Knee replacements - what should I be doing before and after?

[mzjo]

I am scheduled to have an artificial knee joint fitted early next year (provided my rotting teeth don't pose an infection risk!). The surgeon has already agreed to me having some physio before the operation to try and build up some of the muscle mass that I have already lost.
Intensive physio for 4-6 weeks afterwards in a centre of re-education is already in the plan (with more physio after as needed). The bikes already have shorter cranks. Is there anything else (other than keeping my weight at a reasonbable level) that I should be doing?
Has anyone out there got any experience of this? I am hoping to get back to a fairly physical job as soon as possible afterwards (need the money) - it's not just the cycling, I still have a couple of years before retirement.
the president of my club had a knee replaced in january but he still isn't back to full activity. I am hoping to do rather better if I can (but he is older than me!).

All advice taken in. Cheers Jo

[Robh]

I had a total knee replacement early in 2015. I was on an exercise bike within days, I did my first gentle ride in the second week. I didn't do my regular ride across France that year, but I did take the bike with me on holiday. In 2016 I did my regular ride across France - Channel to the Med - with no problems. Since then I have been riding normally and, just recently, I have begun to use the rowing machine again - taking it easy at first, but now I'm only just a little off the pace I had before the op.

I'm 63 now, and have been an active touring cyclist my whole life, so I had a pretty solid base level of fitness to work from. I put in a *lot* of work during my rehab, pushed myself very hard and I have managed to retain a good proportion off my flexibility in the leg. However, despite all of my best efforts, the 'good' leg still has more muscle mass (in the vastus medialis to be precise), but this could be because it gets worked more to compensate for the other, for example when standing and walking.

I've done any number of long days in the saddle since the op - though, to be honest, I don't think I've done more than about 80 or 85 miles in one day. I'm thinking I might like to do a 200k ride next year, just to see how it goes. I'm a little slower than I was - just a little, and I was never fast anyway - but that is probably due to me taking more time to enjoy my surroundings as much as anything. I haven't had to shorten my cranks, but I have adjusted my position so that I sit a little more upright, though this is not because of the knee.

The main advice I was given that I was only ever to consider running if my life depended on it, so I don't run. A lot of walking leaves the knee feeling uncomfortable, but I walk none the less - it's difficult to avoid.

Advice? Do as much as you can as soon as you can - physio, exercise bike, whatever. My understanding is that once your flexibility is gone it's gone.

Good luck!

[De Sisti]

Get your quad muscle as strong as possible. This will add stability to the knee and there will be less
muscle wastage after the operation, thus making recovery much quicker. That's what I did for my four
previous knee operations and what the Consultant Surgeon has recommended I do before my next
kneecap replacement.

[mzjo]

Get your quad muscle as strong as possible. This will add stability to the knee and there will be less
muscle wastage after the operation, thus making recovery much quicker. That's what I did for my four
previous knee operations and what the Consultant Surgeon has recommended I do before my next
kneecap replacement.

Yes this is what my physio is for; my quads have wasted away badly on the bad side and we are hoping (expecting) that physio before the op will shorten the recovery period and improve the end result.
I haven't been able to run more than 2 paces since my knee troubles reared their ugly head nearly 8 years ago.