Knee Replacements and Marathon Runners

Marathon Man is a seasoned marathon runner who asks:

My right knee medial meniscus is gone. I'm bone to bone. I've run many marathons and am a veteran Boston marathoner. What can I do to get running again?

To quote Baretta, the great TV philosopher, "Don't do the crime if you can't pay the time."

Patients who feel they should run marathons after joint replacement surgery and told that they can't seem to feel that medical science has let them down because their pain has been eradicated, they can walk again but due to the mechanical limitations of metal and plastic based on years of testing they are getting advice to not run 26+ miles because it will destroy the plastic.

To the person who asked this question in the first place- Here are the facts - it will wear out very early if you run or even train for a marathon. It will also fail to function well if you jump off the Empire State building. Also, if you play rugby with the New Zealand National Team you will also destroy it.

It is actually the price we sometimes have to pay to be responsible to our bodies. Try cross training with weight lifting, cycling, tennis, golf, and numerous other things.

Maybe include an intensive work-out program reading Russian novels. They have the longevity of marathons, will give your mind the important exercise it needs, and I can guarantee minimal wear of the metal and plastic of your knee replacement.

Also, the chicks seems to love it when you quote from Anna Karenina.

Dr. K

Related Topics: How Weekend Athletes Get Olympic Edge,Knee Pain Management

Technorati Tags: marathon, kneeinjury, kneereplacement

Knee Replacements and Mental Status Changes

To the family of the father 2 weeks after knee replacement with mental status changes.

This is of real concern at times. Sometimes it is also a common (note I did not say "normal") response to major surgery in the elderly. Of the serious things that can happen- your father could have had a small stroke, a brief time of oxygen loss in the operating room, or may have a self-limited chemical imbalance- sodium levels, potassium levels, for example. The medical doctor should check out all of these "organic" causes of a mental status change.

In general the term "allergic to Morphine" is one I don't care for. Morphine is a kickass pain medicine with powerful side effects of nausea, dizziness, and changes in mental status. The street form of Morphine is heroin. The addicts don't take it to get them in touch with reality - but rather to remove themselves. In the same way, a common response to morphine, especially in the elderly, is confusion and mental status changes. Reversal of the morphine with a drug called naloxone would make the diagnosis immediately. If will also give your father a return of the pain, immediately. A small short-term price to pay to make an important diagnosis.

Assuming no organic cause, these mental status changes whether from the morphine or what is often called "sundowning" (the unexplained weird behavior of the elderly at night), will drift away.

Dr. K.

Related Topics: Newly Diagnosed with Osteoarthritis, How Osteoarthritis Affects Your Knee

Technorati Tags: kneereplacement, elderly, confusion, medicationreaction