Planning on a total knee replacement this summer....

Glenn D

Glenn D

Pre-takeoff checklist
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Glenn D
... and looking for the impacts for a 3rd class medical. I will be up for a medical renewal in the fall, and was interested in how this surgery would impact the renewal, and what might be expected as an impact to flying. The No-Flying during recovery is apparent, but how soon can one go back to the air??... PP, Day, VFR only.... really not looking forward to loss of flying time this summer but need to get this thing fixed.

And from those that have completed this, what was the impacts, what questions need answers to better understand the limitations... I do not know what I do not know, so need to know from those that have gone down this path.... Thanks, ....
 
Any way you can buy a case of Aleve and put it off until late fall? ;)
Otherwise, there should be no health implications. My DPE had a metal hip joint.
 
Wife is now 4 months out. (Dec 5th) Still some pain, but 75% functional.
Not to scare you off, but this was not an easy one.
(And, to give you perspective on that comment - she has gone through 2 total hips so she is not a newbie to this.)
Just be prepared. There are patient differences, some are not painful.
But if you have pain, use the pain meds. Otherwise, you will not move around or do the PT and that will set you back. Need to move around, use the leg, keep the ligaments/tendons/muscles in motion otherwise they will get a set, fixate.
The pain meds. Assuming its hydrocodone, which is often the only thing that will do the job. STAY ON MIRALAX before during and after, or you will have worse GI pain than the leg ever caused! She experienced this.
Also, a friend just had back surgery and did not take a stool softener during the hydrocodone use, and ended up back in the hospital for a blockage.
I would not plan on flying til the 4th month post-op.
 
It takes work to recover, but both my parents said it was one of the best things they did health wise.
 
Let'sgoflying! said:
Wife is now 4 months out. (Dec 5th) Still some pain, but 75% functional.
Not to scare you off, but this was not an easy one.
(And, to give you perspective on that comment - she has gone through 2 total hips so she is not a newbie to this.)
Just be prepared. There are patient differences, some are not painful.
But if you have pain, use the pain meds. Otherwise, you will not move around or do the PT and that will set you back. Need to move around, use the leg, keep the ligaments/tendons/muscles in motion otherwise they will get a set, fixate.
The pain meds. Assuming its hydrocodone, which is often the only thing that will do the job. STAY ON MIRALAX before during and after, or you will have worse GI pain than the leg ever caused! She experienced this.
Also, a friend just had back surgery and did not take a stool softener during the hydrocodone use, and ended up back in the hospital for a blockage.
I would not plan on flying til the 4th month post-op.
Click to expand...

Exactly what he said. My wife is 2 months on her 2nd knee replacement. You have to take the pain meds so you can withstand the rehab pain. You have to deal with very significant pain to achieve full mobility. Probably one of the few surgeries where you are asked to take pain meds so you can hurt yourself more!
 
I did my right knee mid-May last year. Went off controlled substances within a week. Whenever anyone asked what I was taking for pain, my response was "Ben & Jerry's Chocolate Fudge Brownie". The surgeon prescribed a topical analgesic/anti-inflammatory - diclofenac. It's not cheap locally, but there's a compounding pharmacy in the southeast US that makes up a tube for 1/3 what it cost in the Denver area.

I was driving in 2 weeks but...with a low wing cherokee, I put off flying until mid-August (3 months). Why? Because I could get into the cherokee, but needed a hoist and crane to get out. In the event of an emergency, not a good idea.

PT ASAP...It will be painful because the goal is to breakdown the scar tissue around the knee. There's a recognized category - orthopedic massage - that is definitely a good idea in parallel with the PT.

My only complaint with the surgery is the total lack of information concerning what I would go thru after surgery. No one told me (until the 4 month checkup) that it takes at least a year to completely heal. The surgery itself was excellent, I just don't like the surgeon or his staff for lack of info.

There should be a class that the hospital (or surgeon) that discusses how to re-arrange your home to be more convenient, recovery, etc - go take it. No one told me about it until Sunday before surgery on Monday morning. Again, another complaint against the surgeon and staff.

I didn't have a chemical anesthesia - I think it was more like a spinal block. Definitely preferred because it's much easier and faster to wake up with minimal (if any) reaction to drugs.

I don't have pain per se, it's mostly more like a muscle soreness. In fact I never had serious pain, just severe aching. Of course it didn't help that a month ago I tripped over the dog going down the stairs at 4:30 am to open the doggie door so he could go out. Fortunately, it was the bottom step. Had it been the top step, he'd probably be eating my carcass for breakfast that day. I called the surgeon's office as soon as it opened. Their response? "We can't get you in until tomorrow afternoon" while they listened to me screaming in pain. You can guess my reaction. Neighbor took me to the ER for xrays 30 min later.

What they are most worried about is the appliance fracturing the bone before it's completely merged together. Fortunately, radiologist saw no problems or indications this happened. But there was "soft tissue contusion", translation - I sprained my lower leg (calf). I called the surgeon's office so they could get copies of the xrays and let me know their opinion. 4 weeks later, haven't heard a word from them. Another strike.

Downside - I'm sleeping on the couch on the first floor (it's a sleeper sofa and quite comfy) so that I don't have to take the stairs in the middle of the night because of the dog.

Lots of ice packs. Lots and lots of them. Last summer I kept a cooler next to the bed with ice packs. When my knee started to ache, reached over and grabbed an ice pack.

Won't be comfortable to sleep on the side for quite a while. Keep a good sized pillow under the knee when sleeping on the back, and between the knees if on the side.

If you have a stationary bike at home - use it! If not, there are small, portable pedal units that work.

https://www.target.com/p/wakeman-fitness-folding-pedal-exerciser-with-electronic-display/-/A-52269725?ref=tgt_adv_XS000000&AFID=google_pla_df&fndsrc=tgtao&CPNG=PLA_Sports+Shopping&adgroup=SC_Sports&LID=700000001170770pgs&network=g&device=c&location=9028770&ds_rl=1246978&ds_rl=1248099&ds_rl=1246978&gclid=EAIaIQobChMI1qL66YWw4QIVhLXACh0Q8AsREAQYAyABEgJda_D_BwE&gclsrc=aw.ds

For the bathroom - head to the local consumer medical supply shop or amazon and get this

https://www.walmart.com/ip/Drive-Me...MIzIzu7ISw4QIVGbbACh201goYEAQYBSABEgJcT_D_BwE

Also, a gadget to make it easier to put on socks - fortunately I had my father's (he had hip replacement)

https://www.protherapysupplies.com/..._jBx338gIuEAQYASABEgK09vD_BwE&source=googleps

I was really expecting to be able to ski this year...nope. Maybe next year.

Worst part - my right knee and stop & go traffic is KILLING my ankle!

PS: I cancelled my class at the university that day. Next class period the students asked not if I was ok, but how was the dog?
 
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Murphey.... THANKS... this is helpful!....

I was told 40 years ago to plan on knee replacements.... growth issues.... well now is the time. just turned 61 so hope the healing is fast.. the past 5 orthroscopic knee surgery's went well and healed fast.. so planning on the same.

One of my co-workers had the same knee replacement work done 3 months ago and is back at work pain free... yes, everyone is different.... PT will be bad, but nothing good ever came free.... I have not gone snow sking for 30 years, not really planning on going again. Currently I MUST have a pillow between knees, or dangle my right leg off the bed... so that's about the same.

What impact on getting a 3rd class medical??... Yes I will not be flying until getting into and out of the plane is doable... what needs to be reported??... any Dr reports of other info needed??.. could ask the AME but really do not like asking too much.
 
I am on the process for bilateral replacement, meaning both in June. Will be an adventure I am sure.

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You can hold both a Class III and Basic Med at the same time. I would get a Basis Med before surgery.
 
Glenn D said:
Murphey.... THANKS... this is helpful!....

I was told 40 years ago to plan on knee replacements.... growth issues.... well now is the time. just turned 61 so hope the healing is fast.. the past 5 orthroscopic knee surgery's went well and healed fast.. so planning on the same.

One of my co-workers had the same knee replacement work done 3 months ago and is back at work pain free... yes, everyone is different.... PT will be bad, but nothing good ever came free.... I have not gone snow sking for 30 years, not really planning on going again. Currently I MUST have a pillow between knees, or dangle my right leg off the bed... so that's about the same.

What impact on getting a 3rd class medical??... Yes I will not be flying until getting into and out of the plane is doable... what needs to be reported??... any Dr reports of other info needed??.. could ask the AME but really do not like asking too much.
Click to expand...
As per Dr Bruce....no big deal. Once you are off the pain killers (I think Dr B said 30 days), the surgeon is happy and YOU are confident, 3rd class is a no brainer. It's a surgery that you report. Take a copy of a letter from the surgeon that says he/she is happy with the surgery and that there are no issues. Check with AOPA medical (or Dr B) for specific verbage.

https://www.aopa.org/go-fly/medical-resources/health-conditions/bone-and-joint/joint-replacement

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435652/
 
Wife is bustling about here; 5 & 1/2 months out.
Occasional moderate pain (on days she over-does it) and some annoying 'clunking' which the doc says is not important. (I suspect it means he cannot fix it or is too busy to address).
So now the ankle is more noticeable!
hips -> knee ->ankle. If you fixed the ankle, it would be something else! (natural result of resolving any pain)
 
Let'sgoflying! said:
Wife is bustling about here; 5 & 1/2 months out.
Occasional moderate pain (on days she over-does it) and some annoying 'clunking' which the doc says is not important. (I suspect it means he cannot fix it or is too busy to address).
So now the ankle is more noticeable!
hips -> knee ->ankle. If you fixed the ankle, it would be something else! (natural result of resolving any pain)
Click to expand...
Hence the song...
 
My first total knee I climbed in my Citabria early one morning on the way to work to see if I could get out easily then went flying after work. That was three weeks out. But I quit pain medication at 10 days.

However, I really should have waited for a release from the surgeon to be totally legal. On BasicMed you could discuss a partial release and get away with it. Assuming it is functional there is no issue for the FAA.
 
As for me, I have pretty much hung up my headsets but have a good Class 3 from 2015, so I could go Basic Med at about anytime, with no new issues but a shoulder replacement and the two knee replacements. Who knows with the ailments taken care of I might do that. Of course that is assuming the Alphabet company doesn't want me to jump through SI hoops. No worries here either way.
 
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