Knee Replacement & Sailing

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alla_breve

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Morning all,
I've read a couple of threads on the above subject, but hope for some advice from someone with "the t shirt"!
I'm a healthy 57 year old male, but I've had two meniscus ops on my right knee in the last two years, and now have no meniscus left, and it hurts, hello osteoarthritis! I can walk slowly about half an hour a day, but with pain after. For context, I did my last sprint triathlon 4 years ago!
I now need to decide WHEN/IF to have a knee replacement, and how long before I could think about sailing/cycling/swimming afterwards. I sail a 27fter solo.
Current thought is that it pays to get it done sooner rather than later, and that post op physio is important.
Any advice from those who have been through this much appreciated,
Thanks.
 
Haven’t had one (yet) but a) have fractured my left knee umpiring hockey with associated meniscus damage, b) managed one of the largest ortho units, and c) was a diagnostic radiographe specialising in trauma and ortho.
Most would say that you should try to hold off a TKR for as long as possible as replacing one when they fail is much trickier. Of at least equal importance to post op physio is pre op. Getting stable musculature around the joint makes post op much easier. In some units that practice enhanced recovery it is possible for a patient to walk back from theatre and be discharged the next day.
 
I damaged mine about seven years ago, compressed the cartilage trying to help a woman struggling with a heavy lock gate, they tried to fix it with keyhole surgery but the cartilage as too badly crushed, I had the new metal knee in the following January and the boat was launched in April and we went sailing.
I work on the canal helping boats through the locks and have been doing that ever since. They did the op. with an epidural so I had the whole joinery workshop experience including the electric saw screeching and the cooking smoke. I was doing physio on a treadmill and exercise bike inside a week or two, but other younger patients seem to recover much more slowly. I may have been helpd by the surgeons advice to exercise pre-op to give strength for a rapid recovery.
Downsides, kneeling is a very strange sensation still, and can be awkward in confined spaces. Walking, particularly downhill on rough ground is not so pleasant but I really enjoy cycling and use an exercise bike in winter. As for the boat the main problem is ascending the mast, I can no longer grip with my knees and calves and have to rely on my arms to reduce the load when ascending in the bosuns chair. Antifouling or other activities involve a lot of stooping can leave me quite stiff but a hot soak relieves it. I was in my seventies when I had mine done, other than hill walking I have not found it a particular problem and do not regret the op. at all but admit that my recovery seemed to be faster than the average at the metal knee physio. group I attended at the local cottage hospital for 4-5 months after. I am content that the knee is stiil as good as when they hammered it in but I suspect the surgeon might not approve if he saw a typical day shoving 42 lock gates.
I recommend staying awake, you are back in the ward much sooner, they check that you can manage a short flight of stairs and sit on a bog and you are home in no time, and the Aussie anethetist was great craic with her life story as the hammering was going on.
 
I had a total knee replacement in March 2008. I was 62 at the time. I sail (and in the winter maintain) my 28' gaff rigged Broads cruiser . I also volunteer as a keel boat instructor at a charity providing water based activities for the disabled and disadvantaged.
I qualified as an RYA keelboat SI a couple of years ago.
None of this is an attempt to boast, but as encouragement to you and others to GET IT DONE . You should not find it limiting in any way, apart from being unable to kneel on that side.
Physiotherapy is very important. It's in fact impossible to overstate it. Additionally the exercises pre operatively are very important in strengthening the surrounding muscles and helping towards a full recovery.
You may hear about pain. Yes, for a few weeks afterwards it hurts ! The exercises hurt too, but help with that is available and it's only temporary after all.
Good luck, whatever you decide.
 
Also in my 70's. I got my left yin swapped in January last year. Beware of physios whose expectations are low - my first one signed me off when I managed a 90 degree bend. After post-op review I was referred to a guy who wanted me to achieve olympic performance levels. He failed but I am so much more mobile than before the op. Still have to remember which leg to lead with when transferring to and from the dinghy and need more work on balance confidence for scree running and the like. I even got invited to participate in a post-TKR study as one of the "high performing" candidates.
As a post-script I recommend cycling to all appointments - apart from being a lot more convenient than buses or car parking it puts a positive spin on what you expect them to achieve.
 
awol said:
Also in my 70's. I got my left yin swapped in January last year. Beware of physios whose expectations are low - my first one signed me off when I managed a 90 degree bend. After post-op review I was referred to a guy who wanted me to achieve olympic performance levels. He failed but I am so much more mobile than before the op. Still have to remember which leg to lead with when transferring to and from the dinghy and need more work on balance confidence for scree running and the like. I even got invited to participate in a post-TKR study as one of the "high performing" candidates.
As a post-script I recommend cycling to all appointments - apart from being a lot more convenient than buses or car parking it puts a positive spin on what you expect them to achieve.
Click to expand...

Scree running?? I'd say you're doing very well!
 
I've got the T shirt: I had both knees replaced four years ago aged 58 with "half knees" - having put it off for several year on medical friends' advice. I really wish I had had it done sooner! I walked up Machu Picchu just over a year later, without any pain. I started walking within a week of the op and I was walking to the end of my road the following week. We had a holiday in Greece 2 months after the operation which I coped fine with. I can do most things now, but I do find kneeling a bit uncomfortable. I've given up running, but I can walk, cycle and swim. Find an experienced surgeon with a good reputation!
 
My wife had a knee replacement 4 years ago.

You need to be very disciplined and determined with the physio for a few months , that seems to be the key

She had to be careful, couldn’t jump onto the pontoon, and found getting intomànd out of the tender a bit of challenge but was able to fully enjoy sailing. Having deferred the operation the year before, she was glad she had it done and regretted not getting it done tithe year before

BUT ...four months ago she suddenly had pain again and was severely restricted in beiñg able to even walk.

It now seems the pOsterior cruciate ligament (PCL) which stabilises the knee has failed . As the design of knee she has needs the PCL to function, it seems that she is going to need the replacement replaced with a different design

This is an absolute bummer and causing immense distress to her' as it means she is going to have to go through the whole thing all over again.,
 
I have more to less permanent pain in both knees although it does seem be be worse in one and then the other. I have considered replacements but have heard kneeling can be an issue and am putting it off at present. I have already had one hip replaced which was done under epidural and despite the noise and smell I would recommend this. Recovery is so much better. I was sitting up in bed having a sandwich and a cup half an hour after the opp and walking on crutches the same day.
as far as the knees go I think I will just carry on moaning about them.
 
I have had both knees replaced . The first one 2 1/2 years ago and the second 18 months past. Despite a considerable amount of physio I find that the bend in both is limited to 90 /95degrees. This makes coming down stairs awkward.
However prior to having them done my walking ability was limited to under 1/2 a mile. Now 5 miles is no problem.
After the second op I was Back helming my boat in our annual winter series within 3 months and now regularly sail my H 323 singlehanded
 
My wife had her right knee replaced on the25th March just as we went into Lock down. Very lucky to get it done then as we had many weeks when we were stuck at home obviously, but for 2 reasons, I was also going to have to take a couple of weeks (At least) off work anyway.

Op went well but because of Covid 19 physio has been via Zoom, she did request physical physio and had some last week with a different physiotherapist. I have just started to be her physiotherapist, so far we are still speaking.

She did climb onto the boat on the hard (It is by our house) today under supervision but I think sailing would be dodgy for a week or two more at least.
 
You know they say physio helps, well when I was struggling with triathlon induced knee injuries we were just discovering sailing and had purchased a Graduate dinghy. It was the best physio I ever did, the improvement was clearly noticeable after a few months.
 
My brother banged his knee up in a bike accident years ago. He had a number of ops over the years and finally had a replacement last year. It’d be fair to say it has revolutionised his life: he was unable to walk more than a few hundred metres and that in pain. He’s now walking miles everyday and is pain free. Message from him is follow the recovery guides and go for it..
 
My wife had hers done a few years ago. the result was an improvement, but short of a complete cure and there are limitations to what she can do. Lack of bend and ability to kneel can make foredeck work difficult, and she tends to need assistance when picking up a mooring unless it is straightforward. Boarding is only a slight problem as we have moderate freeboard, but some newer boats would need ladders or step. A knee should last 20 yrs, so someone in their 50s should be prepared for possible revision later. Obviously, results are mostly good but one should be realistic neverthelass.
 
I had a total knee replacement at a relatively young age (36). Four years on and the improvement in quality of life is immeasurable. There's no point in sugarcoating it; the procedure and the first few weeks of recovery will be unpleasant but as the others have said, commitment to the physio is the key to getting back on your feet.

I can now partake in so many physical activities that I couldn't before including weight training, lots of cycling, swimming, gentle jogging and of course sailing. The only downside is that I still can't bend the knee quite as far as my other and I'd be very wary of kneeling for too long (which comes with a very numb sensation).

It causes very few issues on the boat and 12 months after the surgery I completed my YM offshore, commercial endorsement and more recently obtained cruising instructor certification. The only complication there being a requirement to go for ENG1 over ML5 on the medical certificate. ML5 would have to be referred to the MCA by default, ENG1 will be signed off during your appointment (assuming your GP is satisfied that the joint replacement hasn't incapacitating you too much).
 
alexincornwall said:
I had a total knee replacement at a relatively young age (36). Four years on and the improvement in quality of life is immeasurable. There's no point in sugarcoating it; the procedure and the first few weeks of recovery will be unpleasant but as the others have said, commitment to the physio is the key to getting back on your feet.

I can now partake in so many physical activities that I couldn't before including weight training, lots of cycling, swimming, gentle jogging and of course sailing. The only downside is that I still can't bend the knee quite as far as my other and I'd be very wary of kneeling for too long (which comes with a very numb sensation).

It causes very few issues on the boat and 12 months after the surgery I completed my YM offshore, commercial endorsement and more recently obtained cruising instructor certification. The only complication there being a requirement to go for ENG1 over ML5 on the medical certificate. ML5 would have to be referred to the MCA by default, ENG1 will be signed off during your appointment (assuming your GP is satisfied that the joint replacement hasn't incapacitating you too much).
Click to expand...

The most important piece of advice of all. I have met a number of people who complain that their replacement was not as sucessfull as they had hoped, that their movement was restricted.
The common feature to every case was that they found the post op. exercise too painful. As is often said,and never truer than here,
'There is no gain without pain' Sounds harsh, but it's true I'm afraid.
 
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