A knee osteotomy is a real alternative to a knee replacement, but remains relatively unknown, meaning that patients choose to ‘do nothing’ rather than face a major operation. Often known as knee realignment, a knee osteotomy involves cutting and realigning your shinbone, and sometimes your thighbone, to relieve pressure and effectively straighten your leg. It is less invasive, less painful, and gets people back doing what they enjoy. Here is Richard’s story, which involved cutting and inserting a metal plate in both his shin and thighbone.
Richard was a very fit and active 56-year old gentleman with his own business, but he developed distressing and limiting medial knee pain on the left side and noticed quite a bowing of his leg which was getting progressively worse.
Richard explains: “I’ve previously enjoyed squash and cricket, but by the time I got to have surgery with Adrian, I was struggling to even walk around. I’d think of other things to do or ask people to do things for me. If I did anything of an athletic nature the knee would swell up and if I played any serious sport it would swell up and stay like that for several weeks.”.
Richard has been a keen skier for many years and for the last 8 years has skied with family and friends in Obergurgl in Austria over Easter. His knee would swell up and be very painful resulting in him limping badly. It also meant he was doing less skiing and more sitting down.
Prior to making the decision to go ahead with osteotomy, Richard searched online about ‘new knees’, and had gone to see a doctor who said he was too young for a knee replacement, but who suggested injections. The doctor did not mention osteotomy. Richard went online again anyway, and while researching knee replacement surgeons osteotomy started coming up as being an option to avoid having an early ‘new knee’. After further extensive research Professor Adrian Wilson’s name came up, both as a surgeon and as lecturer on the topic, and he thought that he would rather have someone who taught surgeons and is a surgeon himself.
Adrian explained the surgery: “Richard was an ideal patient for an osteotomy as he was fit and had been previously active. His osteotomy involved cutting both the shin and the thigh. This allowed me to straighten his leg so he was able to walk and carry out all the activities he enjoyed previously. The X-rays I took after Richard’s operation reflect that we actually got a perfect result.”
Richard explains the lack of pain he felt: “I had no pain on the day the surgery or the day after. Because there was so little pain, there was a temptation to put too much weight on my knee and people were astonished that I was really in so little pain.”
Nine months after his osteotomy, just prior to having the plates removed, Richard said at the time: “I am able to walk upstairs with no pain at all, I can stand up from a settee or chair with both legs rather than favouring one, a round of golf is fine except for a slight ache which is due the muscles in that leg not being back to full strength”.
Although it was only 5 months after surgery he was keen to Ski in April last year but Professor Wilson said it was too early, so while everyone else skied, Richard walked up the mountain which was good exercise. Previously, he would have found walking painful and not pleasurable at all.
In November 2017, Richard had the metal fixings removed and started building up the muscles around the knee in the gym. He explains: “Prior to surgery exercise was painful which resulted in a reduction in muscle around the knee. Following surgery I have been able to cycle and use a rowing machine which has really improved my fitness.”
A further few months on, Richard enjoyed a ski holiday in Obergurgl, Austria in March 2018, and updated Adrian by email: “Back on the slopes and no pain! For the first time in many years I was able to ski without pain, even after a full day on the slopes the knee joint was fine with no swelling or pain and no limping. Due to the increased amount of exercise I was able to do prior to the holiday I skied better than before. I had thought that skiing with the kids was a thing of the past so it was a real pleasure to be able to try and keep up with them. Although my legs ached my knee was fine. Many thanks Prof.”
Adrian said: “I am delighted as Richard with the result. A knee osteotomy is an ideal treatment for such active patients as Richard and I’m very glad he is back to his previous activity levels.”