Advice For The Kneedy

[Kent Berry]

Rip,

I refer you to my previous posts here and here about my knee problems. I experienced a really bad "flare up" of unknown (and irrelevant) etiology in late August and have been essentially disabled since then. I'm having it replaced tomorrow. It's so far gone there are really no other options. I'm 51.

On page 141 of the 2nd edition of SSBBT, you mention your friend Phil Anderson and I know you have at least some experience in dealing with trainees and observing people who have been through this procedure, yet I can't find any detailed info with a search.

I'm especially curious about how long these patients are waiting after the procedure before they can resume light squats and pulls and begin working back up? The surgeon uses the hybrid replacement, meaning the tibial and patellar implants are cemented, and the femoral implant is pressed on. He's a little Vietnamese guy who looks like he might weigh a buck fifty soaking wet. He's a nice enough fellow and the people I know who've used his services are satisfied with his competence, but I'd really as likely ask him about homesteading in Antarctica as strength training.

Thanks.

[Mark Rippetoe]

They'll have you up and walking on it after surgery, before they send you home. Wait a couple of weeks for the prostheses to incorporate, and then start on leg presses as pain permits. You'll be squatting in 4 weeks, as pain permits.

[Kent Berry]

Thanks Rip. That's exactly the sort of specific information I was seeking and which is almost impossible to obtain. I'm awake and in my room, so far so good.

Not training is not an option, but smart training is always required and is especially important for me now. Have you ever seen a trainee whose implants loosened? I'm particularly concerned about the cemented components. Obviously ballistic movements are not going to be a good idea for me from now on and I guess my days of dunking basketballs are behind me as well. I don't care about wearing out the insert, that's what it's for, but apparently (from what I've read on teh innerwebz) loosened implants can be a real problem due to the accompanying bone destruction. Since the cemented implants are not incorporated into the bone over time, as I understand it, strength training's ability to increase bone density might provide a better platform for the implant to rest on but I can't see how it could increase the strength of the bond. But wouldn't pulling and squatting apply mostly an axial, compressive load to the cemented tibial bond with little shear component? This would work in our favor, I should think.

I'll see the surgeon or a P.A. tomorrow and I intend to inquire about ligament damage, if any.

Thanks for your time and sorry for the rather long and "thinking aloud" nature of the post but as I said, there appears to be no one else providing this kind of information. Certainly no one else I would trust.

[Mark Rippetoe]

I'm interested in what kind of implant they used that does not incorporate into the bone.

[Kent Berry]

Yeah, I was all wet. The tibial implant has a shaft or shank like a nail which is inserted down into the tibia. The P.A. said there is undoubtedly some bone growth around the tibial implant, but that it wouldn't stay in place without the cement.

[Mark Rippetoe]

It won't stay in place without the cement AT FIRST. Don't be stupid and you'll be fine.

[Kent Berry]

I believe I can do that. Thanks Coach.