Conditioning Makes A Huge Difference To This Skier’s Post-Op Experience.

A lifetime of abusing my body never really bothered me until it did. Coming down a blue trail five miles long at Park City, UT, one of my all time favorites because of the killer views, suddenly posed a problem.

My knees were killing me. The pain traveled into my hips and the last three miles of the slope seemed to be as long as a trip around the world. It was never going to end. My knees seemed to be grinding into each other.

What a new knee looks like when it is all over. Credit: Bob Nesoff

At the base, the skis came off, and I used them as crutches on the way to the lodge. With some help, I made it back to our accommodations and iced my knees. Walking they felt as though the bones were rubbing against each other. Fortunately, this was the last day of the trip, and before the flight home, I called and made an appointment with my orthopedist.

The day after arriving home, he x-rayed my knees and, as I feared, was told my ski season was over. The bones in the joint were actually rubbing against each other and the only realistic course of action was a replacement. The question then became one knee or both at the same time.

The skier’s mind went to work. I’m 80 years old and not getting any younger. The surgery won’t be any easier when I’m 81 and why do one at a time and then have to come back and rehab all over again.

With a recommendation from my doctor, I made an appointment with Dr. Gregg Klein of the Hartzband Center for Hip & Knee Replacement, Paramus, NJ.  Doing due diligence, I looked them up and found out that they arguably do more knees and hips than any other medical facility in the country. That gave me some comfort.

Meeting Dr, Klein for the first time I was pleasantly surprised to learn that he too was a skier and was able to not only answer my questions, but had an understanding of my special desire with regard to skiing.

“Age is not a problem in knee replacement surgery,” Dr. Klein said. As long as the candidate is in relatively good health, there is no adverse problem.

“However,” he said with a smile on his face, “you won’t be doing moguls any more. You’ll be able to ski more comfortably, but stay away from high impact slopes.”

Physical conditioning is one of the most important factors both prior to and following the surgery. Dr. Klein prescribed six weeks of physical therapy, three times weekly, both prior to and following the operation. I added another two days of workout at my home gym. That, I was told later, made the operation and recovery go faster.

Three hours after the surgery I was up, standing and walking. No great distance, but there was far less pain that I anticipated. That, according to the nurses was due to my pre-op workout regimen.

After only two nights in the hospital, I was released and the following week a therapist visited daily for two weeks. He called my recovery “absolutely amazing,” again due to the workout I had done before surgery.

The two weeks at home were followed up by six weeks of outpatient physical therapy three times a week. Here I threatened the life of my therapist when he bent my legs into positions God never intended them to go.

Less than three weeks following surgery, I was walking without a walker. For jaunts outside of the house I used a cane but was able to walk comfortably without one at home. Another couple of weeks and things returned to normal.

There is some debate as to whether holding the prosthesis in place with special cement or using one that adheres to the bone is better for sports such as skiing. The cement holds and heals more quickly. Waiting for the bone to adhere to the replacement will take longer. The opinion appears to be that one is not better than the other.

“If you are a good skier and enjoy the sport,” Dr. Klein commented, “keep on doing it.”

There are a couple of long scars on my knees but they’ll fade with time. I won’t be doing moguls or extreme blacks, but I don’t care. I’m working out on a regular basis and by the time of the first decent snowfall in the fall of 2019, I’ll be waxing my boards and heading for the hills. As a prelude to the ski season, I’m also planning on making a parachute jump this summer. Hey, George H.W. Bush ain’t the only one who can do that kind of stuff.

23 Comments

  1. Yvette Cardozo Yvette Cardozo says:

    DId this happen suddenly or were you aware, for some time, that your knees were on borrowed time.

    • Avatar Bob Nesoff says:

      It doesn’t really come on suddenly but rather from a lifetime of abuse. My right knee was injured twice and once underwent arthroscopic surgery. It was just time to s uck it up and have it done so that I didn’t blow another ski season.

  2. Avatar David Burka says:

    I had a knee replacement for the same reason as you. Lucky for me, my preop and postop was also identical to yours and my results the same. My PT therapist called me her poster child and my gym trainer that I used preop and after PT showed me off to other clients of his. The take away, being in good physical shape before hand is the most important part of the process. My knee was operated on in May, 2012, and I have been skiing a couple of times every year thereafter. I am currently 77 and just got back from Snowmass. 🙂

    • Avatar Bob Nesoff says:

      Conditioning is absolutely the best. I’m walking well just a month after and looking forward to doing crazy things this summer-sky diving, zip line, etc.

  3. Hi there, Mr. Nesoff, I enjoyed reading your knee replacement story. I know people much younger with KRs who would love to be in your shoes.

    I’d love more info on the Prehab portion of your physical conditioning. It couldn’t have been easy given the way your knees were. Was it the same work as the post-op therapy? Was the Prehab focus on cardio, strength, or flexibility? Perhaps that is the secret. In any case, 5 weeks out of surgery, and you felt like things returned to normal–that’s awesome.

    Happy skiing!

  4. Avatar Inga Schalburg says:

    Thank you, your article has encouraged me to have my knees replaced sooner rather than later. I hope surgery is as successful here.
    I live in the U.K. and ski for a month or two in Canada during the winter. Due to having done too many impact sports along with serious amounts of skiing and now being 71, my knees are only holding on with the help of injections pre skiing and pills.
    Your article is inspiring, but one is given little therapy in the U.K. compared with your experience. It would be really helpful to have more information on what it involved, so please be kind enough to enlighten us !
    It’s always good to see how many of us want to stay on the slopes even with worn out knees, so getting the best surgery and pre and post op therapy advice is paramount.

  5. Avatar Todd Clark says:

    I have been skiing on my replacement knees 13 and 9 years. I average between 20-25 days a year. I skied 8 weeks after my first replacement using a system called CADS developed by Walter Dandy. I was able to demo them in Vail and have been skiing with them ever since. It is a strange looking apparatus but it works on taking pressure off your knees and quads. His website cads.com has a wealth of information. I am 72 years old and hope to keep skiing into my 80’s. There is another system called ski mojo out of Europe which seems to hold some hope in helping take pressure off the knee but it has not made it to the US that I know of. I still try to avoid the moguls as much as possible.

  6. Great to read about your experience and I salute your hard work before and after surgery as well as your brave decision to replace both knees at once. I replaced my left knee, the worst one, in June 2018, age 69. I, too, was diligent with my exercise program pre-surgery figuring it couldn’t hurt to be as ready as possible. My worst knee pain was always from alpine skiing, not from walking or hiking. That was my therapy before surgery, daily walks and hikes of 3-5 miles once I had committed to the surgery in early April. After surgery, I put the walker away after a couple of days, enjoyed home PT, used my hiking stick(s) everywhere, started driving to PT in 2 weeks, got back to hiking in 1 month, got a Synvisc 1 for my right knee in late Oct. I skied again by Dec 1 and the next few months with no pain in either knee, no more bones clicking and rubbing together, no more braces! I just enjoyed a week of March skiing in Colorado in lots of fresh, soft snow, mostly blues, but a few blacks with soft turns (no hard bumps), great way to celebrate turning 70. And for the first time in many years, I skied 5 days in a row with only minimal right knee pain. Maybe someday, I’ll need TKR on the right one, but for now very happy to keep on skiing. There are also great knee surgeons in CT with Hartford Orthopedic Group who practice at both St Francis and Hartford Hospitals.

  7. Avatar Scott Jimmerson says:

    Great article, Bob, and sage advice on getting fit before surgery. It helps with golf, also. I tore my knee up in 1969 out-of-bounds at Vail using Marker long thongs. Cartilage was removed and ligament repaired. 6 years ago I couldn’t walk for golf, let alone ski. Over the decades I had followed different knee replacement advancements knowing my day was coming. At the time my doc did 300+ per year and did 7, in 2 operating rooms, when I had mine. Computer navigation and tools he designed. Overnight in hospital. In 8 weeks I was climbing in the Cascades again. I have a 5″ scar and no swelling today. Skiing groomers and powder as I did 40 years ago. No bumps, but that is just fine. There are lots of great docs, not all use the newest methods. Depending on one’s health, knee replacement is now day surgery……amazing. My scar is so small because of these new techniques. Ask a LOT of questions about how the replacement is done. How is the patella treated. How are the bone cuts decided. Get 2nd and 3rd opinions. Stay fit and best of luck.

  8. Avatar George Covington says:

    I had a replacement two years ago, at age 74. A friend of mine, a skier and former captain of the South African national rugby team, gave me the advice of doing PT before the surgery. I did for two months and made a remarkably fast recovery. I was told that the best predictor of range of motion after surgery is the range of motion before it. I now tell all my friends the same thing: get going on PT as soon as possible; don’t wait until after surgery.

  9. Avatar Charles Shaffer says:

    I’m 80 and my experience was similar. I fell down the steps from the second floor in my house last year carrying a desk chair to the first floor. Tore the ACl and couldn’t ski on that knee. Dr Israleite at Univ. of Pa. Med Center, a skier, did the operation and I am sking fine this year.

  10. Avatar Bruce Lund says:

    I had knee replacement surgery 3 years ago. When it became apparent that I had to have it done, I interviewed several surgeons and asked them “Will you allow me to ski after the surgery/”?One said “NO” and I immediately rejected him. I also have had hip replacement surgery 5yrs. ago and asked the same question. I am now back to skiing, the main problem being an apparent arthritic knee caused by a PT who did not straighten out my leg after ACL replacement ( same knee) 20 years ago. I am 86 yrs. old and skiing blues Anyone have a solution to my bent knee???

    • Would a prosthetic knee brace help? Ask your orthopedic Dr. I used to wear prescription hinged, metal Townsend braces for skiing fitted through Hanger Prosthetics. They were great for proper alignment and cushioning the knee joint.

  11. Avatar John T Cunningham II says:

    I am skiing without Knee or Hip pain, again. Replaced Right Hip 9.11.07, skied 2008 season until other joints failed during the 2017 season. Replaced Left Knee 9.12.17 & Left Hip 3.5.18 by Dr. Paul Lombardi at Tri County Orthopedics in Cedar Knolls, NJ. Have skied 2019 season without pain and heading, with my wife, to ski Whiteface NY.
    PS I am 701/2

  12. I had 2 total knee replacements, left on 8/23/18 and right on 11/28/18. I have skied 12 days since mid February and I am delighted. No knee pain, muscles still regaining full strength but close. Have done deep untracked powder on blue, and maybe easy black slopes, I’m not sure. All my old skills are still there. I’m 77. Last season the pain was getting to be too much for skiing and in summer I tried to go fly fishing and couldn’t walk down the bank to the river. It was time. Did my own prehab, mostly walking around the hills of San Francisco where I live, and riding a stationary bike with no resistance. I’d lower the seat a notch after a few minutes, then repeat, until it got uncomfortable. I didn’t dare do anything really strenuous for fear of getting an arthritic inflammation cycle started just before surgery. I have continued with the bike post surgery.

  13. May and June of 1973, at the age of 67, Kevin Fricka MD of the Anderson Clinic in Northern Virginia performed bilateral partial knee replacements on both my knees. In February of that year I returned to Jackson Hole, where I spend 5 weeks every winter and skied all their blue and double blue runs.
    The following season, 1974/1975 and each year thereafter I pretty much ski everything except Corbets and did not hike headwall. Jacksons blacks with soft moguls, of course powder and groomers also are still lots of fun. At 73 I just returned from Jackson, after spending 5 weeks there and all is good.

    My only change for next year is I bought the Ikon Pass instead of a Jackson Senior Pass. The lift-lines, owing to the Ikon pass, were ridiculous – so if I have to wait in lift-lines I’ll spend 600 bucks less, ski more mountains and still ski Jackson for 7 days. Looking forward to big sky.

  14. One last piece of information, I ski Nordica Enforcer 100, 177 length, and Diabello Krypton K Boots 28.5, with 120 stiffness tongues.

  15. Avatar David collins says:

    I had ACL replacement 12 years ago. I went for the Cadaver. Skied for 6 years with no problems and one day had my left knee lock up on me. It was late summer and I told my orthopedist that I need to ski that winter and he operated and cleaned it up, after the surgery he told me I needed a replacement.
    He made me a brace and gave me a couple of sinvisc shots and I skied all winter. The day after the season was over, I had the replacement. Skied the following November and skied better than ever. This last fall I had my right knee lock up. Same operation and was skiing In November. Probably replace it In April. I am 73 and ski with ex Olympic skiers. Get the replacement sooner than later. You won’t regret it.

  16. I had my left knee total replacement last April and was happy to be skiing this year with no pain for the first time in many years. At 57 it may need to be redone at some point but for now it was entirely worthwhile. The more I walk, ride a stationary bike, or exercise the better it feels.

  17. Would it be OK to re-publish this article in my ski club’s newsletter? In the past several issues, we have had a series of articles about various knee treatments submitted by our own club members. Most of these accounts were about various types of injections into the knee. It would be great to round off the series with an account of total knee replacement.

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