knees
Boats are tight confined spaces, two legs that wont bend past 140 degrees makes bilge ratting and some of the maintenance task a trial.
Knee braces and tiler's knee pads are essential
Bracing your knee against the bulkhead to drag a sheet or halyard is uncomfortable.
Limited knee flexing makes clambouring onto the boat a struggle
Limited knee flex and some diminished strength makes climbing ladders much harder.
On the flat I can now walk for hours
I have found that I ma far less agile around the boat as well

Like my intra occular lens implants the knee replacements changed my life for the better

[GordMay]

Greetings and welcome aboard the CF, Sandy, and casamacs.

[Bruce K]

I had a bilateral TKR about 5 years ago, after years of live aboard costal cruising, i was unable to do many things I wanted to because of pain and fear of further damage. I was home from hospital 5 days after surgery walking with little pain, and not using sticks, back on the boat within two weeks, my new knees are vastly superior to my old ones, they make a bit of noise, but no pain, I now walk my dog (Admiral Benbow) for about 5km each day. Now I need to get both shoulders replaced!!!!!!

[colinalleck]

My 80 year old skipper was back yacht racing 6 weeks after surgery however as a 64 year old I wasn’t back racing until 8 weeks after surgery

2 tips

1 do your exercises before surgery to build up muscle strength

2 after yr hospital stay go to a rehab hospital don’t go home yr recovery will be swifter

Cheers

Col

[LittleWing77]

I can add a plus for the ice-water circulation pump with cuff. What a difference!

I had stem cell PRP on both knees last year to rebuild my cartilage (using your own stem cells! Find out about it!) And during the post-treatment PT, they used the ice-water cooling post-PT for 15 minutes each appointment and it was incredible. I only wish I had one at home!

Good luck, Dave!
Warmly,
LittleWing

[lordgeoff]

[QUOTE=Dave_S;2882506]Plan is to take off this time next year for 6 months +.

My knees weren't great but workable. I tore the cartilage in my knee recently and have one old snapped ACL and mid range arthritis in both knees and knee caps. They used to get a bit sore but workable. Since the tear they (for some reason both) have been getting worse and now if I step around obstacles occasionally my knee just gives way.

My thinking is to get both knee replacements done in one go.

For those old farts (meant in the nicest possible way :-) ) with experience how long until you can manage a sail boat full time after replacement surgery. I like to think I'm pretty hardy, so what is an optomistic time frame ?
I had one Total Knee Replacement 6 weeks ago. Will be back on the boat in early June. Probably would be ok now to go back on the boat. Do the physio exercises religiously.

[sail sfbay]

Very timely topic as I am scheduled to have knee replacement on May 28th at 68 years old. The orthopedic surgeon put it in perspective this way: "well you had many good years of water skiing, backpacking, mountain climbing, triathlons and skiing and now its time to replace that knee for another 20+ years to restore your active lifestyle and get back on your sailboat.

Lots of great advise in this forum!! While I am going to miss sailing my new to me sailboat until I recuperate but I figure the sooner I restore full knee range and leg strength and standing without pain the sooner I can get back to sailing and other activities.

[rsn48]

My suggestion is to listen to all who describe their rehab then throw all that info out. We all are an experiment of one, so your experience will vary. I had one hip done and I went through an abnormal two year recovey. Had the second hip done and rehab was going great until I developed a thrombosis. Thrombosis from knee and hip surgery is among the highest of all surgeries.

The body in some ways is like systems in a boat, it's all about redundancies. Have both knees done at the same time is leaving yourself open to no redundancy if you have a problem with one of your knees.

The doctors who do both surgeries at once aren't working in your interest, they are just looking to increase the down payment on their next luxury car. A good doctor will refuse to do both at once unless you have some condition that warrants over riding that advice.

[JPA Cate]

Sorry, I failed to state how long to get back to sailing....

The second time, after the revision, the surgery was 28 Sept., and I was back on the boat in the middle of December...about 5-1/2 yrs. ago, and i am 79 yrs. old.

Ann

[Prairie Chicken]

It seems lots of us have experience in this area. I'll add ours. My husband had TKR mid Feb of last year. He has multiple medical issues & isn't physically fit. The first 6 weeks were very painful, lots of swelling, and hard, painful physical therapy that left him with back strain & spasms. The doc, a very good one, was satisfied with the surgery & progress, & suggested less aggressive PT. His instructions were to work at home doing the exercises, but don't screw up the brand-new knee I just gave you! That helped. Mid May, 3 months post surgery, after receiving the surgeon's blessing, we flew to the boat. My husband swears 'sailing boat therapy' was absolutely the best thing for the knee! You are always stepping up or down, and the little muscles in the leg are always working to keep your balance against the sea. It did him a world of good! Good luck.

[bstreep]

I'll jump in here, because my wife is getting hers done shortly. Best friend had both of his done.


1) Do them one at a time.



2) Find a surgeon who does "minimally invasive" surgery. They are expensive, and often don't take Medicare and/or some insurance. HOWEVER, the recovery is a fraction of the time of regular replacements. My friend walked out of the hospital on each of his new knees the day of the surgery. He said each of his new knees was better than his old ones within 2 weeks. He was back on his boat within a month. Yes, it makes that much of a difference. He had his done 3 months apart.


Just to point out: He's not a physical specimen. I mean, ex football player but a pretty big guy.

[DockDoc]

1. Go to an orthopedist who does a lot of, or even better ONLY, joint replacements. If in your area you have an orthopedist who does just knees, see that person. You want a surgeon who does what you need, over and over and over. Don't see just a 'general orthopedist'. As a doctor I know we are good at lots of things, but we are great at that which we do repetitively and often. Get someone who is great at knees.

2. Maximize your health now. If you're overweight, smoke, have poorly controlled hypertension, be honest with yourself. Try as best as you can to get in shape and lose that weight, stop smoking, get that hypertension under control. Try to get into a physical rehabilitation gym/program, they have bikes that can be pedaled with your arms not legs allowing you to exercise and not overuse your knee joints. They even have treadmills submerged in pools to take the stress off your joints. Many times your orthopedists can prescribe this and Medicare or insurance will pay for it.

3. I have drained a lot of joints, cysts, and abscesses, I have never drained a bakers cyst. I see many on ultrasound whilst looking for DVTs. I am not saying it can't be done, but we usually recommend compression.

4. The success of a double joint replacement vs a single is usually preoperative health of the patient, skill of the surgeon, support for the patient after surgery, and good PT after surgery. If one of those areas is lacking, even by a small amount, go for the single replacement first.

When you get back on the boat is hard to predict. If everything went perfectly 6-8 weeks, if something doesn't it could take much longer. What you do before surgery is going to be just as important as the surgery in your recovery phase.

[Nornor]

I had a knee replaced a few years ago and can give you some GOOD advice:

First, before and after the surgery TAKE a laxative. The pain medicine can cause a blocked bowel called a ileus. I wound up in the hospital for almost a week.

Second, get in the best shape possible by doing some exercises before the surgery

Third, do the rehab as prescribed. If you don't follow instructions, the success is not coming.

Over all, I am thrilled:smile with my success.

[Amicus]

Originally Posted by maxingout

My wife had 2 knee replacements done three months apart. She did great and we are out cruising.

I blew out a hip socket and ten weeks later started cruising.

My father in law had bilateral total knees and the day after surgery had a big stroke.

I am a physician, and here is what I have observed.

You range of motion, level of activity, and muscle strength before surgery will significantly determine the speed of recovery. My wife did vigorous jazzersize five days a week for years before surgery, so her recovery was extremely rapid.
She was back to normal after 3 months.

If you have limited range of motion now with poor muscle strength and minimal physical activity, you will have a more difficult and prolonged recovery. I recommend that people in this condition get physical therapy before surgery to increase muscle strength and range of motion so that after surgery they are not starting their recovery in a hole.

The problem with getting 2 knees done, is blood loss may require a transfusion of blood. You could donate blood to yourself for storage a month before surgery and have an autotransfusion of your own blood if you need it at surgery.

If you are hypertensive or have heart problems, doing bilateral surgery is more risky.

As an eye surgeon, I never operated on 2 eyes at the same time for cataract surgery because if their is a problem with infection post op, you don’t want to have 2 eyes in trouble at the same time.

As far as I am concerned, the same principle applies to knee surgery. Sometimes there are contaminated fluids or break in sterile technique during surgery, and you would be in major trouble if you had 2 infected knees at the same time.

The above is the key response especially the pre-op exercising. I wore a brace for 16 years and was bone on bone for 2 before a total replacement. Most people haven't exercised or even walked for months before the surgery so they are trying to get both muscle tone and flexibility back which is really difficult. I had been doing specific leg muscle exercises 3x a week and Aquafit on the other 2 for several years before my surgery and post-op at "Knee School" I was doing flights of stairs while others were still struggling to do 2-3 steps. Do the post op physio and exercises religiously. If they hurt push much harder. If you feel like screaming get help pushing so you scream a full octave higher. The difference between really pushing and just doing the exercises is like night and day in speed of recovery and long term benefit. My Orthopod was a sailor who raced in the same class and said NO foredeck because if you fall the replacement won't break but you will feel pain like you never imagined and those around you will hear screams like they never imagined as the bones around the appliance shatter.