My knee first started to complain over 20 years ago while we were living in New Zealand. We did a 4 day backpacking trip and when we finished up, I could barely bend my knee to get on the bus for the lift home. After some rest, I regained my normal range of motion. From that point on, I had no problems cycling, but did have to use poles when hiking, and usually had some swelling, ROM issues and pain after multi-day hikes. I saw a PT there who pointed out that I couldn't fully straighten my leg. He gave me some exercises to try to get the leg straight, but despite working hard I could never get it fully straight. The straightening issue wasn't noticeable to casual observers or causing me problems. However, I did have occasional give-way and pain issues with the right knee. When we returned to the US, I saw a few doctors before finally finding one who diagnosed loose bodies in the joint. Basically there were pieces of cartilage that had broken off that were moving around and randomly pinching something. I had arthroscopic surgery to remove the loose bits and cleanup some more that was about to break off. I then went years with no pain.
But then a couple of years ago, I started having severe pain again. A local sports medicine doctor gave me steroid injections, which really helped. I was able to get these every three months. But every time I went in, he said a joint replacement was in my future. This worked well for three years. Then about a year ago, a short time after my latest shot, the pain came back much earlier than after other injections. So I finally went to see a knee replacement surgeon in January, 2025.
X-rays showed almost all the cartilage behind the knee cap was gone and I had bone rubbing on bone. He cautioned that if this continued, the knee cap might be worn too thin for the standard replacement with a plastic button the back of the kneecap. He also suggested doing it while I was strong since the recovery should be better if I went into it strong.
We scheduled surgery for March 11. I started pre-hab with a physical therapist to strengthen what I still could. I continued winter activities, with a bit of fat biking and lots of snowshoeing. I had signed up for the snowshoe race on Mt. Washington, so I did lots of long snowshoe hikes all winter. I joined several group hikes where we tried to pack down trails for fat biking. I started to notice a little pain when pushing off after a stop fat biking. I'd not had any significant pain before with cycling. It was mostly weight bearing activities that resulted in pain. Despite that, I still did 8-10 mile snowshoe hikes all winter, with some cycling when conditions allowed.
For the Mt. Washington event, there were 3 different races: nordic ski, fat bike and snowshoe. John was doing the fat bike race. I chose the snowshoe event. The race starts with 4km on the flatter Great Glen trails, before heading 6km up the auto road, finishing at treeline. The fat bikers and skiers get an easy ride/ski back down the hill. Snowshoers stay much warmer tromping back down hill, since it's a bit more effort than coasting or skiing down. Between my warmup and the descent, I ended up with close to 20km for the day.
This was two days before my surgery! My
anesthesiologist friend said, "Leave nothing on the table."
