Expert advice: Knee prosthesis and road cycling - Cycling training with a knee prosthesis: What is still possible?

Question from TOUR reader Hubert K.: I (60 years old) am due to have a knee joint replaced in the next few years. The joint is pretty worn out and I have a pronounced X-B alignment after a skiing accident many years ago. At the moment, I'm not suffering so much that I want to have it done straight away. The knee pain is limited when cycling, last year I rode the Gold Tour of the Alps brevet, I don't need painkillers regularly yet. What is still possible in terms of sport with a knee endoprosthesis, what should I be prepared for?

Answer from Dr Olaf Pingen: If, as I read with appreciation, you have done the gold tour and are not in too much pain, I would advise you to wait with the artificial joint as long as possible. Even if the endoprosthesis fits perfectly and the rehab is optimal, a replacement can never be as good and long-lasting as a natural knee. Especially as your X-B alignment makes the operation more difficult.

The lifespan of a knee prosthesis depends on the load it is subjected to, similar to the number of kilometres and driving style of a tyre. The younger the patient is, the higher the probability that the prosthesis will be worn out and need to be replaced within their lifetime - especially if they are more active. In the case of a repeat operation, the chances of a good healing process are worse than with the first joint replacement. Greater strain, such as long uphill journeys, can cause increased wear and subsequent loosening of knee prostheses. Shorter distances on flat terrain would be better. With an artificial joint, you would therefore have to lower your competition goals somewhat. What is still possible also depends crucially on the course of your rehabilitation. Pay attention to your fitness level and control the load with the help of a qualified trainer (see TOUR 2/2015, page 68). To ride a road bike, you need full extension of the knee joint and a flexion of around 110 degrees. With your fitness and musculature, however, you have good prerequisites. If practised appropriately, cycling is an ideal sport for knee patients.