Breaststroke kick and artificial knee(s)

Dan,

I am 2 yrs post TKA.  Before TKA, I could not kick breaststroke due to bone-on-bone osteoarthritis.  Almost from the time I started swimming (6 weeks like you), I have used breaststroke kick as part of my rehab.  For the first 4-5 months, it was gentle, slow, and a mechanical 3 step kick: draw heels to butt with knees hip width apart, turn toes out, kick straight back.  During that time, any lateral/circular movement was uncomfortable.  Forward movement was minimal.  :)  I focus on good mechanics to avoid a sloppy, circular kick.

Today was an IM day, of the 4,000 yard practice, 900 yards was breaststroke. No pain nor discomfort and I am kicking forcefully.

Your flexion/extension as well as your muscle strength and ligament tension will dictate what you can/cannot do.  At 6 weeks, I was >120 and -2, so able to go through the motions.  However, there was tightness in the joint which limited active flexion to about 90 degrees.  You probably see the same thing when do standing leg curls.  

As your surgeon probably told you, you are not going to hurt the components.  I did alot of research including a chat with an engineer who spent 30  years studying why knee replacement components fail.  The guys playing 3 hours of basketball and running marathons are rare and there is no literature on what happened to them in 10 years.  My engineer friend (Dartmouth Thayer School of Engineering) told me to avoid regular, consistent impact activities (like running) because, over years, the impact can loosen the component stems in your femur and tibia and they have to be replaced with longer stems.  Luckily, swimming (flip turns, breaststroke, starts, etc.) is not on the list of activities to avoid. A TKA revision is not something I want to go through.

So, from my experience, give it a go with the caveat - if it hurts, don't do it.  You have to realize that complete healing will take at least a year.  This procedure messes with every muscle, tendon, ligament in the leg.  Don't be surprised that you are still only lightly kicking breaststroke after 12 months.

Feel free to PM me separately if you want more info.

Happy Holidays,

Paul

Thanks for the info and response, Paul. Very informative. As a (former) runner, and an artificial hip recipient I understand that regular long running is not the best activity. Although I was under the assumption that it was the contact surfaces that would degrade, and not the stems loosening. I also do a fair amount of cycling. I just wish I could again be a runner.

Dan

Thanks for the info and response, Paul. Very informative. As a (former) runner, and an artificial hip recipient I understand that regular long running is not the best activity. Although I was under the assumption that it was the contact surfaces that would degrade, and not the stems loosening. I also do a fair amount of cycling. I just wish I could again be a runner.

Dan

FWIW - Prior to 10+ years ago, one of the primary failure points was the polyethylene cushion (which acts like the meniscus) degrading.  Around that time the research world discovered that adding Vitamin E to the polyethylene before sterilizing the component resulted in much higher cross-linking of the polyethylene bonds.  Today, polyethylene degradation is really a non-issue if your component manufacturer used highly cross-linked polyethylene.  You can check with your surgeon or if you have access to the medical notes from your procedure. 

My knee is the Zimmer Biometric Persona model.  The website specifically outlines the kind of polyethylene that Zimmer uses.

Another FWIW, there are several methods for securing the component stems.  Mine were glued in.  For younger patients with a longer life expectancy, there are components that allow bone to interweave with the stem which is supposed to reduce the risk of loosening.  If you have this type of component, you might be able to run a bit.

Paul