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Knee replacements in the brain – 18 months on

By David Butler Patient examples 07 Apr 2015

One of our most read posts was the story of my good mate John Barbis and his double total knee replacements . It’s now 18 months since the operation and I caught up with John at Emu Bay beach on Kangaroo Island, South Australia, of all places. Have a look at those knees flexing in the photo below! Barbis2I observed John scrambling over rocks, jumping out of a four-wheel drive, squatting and lifting large boxes and I had to stop him chasing kangaroos. The knees looked great – healthy with no swelling and neat scars and I wanted to find out how John was travelling a year and a half on from surgery:  

How are the knees John?

“I don’t even know they are there. They are no different to any other part of my body and they have felt like this since 6 months after the surgery”  


That’s great – can you reflect on the things that really helped you get to this stage?

“Sure… First, it was a simple determination to get on with life. Secondly, I kept challenging myself to do things that were a bit scary, such as jumping and running, but I did this in a graded way. Thirdly, I thought and reflected quite a bit – I trusted my surgeon and I thought of the tough things I had successfully been able to get through in the past. Finally I reminded myself about time frames for tissue healing – I knew everything had to be healing, that graded movement would help and also that nerves would take a little longer to heal than ligaments and skin.”  


Did you have some ’nervy’ problems?

“Yes, in the skin where they cut into the knees, but I knew it wasn’t dangerous and I knew I had to challenge it.”  


This “nervy” pain is quite common after surgery – what do you mean challenge it?

“Well for example, if I was walking up a hill, for the first 100 meters there were a few “zaps” – I think from skin movement around the knee – but they would then go away. So from this, I was confident if I kept going they would adapt. Kneeling was hard initially, but I did it 3-4 times a day with slowly increasing pressure on the knee.”


John – you mentioned that your knees “talked to you” – what do you mean by that?

“Yes, I get some interesting sounds coming from my knees, but I understand that “noisy knees” are quite common after total knee replacements. Just knowing this helped as I knew that they weren’t ‘coming loose’. I sometime feel vibration too but I don’t worry about it either.”


What are your thoughts now on having both knees done at once. For some people that would be a quite a worry?

“I have thought about this quite bit. There was some discomfort after the operation but I think if I had a single TKR I would have been more fearful when I had the second one done. I also think the natural fear of “not having a good one to rely on” was unfounded because if they were done separately there would have been more time inactive and rehabbing. Perhaps there is also something about doing things bilaterally –  I didn’t feel off balance and I was forced to use both sides equally!”

“Hey, this is really interesting , just as I am sitting here talking about my knees in detail, they are starting to itch. I guess this could worry someone but while I think it is amazing, I look on it as my brain integrating my knees, welcoming them and reminding me about them.“  


OK – let’s summarise – what are the 5 key points that you think helped you to get to this highly functional state? 


  1. I really wanted to be ready for trout season
  2. I knew I couldn’t hurt myself unless I did something really stupid.
  3. Not using a walker, but using crutches and a four-point gait. I practised this before the operation.
  4. Cutaneous lidocaine patches on the tender scars helped me sleep. (I started these too late)
  5. I just wanted to forget about my knees after all those years and get on with life.”

Thanks John – grab those few beers, jump up into the boat and we’ll go fishing…  



-David Butler


  1. davidbutler0noi

    Hi John – Thanks again for this interview. There has been a lot of interest in this piece and a number of people have commented about feeling much more confident about impending knee surgery.


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