Cycling after knee replacement.

Bikerbob

Pedelecer
May 10, 2007
215
0
Isle of Man
Apologies to the more squeamish among you. I've had a conversation with my doctor about knee replacement. He maintained that a new knee would not bend at an angle greater than 90 degrees and that cycling would not be possible, even with my pedelec bike. Has anyone got experience of cycling with a replacement knee?
 

eddieo

Banned
Jul 7, 2008
5,070
6
I always thought surgery either hip or knee meant no cycling unfortunately.....
 

Fecn

Esteemed Pedelecer
Sep 28, 2008
491
2
Warlingham, Surrey
My dad had a new knee in around 3 years ago. He's bought an e-bike about a year after the surgery to build up strength in his leg again, and is now an avid e-biker tackling 40 mile rides without too much trouble. He's far fitter and more active now than he was before the surgery - The new knee has definitely benefited him a lot.
 

flecc

Member
Oct 25, 2006
46,478
23,295
If the replacement knee doesn't bend more than 90 degrees, cycling on most standard bikes won't be possible since with normal crank lengths the knees have to bend beyond that.

However, some keen cyclists use very short cranks with lower gearing and pedalling at a faster rate. Well known advocates of this are Rob Walker of West Country Recumbents and bicycle designer Mike Burrows, and cranks of 100 mm in place of the usual 175 mm are sometimes used.

Since such short cranks cover a small arc and move the foot to front and back much less, with the right seat height it may be possible to conform to less than 90 degrees, depending on your leg length.

It may be that pedalling at a fast rate isn't advisable with replacement knees, but that might not be so necessary on a electric assist bike with the motor doing much of the work.

Of course this is not a medical answer, merely a geometric one.
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Phil [OnBike]

Pedelecer
May 21, 2009
54
0
OnBike Electric Bikes

Hi Bob,

Phil from OnBike here - We get many customers with leg complaints come and try out electric bikes.
They often opt for something smaller and also in a step-through frame.

I'm not sure what kind of bike you after, but we have a large range - see here: OnBike Electric Bikes UK - The Electric Bicycle Specialist

Popular ones for leg problems are the eZee Sprint and the eZee Chopper. Both are similar bikes, just different frame sizes. Both are easy to ride and are great up hills, plus throttle controlled!
There maybe other bikes in our range that may appeal if that's not the style you were after.

We have over 15 demonstration models available in outr showrooms if you are interested in trying out technologies from E-motion, eZee, Wisper etc etc

Hope this helps - Any questions, just let me know!
 

eddieo

Banned
Jul 7, 2008
5,070
6
I almost forgot. I had a fall 2004 and seriously damaged my knee. I severed all the ligaments? tendons? and the leg was just flapping about:eek: they opened me up and drilled and sewed everything back together and i was in plaster for 3 months:rolleyes: I have a 18 inch scar to prove it lol. I nearly died as I got DVT from the operation to my lung, I am a lucky to be alive.

walking gets painful sometimes especially in the winter and stairs are particularly troublesome...But the bike really helps, it seems to improve the knee. I still have my own knee though.....
 

Bikerbob

Pedelecer
May 10, 2007
215
0
Isle of Man
Thanks for the replies. Interesting that Fecn's Dad is managing well despite the doctor's 90 degree issue. I understand that these replacement knees have a limited life and the younger and more active you are the less time they last. Apparently a second attempt on the same leg can be very problematical. The advice seems to be to leave it as long as possible and then, when you get one, to look after it.

The question might be whether the exercise of cycling is beneficial after such an operation - as it seems to be at present with just an arthritic knee - or whether you risk doing damage to the artificial knee, possibly by forcing it beyond the angle for which it is designed. It isn't immininent - there is a long waiting list anyway - but its obviously something I'll look into further.
 

eddieo

Banned
Jul 7, 2008
5,070
6
They said I would need a hip transplant when I was 40 (after a car accident) and yes it does sound like I'm accident prone! lol But I am mid 50's now and still managing......like you say you have to use it or loose it, and put off the Operation as long as possible.
 

Bikerbob

Pedelecer
May 10, 2007
215
0
Isle of Man
They said I would need a hip transplant when I was 40 (after a car accident) and yes it does sound like I'm accident prone! lol But I am mid 50's now and still managing......like you say you have to use it or loose it, and put off the Operation as long as possible.
I agree, and I had decided that it would be a last resort. However, having got to the stage that I can't even find a position to lie in bed without my knee giving severe pain I thought the time might have come, but not to be able to cycle would be a sad loss. Whoever designed knees didn't make much of a job of it!
 

Barnowl

Esteemed Pedelecer
Sep 18, 2008
954
1
I agree, and I had decided that it would be a last resort. However, having got to the stage that I can't even find a position to lie in bed without my knee giving severe pain I thought the time might have come, but not to be able to cycle would be a sad loss. Whoever designed knees didn't make much of a job of it!
Sorry to hear that Bob and I totally agree about the shortcomings of knee design. I'm mid fifties with very bad knees. There are other joints that are wingeing quite a lot as well. In my case I'm reasonably confident that my problems are not caused by sports injuries or cycling and I'm managing it as best I can. Being kept awake at night with painful joints is the pits and very detrimental to general health. Good luck whatever you do.
 

Nick

Pedelecer
Nov 4, 2006
152
0
BikerBob

I would try to research this more thoroughly with your surgeon and also the prosthetic manufacturer if you can find out who it is.

As you say, cycling may not be a good idea, but it is possible to get more than 90 degrees knee bend after a knee replacement for some people, but it takes a lot of effort from Day 1. 90 degrees is generally regarded as 'functional' but, as Flecc says, it is not enough to pedal a standard bike. It is also insufficient in a variety of other circumstances.

Highpath Engineering manufacture a alternative, very similar to what a friend made for me - though I reckon mine is better. Unfortunately, my site is down at the moment so I cannot show you various pictures but I've uploaded one to Flickr



I've had knee flexion of about 90 degrees since 1995 when I crashed my motorbike, and am now a student physiotherapist so have seen a few replacement knees - but your surgeon should be your first port of call for things medical.

Shout if you want any more info.

Added - I ride a Bionx, which I reviewed here.
 
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flecc

Member
Oct 25, 2006
46,478
23,295
My brother who has long been a keen sport cyclist has a very badly damaged and arthritic right knee which is at the point of the replacement option. He's decided to stay with his natural knee for as long as possible and keep it freed up with gentle cycling and other exercise. He is on prescribed diclofenac anti-inflammatory tablets to keep the pain under control.
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torrent99

Esteemed Pedelecer
Nov 14, 2008
395
36
Highgate, London
However, some keen cyclists use very short cranks with lower gearing and pedalling at a faster rate..
Indeed they do :D

I have fitted 100mm cranks to my Wisper 905. Rather than the very nice but pricey Highpath crank adaptors, I used a childs crankset available from SJS for a mere £20.

Hasn't really helped my knee that much unfortunately, but it's a cheap way to try it.
 

flash

Pedelecer
Apr 1, 2009
148
47
65
CW12
My father has two old cycling friends who have had knee replacements.
One is cycling fine the other as you say has limited movement of his knee and cannot cycle at the moment. Both are in their eighties!

I don't know where you are in the country but George Longstaff cycles specialise in custom made cranks etc,

Longstaff Cycles
 

tillson

Esteemed Pedelecer
May 29, 2008
5,145
3,003
My wife had a total knee replacement 2 years ago aged 41. She damaged it 10 years prior playing netball and had lived in constant pain.

Since having the operation, she has, with a huge amount of work, gained 110 degrees movement and says that it feels as good as new. She can cycle and walk good distances now. She wishes that she'd had it replaced in her thirties as she now feels that she lost 10 years.

We know that they don't last forever, but following much research and consultation with many surgeons, the most likely failing of the prosthetic joint is loosening and not the actual wear of the surfaces. Impact must be avoided for these reasons, but cycling is OK. In fact it has helped her gain the 110 degrees of movement. She has regular reviews and at the moment the surgeon is saying that 15 years plus is a likely life expectancy for the present joint if she continues to look after it. These things are developing all the time so we hope that in another 13 years, there will be something even better.

Experience seems to suggest that choosing the right hospital / surgeon is important. After a lot of money had been spent on consultants, they nearly agreed that The Royal National Orthopaedic Hospital at Stanmore is the place to go. It's a bit of a shabby Army Camp type of place, but the results are what counts and they have been first class. Interestingly, when my wife was there, most of the patients on her ward were having remedial surgery on for botched operations carried out elsewhere! One lady had spent twenty thousand pounds on a private knee replacement and it had been fitted upside down!
 

Bikerbob

Pedelecer
May 10, 2007
215
0
Isle of Man
Thanks again for all the posts. It seems that the degree of movement is down to what the individual patient is able to achieve rather than limitations of the actual artificial joints. Presumably my doctor meant that most people don't achieve more than 90 degrees. Certainly you would discuss this with the consultant, but these reports from people with direct experience are very enlightening. If the operation does become necessary then the message is to work hard, do the exercises, get as much movement as possible, and if necessary look at the bike modifications people have suggested.