Ligament repair surgery using the pioneering internal brace technique sees Freda back to the ski slopes she loves

Freda sustained significant ligament damage when skiing and was seeking a solution which allowed her to make a full recovery.

Freda, an experienced skier, injured her knee in a skiing accident in April 2018. She had a slow, twisting fall in poor light and the binding on her ski failed to release. At the time she felt a distinct ‘pop’ in her right knee although remarkably little pain. She was near the end of the run and in sight of the chair lift so she got up, put her skis back on and attempted to continue. As soon as she initiated the first turn it became clear that her right knee was completely unstable and that the only way off the mountain was with the help of the pisteurs and the ‘blood wagon’.

Initial assessment at the local clinic suggested that Freda had ruptured her right anterior cruciate ligament (ACL) and so it was the end of Freda’s skiing for the week. Clearly, skiing was not an option and Freda was reduced to hobbling around Val d’Isere with crutches and a knee brace for the remainder of the holiday.

Initially, Freda thought that the injury was just a temporary setback, however she soon realised that it was more serious and surgery was likely to be necessary. Freda looked into all the available knee surgeons in her local area and found that Professor Wilson seemed to be the only surgeon offering the possibility of ACL repair rather than the more traditional reconstruction. Due to its quicker recovery time, Freda was very keen to see if she was a suitable candidate. Freda self-referred to Professor Wilson’s clinic with an appointment arranged for 10 days after her return to the UK. Her expectations were simple – she wanted to be able to do everything she could do before the accident including skiing the following winter!

Prior to surgery, Professor Wilson referred Freda to Simon Orr for physiotherapy to improve the mobility of her right knee. The more movement she could restore before surgery, the better the outcome was likely to be. She underwent surgery to repair the right ACL and internally brace the medial collateral ligament (MCL) and lateral collateral ligament (LCL). Freda was discharged with very clear advice on what she needed to do in order to start her rehabilitation. Again, input from Simon Orr proved invaluable.

Around four weeks after the initial surgery Freda started to encounter some difficulties with her wound sites and was experiencing an ongoing lack of movement in her right knee. She was seen very rapidly by Professor Wilson and his team. Further surgery was carried out to examine the wound sites and manipulate the knee under anaesthetic followed by antibiotics. By the end of that week Freda could bend her right knee to 90 degrees and her rehabilitation started in earnest.

Within a relatively short space of time Freda was able to use a static bike to rebuild the strength in her quads (front thigh muscles) and was able to venture on to an artificial revolving ski slope by the middle of January 2019, barely six months after her second surgery. By the end of February she had successfully skied on the snow slope at Milton Keynes. In March, eight months post operatively, Freda returned to Val d’Isere and skied for the entire week for six hours or so a day. She explains: “I can’t begin to tell you how amazing that felt and how brilliant my knee was – a true testament to the skill of Professor Wilson. I had two lots of surgery and my 60th birthday over a three month period last summer and I have now returned to skiing, walking for many miles with my Golden Retriever and I am looking forward to a busy, active summer this year.”

Freda’s advice for people in a similar situation is as follows: “The key thing in my case was to secure an early appointment with Professor Wilson – there is a relatively small window in which repair surgery can happen and my return to full fitness would have undoubtedly been slower had I ended up with more traditional surgery.”

She summarises her experience under Professor Wilson’s care: “My early return to skiing and the fact that I now have a fully functioning knee are down to Professor Wilson’s pioneering approach to surgery and the skill he so clearly demonstrates in the operating theatre. On a more personal level, I was impressed by his commitment to his patients. On the day after my surgery he popped into the Hampshire Clinic to check everything was OK at around 5am as he was flying off to a conference in Europe that morning! Also, following my accident plenty of people asked what I expected skiing at ‘my age’! I will always be grateful for the fact that Professor Wilson never once questioned my wish to get back to skiing and had a thoroughly positive attitude to surgery throughout.”

Professor Wilson adds: “I am delighted Freda has done so well after her right knee ACL repair using the internal brace technique which I have helped to pioneer. We also reconstructed her anterolateral ligament (ALL) with an allograft semi-T and carried out an internal brace on her MCL. When I last saw Freda, her knee felt beautifully stable and ready for her to return to skiing.”

May 2019