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Other/Mixed Joint Replacements?

Other strength modalities (e.g., Clubs), mixed strength modalities (e.g., combined kettlebell and barbell), other goals (flexibility)
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SimplicityIsKing

Level 4 Valued Member
Hello everybody,

I have a question about those of you have gotten joint replacements but remained active and were active before.
  1. What caused you to need a joint replacement? Was it improper training?
  2. Do some people just need one eventually regardless of how they train?
  3. What are some tips on avoiding a joint replacement later in life?
Thank you.
 
I have nothing to add but I'm pulling up a chair for this conversation. I've been told that it's likely I will eventually need a knee replacement thanks to two knee surgeries and some arthritis.
 
I thought this thread would have attracted a bit more attention by now.

I haven't had any joint replacements yet, but the clock is ticking & I will need to some time in the future.

What caused you to need a joint replacement? Was it improper training?

For myself with my left knee, it started with a hyper extension. I flipped a motorbike at roughly 80 kmh and just forced it way past where it was designed to go. After that it was a continual cycle of rehab (on a push bike) and re injury.

One time I rode a mountain bike down an 80 metre flight of steps and someone had left a glass bottle 15 metres or so past the landing halfway down, I was accustomed to using the centre landing as a launch pad to jump down the second section of the stairway, so of course I was fortunate enough to land perfectly on that bottle with my front wheel and was promptly evicted from my ride landing for a second high speed hypertension with a twist.

I was operated on after that expecting to have a second knee reconstruction but when I woke up it hadn't been done. The quack (public health ortho - a true quack) handed me what was left of my medial meniscus in a specimen jar and told me he sucked the remains of the other meniscus out with the arthroscope, all my ligaments were torn and 3 of my hamstring tendons were severed. I was furious, the Xray report had stated further diagnosis with a C/T scan or MRI but they refused to do it and went into the operation blind.

The next one was when a car T-boned me, I turned out from behind a van to ride up a hill and & the car came flying over a hill and I went over the top. I smashed myself, my helmet, my bike and did a few thousand dollars damage to the car. There wasn't much left to damage in my knee by that stage so I just tore a bit of articular cartilage and bruised bones etc.

The other knee was smashed when a semi trailer side swiped me going around a round about on a push bike (I'm a slow learner). It was a glancing blow, but I somehow managed to wrap myself around a street sign and made mince meat out that knee and crunched my hip up fairly well, torn labrum etc.

I'm very reluctant to have any joints replaced until it's absolutely necessary though. If I did get it done I'd be getting it done as public patient so it would most likely be done by some arrogant idiot who can't tell his arse from his elbow & they'd use a second rate 30 year old design prosthetic piece of garbage. I used to volunteer at the local hospital for final year med students studying orthopedics ( I'd assumed volunteering would help get my own operation done faster but that never happened) , I basically had everything wrong that could be diagnosed, so I was the perfect example. They'd bring them in one by one to examine my knee and there was only ever one or two good enough to find most the problems, no-one ever found all the problems. Needless to say I never saw the proficient doctors in the public system again but the incompetent ones often became residents.

I read a book one time many years ago that continues to give me inspiration, I think it was yoga for dummies. The author told a story of a dog he'd owned that had a hip so worn out that the vet had told to put it down to release it from its suffering. Then he said he climbed a mountain or a large hill one time (can't remember which) and the dog was right there beside him. So he realised at that time that the dogs spirit was keeping it going, the thought hadn't crossed the dogs mind to lay down and give up. He couldn't bring himself to put down such a spirited animal and the dog lived for many years. When it eventually died it was discovered that the hip had regenerated, it wasn't actually cartilage but the joint was filled with gristle and it allowed the dog to regain almost full function and live out it's days as nature intended.
 
Haven't had one, unfortunately I know several who have. My understanding from those folks is the following;

Q1. Generally the need is either an accident or genetic. I doubt that it is improper training unless you figure a genetic predisposition and then overuse.

Q2. Yes, if they've had an accident or have the genetic makeup.

Q3. Train smart, eat right
 
I'll add some as well, though I doubt I'm an ideal respondent.

I've had a scaphoidectomy and four corner fusion in both my wrists. The right one still has three cap screws but could probably have them removed without compromise if needed. So in effect a bit of a joint replacement in that there is no longer a scaphoid bone to take any load at the base of my thumb/index finger, but the remaining bones are a single unit.

This really only effects three things:
static grip endurance
ROM is about 50% in the middle range
I cannot tolerate a bar pressing straight down into my grip - no barbell benchpress, no renegade rows etc

I suspect a bit of hereditary influence since my sister needed the same procedure, but I certainly didn't help anything with my MA striking practice.

I have a buddy who needed one hip relined, not replaced. He is and has been very active his entire life and this probably played part. He recovered rapidly but did throw a clot and nearly died initially.

I have another friend who needed shoulder surgery and might have been a candidate for replacement - lifetime very active skiing, landscaper, quasi-homesteader. He threw a clot and with complications had a bit of a bumpy recovery.

I think in many cases it is luck of the draw, hereditary influence combined with accidents or occupational injuries. Most training shouldn't cause extreme issues down the road, but some sports certainly can.

I am on the fence re how long one should wait to get a surgical replacement or intensive intervention. On the one hand is good to go as far as you can on the OEM equipment. On the other, recovery from any sort of intensive surgery is not pleasant. Having surgery very late in life is often the last step before someone looses their mobility entirely if the surgery goes poorly or if there are any additional complications like infection or problems with rehab. I have one coworker (semiretired contract worker) who's wife went in for a knee replacement. She had a spill shortly afterward, secondary injury, the site developed a deep tissue infection. She was in a wheelchair for over a year and a half and ultimately wound up with a fusion - lost the use of the knee joint anyway and is lucky to walk with a cane or stroller.

I do not regret having my wrists operated on, despite it being very invasive and a year or so to become fully functional again after each one. Having to go through that in my 60s or 70s the recovery would have left me unable to do any sort of strength training involving grip strength.

I did a ton of reading before getting mine done and would advise the same for any other candidates. Also remember many of the horror stories of people having poor outcomes are often from folk who were not in good physical shape to begin with, or had the procedure done by someone who is not the best at performing said procedure.

I would say the hospital/surgeon who performs it is major factor and worth traveling if your locality does not have a specialist. Outcomes can be very different from one surgeon to another.
 
Thank you to all for the responses! Since joint replacements haven't always been around; Did people just live their life in pain?
 
Absolute agony in some cases I'm sure. Before I had my wrist done it was painful to pour a gallon of milk, and was getting worse rapidly.

Self medication for relief.
Wow. That's insane that people had to deal with the agony and still live their lives. Especially back then when jobs were more physical labor.
 
I had two serious dislocations in 1974 during gymnastics practice which required major surgery( 0ne was from the accident, the other from the Doctors examination!). I was 17. I subsequently spent the next 40 years living a very active sporting and training life. Although the surgery left me with a knee that only bent 90 degrees it wasn't really a problem until 1993 when the arthritis really took hold and I couldn't walk without a limp.

By 2000 I was told a needed a full TKR but the implants only lasted 10-15 years and only flexed 110 degrees, I waited until the technology caught up. My new TRK bends 150 degrees and will last 30 years or 30,000 miles, my Doc says.
Nothing has changed my life for the better more than this surgery! I took my rehab very seriously and still work hard on maintaining flexibilty mobility and strength every day.

This is a lecture I gave last year on the road to my TKR and life after
 
I thought this thread would have attracted a bit more attention by now.

I haven't had any joint replacements yet, but the clock is ticking & I will need to some time in the future.

What caused you to need a joint replacement? Was it improper training?

For myself with my left knee, it started with a hyper extension. I flipped a motorbike at roughly 80 kmh and just forced it way past where it was designed to go. After that it was a continual cycle of rehab (on a push bike) and re injury.

One time I rode a mountain bike down an 80 metre flight of steps and someone had left a glass bottle 15 metres or so past the landing halfway down, I was accustomed to using the centre landing as a launch pad to jump down the second section of the stairway, so of course I was fortunate enough to land perfectly on that bottle with my front wheel and was promptly evicted from my ride landing for a second high speed hypertension with a twist.

I was operated on after that expecting to have a second knee reconstruction but when I woke up it hadn't been done. The quack (public health ortho - a true quack) handed me what was left of my medial meniscus in a specimen jar and told me he sucked the remains of the other meniscus out with the arthroscope, all my ligaments were torn and 3 of my hamstring tendons were severed. I was furious, the Xray report had stated further diagnosis with a C/T scan or MRI but they refused to do it and went into the operation blind.

The next one was when a car T-boned me, I turned out from behind a van to ride up a hill and & the car came flying over a hill and I went over the top. I smashed myself, my helmet, my bike and did a few thousand dollars damage to the car. There wasn't much left to damage in my knee by that stage so I just tore a bit of articular cartilage and bruised bones etc.

The other knee was smashed when a semi trailer side swiped me going around a round about on a push bike (I'm a slow learner). It was a glancing blow, but I somehow managed to wrap myself around a street sign and made mince meat out that knee and crunched my hip up fairly well, torn labrum etc.

I'm very reluctant to have any joints replaced until it's absolutely necessary though. If I did get it done I'd be getting it done as public patient so it would most likely be done by some arrogant idiot who can't tell his arse from his elbow & they'd use a second rate 30 year old design prosthetic piece of garbage. I used to volunteer at the local hospital for final year med students studying orthopedics ( I'd assumed volunteering would help get my own operation done faster but that never happened) , I basically had everything wrong that could be diagnosed, so I was the perfect example. They'd bring them in one by one to examine my knee and there was only ever one or two good enough to find most the problems, no-one ever found all the problems. Needless to say I never saw the proficient doctors in the public system again but the incompetent ones often became residents.

I read a book one time many years ago that continues to give me inspiration, I think it was yoga for dummies. The author told a story of a dog he'd owned that had a hip so worn out that the vet had told to put it down to release it from its suffering. Then he said he climbed a mountain or a large hill one time (can't remember which) and the dog was right there beside him. So he realised at that time that the dogs spirit was keeping it going, the thought hadn't crossed the dogs mind to lay down and give up. He couldn't bring himself to put down such a spirited animal and the dog lived for many years. When it eventually died it was discovered that the hip had regenerated, it wasn't actually cartilage but the joint was filled with gristle and it allowed the dog to regain almost full function and live out it's days as nature intended.

one thing to consider; you can wait TOO long to get the replacement. I did and my TKR tooks 3.5 hours to do instead of 90 minutes which is usual. I had lost so much bone that it was a very rough surgery. They told me to wait until I couldn't take the pain anymore so I did.
Turned out I should have gone in sooner.
the result was still good but it could have been much easier and I could have been out of pain and walking normally much sooner
Something to consider
 
Thanks for your perspective @Rif , I hadn't really considered the bone loss aspect and associated complications to the TKR surgery. Was the bone loss to the femur, tib/fib or both ?

It's amazing how similar our stories are, I first injured my knee when I was 15 after I'd been signed as a junior to an NRL club. If that panned out my life would have worked out much differently. Then I started riding a bike for rehab and found I was really good at it, I was in contention for the national Olympic team leading up to 2000, but a few car accidents put an end to that.

I've also had many dislocations. Mine are bit different to yours as mine are just from a lack of structure (all my ligaments are torn, so it just falls out of place when it's unloaded & if I'm not conscious of how my foot lands it's an automatic face plant. It even happens sometimes when I roll over in bed. Downhill is the worst for me too because the bottom half of my leg falls out at full extension if I don't stay conscious of every step. I go down steep hills backwards too.

I've also had a back injury and found the kettlebells to be one of the few things I can still do besides pullups and bar work etc. I don't post it in my training log but the first two hours of every day for me consists of mobility work and soft tissue massage similar to what you explained in your vid above. If I don't do that mobility work I can't walk at all.

It has been weighing heavily on my mind lately & I know that I really need a TKR (I'm well overdue really), but alas I have no health insurance so I would be at the mercy of a 3rd world standard public hospital system, the same group of people that have butchered me more times than I care to remember. I just don't trust them to cut a piece of me out and replace it with a cheap second best prosthesis.
 
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Thanks for your perspective @Rif , I hadn't really considered the bone loss aspect and associated complications to the TKR surgery. Was the bone loss to the femur, tib/fib or both ?

It's amazing how similar our stories are, I first injured my knee when I was 15 after I'd been signed as a junior to an NRL club. If that panned out my life would have worked out much differently. Then I started riding a bike for rehab and found I was really good at it, I was in contention for the national Olympic team leading up to 2000, but a few car accidents put an end to that.

I've also had many dislocations. Mine are bit different to yours as mine are just from a lack of structure (all my ligaments are torn, so it just falls out of place when it's unloaded & if I'm not conscious of how my foot lands it's an automatic face plant. It even happens sometimes when I roll over in bed. Downhill is the worst for me too because the bottom half of my leg falls out at full extension if I don't stay conscious of every step. I go down steep hills backwards too.

I've also had a back injury and found the kettlebells to be one of the few things I can still do besides pullups and bar work etc. I don't post it in my training log but the first two hours of every day for me consists of mobility work and soft tissue massage similar to what you explained in your vid above. If I don't do that mobility work I can't walk at all.

It has been weighing heavily on my mind lately & I know that I really need a TKR (I'm well overdue really), but alas I have no health insurance so I would be at the mercy of a 3rd world standard public hospital system, the same group of people that have butchered me more times than I care to remember. I just don't trust them to cut a piece of me out and replace it with a cheap second best prosthesis.

The bone loss was at the tibial plateau, the fibula wasn't involved. But the arthritis was massive on that same medial side. Not nice.
Sorry about no health insurance. Not sure where you live but in the US even without funds you could get enough insurance with ACA to cover the TKR.

And I was the same with mobility and SMR work. If I didn't do it I couldn't walk either. But then there came a day when it didn't work either. Try to get some insurance and get a good doc to make you bionic.
good luck

Rif

ps just realized you are in Oz. There's got to be a way to find a good surgeon there. best of luck :)
 
I have a friend that had a TRK a few years ago and struggles daily with ROM issues. It seems his body produces abnormal amounts of scar tissue, according to the doctors. He has tried every recommendation from doctors and traditional PT. I'm trying to talk him into "non-traditional" approaches to improve ROM. I watched @Rif video on YouTube and will share it with him.

Does anyone know of online resources, books, etc. that would be helpful for his situation?

Thanks.
 
I have a friend that had a TRK a few years ago and struggles daily with ROM issues. It seems his body produces abnormal amounts of scar tissue, according to the doctors. He has tried every recommendation from doctors and traditional PT. I'm trying to talk him into "non-traditional" approaches to improve ROM. I watched @Rif video on YouTube and will share it with him.

Does anyone know of online resources, books, etc. that would be helpful for his situation?

Thanks.
Look into serrapeptase supplements. I recommended them to a friend after double knee replacements as she wasn’t getting enough flexion due to scar tissue. After several weeks she was top of the class in her flexion and recovery according to her surgeon and physiotherapist. If I remember correctly, she went from less than 90 degrees to more than 130 and the next year went back to skiing at 66 with no issues.
 
Thanks for your perspective @Rif , I hadn't really considered the bone loss aspect and associated complications to the TKR surgery. Was the bone loss to the femur, tib/fib or both ?

It's amazing how similar our stories are, I first injured my knee when I was 15 after I'd been signed as a junior to an NRL club. If that panned out my life would have worked out much differently. Then I started riding a bike for rehab and found I was really good at it, I was in contention for the national Olympic team leading up to 2000, but a few car accidents put an end to that.

I've also had many dislocations. Mine are bit different to yours as mine are just from a lack of structure (all my ligaments are torn, so it just falls out of place when it's unloaded & if I'm not conscious of how my foot lands it's an automatic face plant. It even happens sometimes when I roll over in bed. Downhill is the worst for me too because the bottom half of my leg falls out at full extension if I don't stay conscious of every step. I go down steep hills backwards too.

I've also had a back injury and found the kettlebells to be one of the few things I can still do besides pullups and bar work etc. I don't post it in my training log but the first two hours of every day for me consists of mobility work and soft tissue massage similar to what you explained in your vid above. If I don't do that mobility work I can't walk at all.

It has been weighing heavily on my mind lately & I know that I really need a TKR (I'm well overdue really), but alas I have no health insurance so I would be at the mercy of a 3rd world standard public hospital system, the same group of people that have butchered me more times than I care to remember. I just don't trust them to cut a piece of me out and replace it with a cheap second best prosthesis.

I believe the bone loss was on both the tib and the fib, I had a huge chunk of inflammed arthritis on the medial side that was taken off after the TKR
Sorry about the insurance situation, I'm not sure what I would do in that case. luckily my surgeon was an artist who really helped align the inplant perfectly after the GPS computer system wouldn't work because of all the missing bone.

Hard decision but if the arthritis takes over too much if might get to the point where you can't have one :(
 
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