Story of 2 knees

Last quarter year 2025 to March 2026

After my left knee replacement, still with op bandages on enjoying the cold sea water. This still my best and walking barefoot also very comforting.

This journey started through my senior school years with rugby, rowing and long-distance running. The first knee injuries I remember were from rugby. Painful, water on the knees and necessary to wear knee braces – the old elastic ones. Even went to the Kineticist who tried said one leg shorter and necessary to balance body – used yellow pages shoe inserts in those days.

I was never into operations and always took the approach of maintaining flexibility with stretching, keeping fit and my weight down.

Long distance running faded away as it was actually painful. I still loved trail exploring and manged for a while but this also became painful. Cycling was my go to and progressed from road cycling to mountain bike and recently gravel. Cycling was never painful on the knees but stayed away from heavy gears and spun a lot. Hiking was a problem. Tried with my cousins in Rooi Els – easy up but hell down. Walking on greenbelts were never without pain and on trips overseas walking around London required many stops and anti-inflammatory in the evening.

In 2022 I decided to get advice again and went to a knee specialist at Christian Barnard Hospital. Confirmed that the knees were not in a good state, bandy legs and all. I was advised to try and carry on for as long as possible. Some super expensive knee braces and special shoe inserts later, nothing really helped.

Then came my trip across the Pyrenees in May June 2025 – 18 days, 1000 km and 28000m of climbing – see separate post. My first expectation was for my knees to fail and to have to manage pain. To my greatest surprise my knees lasted the distance without any pain. The reason was strength in the legs from cycling, walking, carrying which provided a strong support for my knees.

On my return to London however, where there is always a lot of walking, even if you tubes and busses, the extreme knee pain came back. From London I arranged an appointment with Knee Clinic – Haydon Hobbs – Vincent Pallotti. One month waiting but had an appointment on my return in July.

New X Rays and with 2022 X Rays Haydon confirmed that knees were bone on bone and if it was affecting quality of life, to go for the knee replacement. Other options from braces to injections were discussed but didn’t make a difference and would not make a difference now. In addition, the worse the knees got – body imbalance etc, it would start affecting the hips and they would require looking at. It was time and I basically knew this anyway. Pictures below show right and left knees, bone on bone.

Ops had a 3-month waiting list which I didn’t want but they would push me in if there was a cancellation – this is now for worst right knee. Got the call on Thursday 21 August that the operation would take place 25 August. No time to stress or get worried, I did the necessary paperwork and checked in on Monday at 11 at Vincent Pallotti for the 15h00 operation.

The operation took 2 hours. The next two days is all about pain and infection management. Hobbs was happy with the operation and that old knee was not in a good state – See X Rays. On Wednesday I went to Faircape stepdown until Sunday as there was no way that I could manage on my own. This was a very good and sound idea. Images below new right knee – amazing technology.

After 10 weeks on the new knee and left knee planned for March 2026, I decided to ask for another cancellation slot to do the left knee. I just could not face going through this all again next year. On 3 November there I was again for left knee replacement. Same story from Hobbs that left knee was also in a poor state – see X Rays. Wednesday to Faircape and came home on Saturday this time. Images of new left knee.

Picture above after removing left knee bandages after 2 weeks. Also, the progress of right knee.

There are so many questions around this type of surgery, and I shared my thoughts and experiences below.

Pain management and pain medication. Directly after the operation the pain meds were extreme (oxy) type of medication and morphine injection with the second knee. For the operation the anesthetist also dulls the nerves around the knee. I stayed on the extreme (oxy) meds in hospital and on first day at step down. I then went onto Tramodol (100mg), Dolorol Forte and Exinef 90mg anti-inflammatory. I found that I could manage with the Dolorol when I left step-down. With the second knee at start of week 3 I suffered extreme pain and cramps when trying to sleep in addition to sudden swelling – I didn’t sleep for 3 nights. Any medication I had had no effect and icing had no effect on the swelling. Only after 3 days was I given pain meds as described above – I was never given these to take home and manage this on my own. I was also told that this was normal! An incredibly painful week. Pain is also managed with icepacks. These are given to you in hospital, and I still use these consistently to also reduce swelling. So pain management is an every day process even with rehab and trying to get flexibility and mobility.

The story about sleep. With the first operation more or less consistent sleep only started after 10 weeks. It is not just about managing pain. It is about finding comfortable positions not just for the legs but also the rest of the body that has had to adjust and realign. After the first knee I tried sleeping tablets. I found that it helped for a short while but always woke up having slept in an uncomfortable position with more pain. So found it easier not to use them. The first 8 weeks are a maximum of 4 hours interrupted sleep per night. Can be truly exhausting but has to be managed and not to fight against it.

The story around exercise physio and rehab. Exercise and mobility starts the day after the operation with physio’s in hospital and then onto step-down. Getting mobility has to start straight away and it happened a lot quicker with the second knee because I knew what to do. I requires extreme pain management and working through pain barriers and for the first 5 days it is not possible to do without having taken pain medication. After hospital and step down they give you a manual – and also go through the exercises – but nothing else! So I was diligently doing this unbeknown that physio is critical. I met a sports physio at my normal morning coffee – Shane – and I asked him I could see him. He was the first person to explain all the dynamics of the operation and how critical the first 8 weeks are with critical physio to achieve the range of extension, reduce swelling (can only be done with physio) and advise on exercises. With right knee I only started after week 4 but on left knee after week 2. This is so critical to get this specialized treatment, but no-one advises you of this! This physio has been critical in my rehab process. The next critical path was my pilates – which I have been doing since my back injury. The pilates with Janice was crucial to achieve posture and balance for the rest of my body. With the operations but also not being able to sleep, walking differently, pilates is critical for the healing process. To both Shane and Janice I am extremely grateful. Another point was that I was fit and not overweight. I think this has been crucial in my recovery.

The story about step down. The hospital basically discharges you on the Wednesday after the op on Monday afternoon. As I live alone it is not an option to go home on the Wednesday. I was fortunate to go to Faircape step-down for 5/4 days with professional nursing and doctor care, rehab and a safe environment. It was a crucial step in my recovery process and would advise others to do the same. I was able to get a lot of answers from the doctors and physio’s that I would not have got otherwise.

The story of having two knees replaced close to each other. This question is often asked. I think I would have struggled to do both knees at the same time. I was also struggling with the thought of waiting another 6 months and then 6 months of rehab. What I have found. Two operations within 10 weeks is hard on the body – I have found that I get tired much quicker and have had to give my body recovery time. It is a challenge having two knees at different stages of rehab. The first right knee requiring building of strength and the left still in recovery phase. So progress on right knee might now be slightly slower but progress with left knee is quickly catching up.

Cycling with my new knees. Understanding that it is many small steps. I was able to cycle gentle 50km loops after 8 weeks on right knee. Power, flexibility and swelling were all good. It is now nearly 5 weeks after left knee and only this week have been able to rise very gentle 15-20 km loops. The cycling flexibility is so comfortable and easier than walking. But I have realised that it is going to be a slow journey to also rebuild my strength.

An additional comment after 11 months is that cycling has been an absolutely crucial part of my recovery. It was again discussed with Shane my physio today. Cycling gives you mobility but also blood flow and some cardio

Walking without pain. I have realised that I have walked with pain for most of my life. I can now easily walk without pain.

Still a long journey of lots of little steps but very pleased. Grateful to Hobbs (top surgeon), Shane, Janice, close friends checking on me daily, my girls and their partners, friends and everyone that have supported me on this journey. I am truly grateful and feel very blessed.

Already planning next years adventures 🙂

4 January – 9 weeks L and19 weeks R knee – updates. After 8 weeks a whole lot of things start coming together.

• More exercise and ability to do steady 50 km cycling outings – see stats. It is a slow process of also getting strength back. Also, daily pain free walks.
• Getting out is good for mental wellbeing – fresh air and exercise often with others.
• Getting the heart rate and cardio up.
• For the first time after 8 weeks can get more that 7 hours sleep including some REM sleep. I think time from operation, no medication and exercise are all contributing to better sleep.
• I havent used any meds and rely completely on healthy diet. With my regular rides I occasionally take an anti-inflammatory at night when I feel my body needs help. Havent taken pain meds since 3rd week episode.
• I havent had pilates or physio for 3 weeks because of Christmas break – I really miss these and look forward to starting in Jan. In the meantime, I carry on with daily exercises and stretching.
• Left knee still has a little swelling which I try and massage it out. It comes down with cycling but taking longer than right knee.

December 2025 stats to 4 January, 2026 showing slow build up. This week has been steady 50 km day rides.

My go to gravel and MTB bike – relatively easy for recovery andgood coffee.

Cape Town Cycle Tour 6 month 3.5 month milestone. Feeling very blessed that I could not only ride, but ride comfortably the longest ride with new knees. I had no pain, just some stiffness and iced along the way. Quite a journey but shows what is possible.

6 months Strava Stats. Easy riding always within myself. Gravel and Mountain bike

See Sani2C post for 7/9 months stats of 3-day mountain bike race. Very lucky.