Martin is pain free and thinking about a ski holiday following a knee osteotomy with Professor Adrian Wilson and Mr Raghbir Khakha

Martin was in almost constant knee pain when he sought treatment with Professor Adrian Wilson and Mr Raghbir Khakha

Martin had been suffering from increasing pain in his right knee for three years, which had been aggravated by a fall when he was walking in the French Alps. He went to see an orthopaedic consultant and had an MRI scan, which showed a large amount of degeneration in the medial compartment of his knee, which is located near the middle of the knee on the inner side. He then saw another consultant who suggested that the only way forward was a partial knee replacement.

Martin felt that at this stage this was too radical a step and didn’t pursue treatment any further. He was however really struggling with constant knee pain and stiffness, particularly when walking any distance over 400 metres – the pain worsened significantly the further that he walked. Everyone he knew was commenting on how much he was limping, and it was quite apparent to him, as a physiotherapist, that his shinbone (tibia) had become much more bowed than it had been previously. His knee was generally more swollen and painful by the end of the day, particularly after working, as his job means he spends most of the day standing.

Martin says: “I struggled if driving or sitting for more than 20 minutes, as my knee would be incredibly stiff and painful afterwards, so going to the cinema was not a lot of fun! I was also getting woken up virtually every night with pain from the knee, and it could be very difficult to get to sleep because of the pain.”

Martin wanted a second opinion and was able to refer himself directly to Professor Wilson after a discussion with his GP.

Professor Wilson reviewed Martin’s MRI scans and long leg X-rays and after lengthy discussions they concluded that a double-level (femur – thighbone and tibia – shinbone) osteotomy was the best option for Martin and would avoid him needing to have a knee replacement.

Osteotomy surgery restores the normal alignment of the knee, removing pressure on the arthritic or injured area of the knee as a result. An osteotomy can usually significantly delay the need for knee replacement surgery, and as in Martin’s case, remove the need for a knee replacement altogether.

Five months after his operation Martin gives an update: “The difference is frankly amazing! I no longer have constant pain, any discomfort I have is mild (on a pain scale pre-operatively my pain was a constant 5/10 and could occasionally rise to 7/10). Now I am pain free most of the time and occasionally have a mild ache. I do have some very mild stiffness from the knee at the end of a working day, but again this is minimal.”

He continues: “I am 5 months post op. now. I walked 6 miles several days ago over hilly uneven terrain without any problems, the knee no longer swells (although is still slightly larger than the other knee). I no longer have any night pain at all. I no longer walk with a limp and lots of my friends have commented on this, as well as the fact that my shinbone is now no longer bowed, so cosmetically much better too! Pre-operatively I couldn’t do a single leg half squat at all due to pain and had discomfort walking up or downstairs and I can do this without any issue now. I have driven several times now for 3 hours at a time without any reaction from the knee at all!”

He does however explain how the rehabilitation, whilst beneficial, is time-consuming: “The procedure I have had has been life changing, but I did have to take almost 5 weeks off work and have spent a considerable amount of time working on my rehabilitation exercises which are still ongoing. My procedure has been a great success, but I would say that it is not a quick fix, I am 5 months post op, and I would say that I am still getting small improvements each week and I am hopeful that this will continue over the next 6-8 months or so.”

He has this advice for potential patients: “I would certainly highly recommend Professor Wilson and his team for the management of any knee problems, particularly for patients trying to look at alternatives to joint replacement.”

Professor Wilson concludes: “I am so pleased Martin is functioning fantastically well with a great range of movement and he feels as though he has a new lease of life. As a physio himself, he is very well versed on how to rehabilitate. He has built up his quads muscles very nicely and overall is really enjoying life. He is due to go skiing in January, which he is very much looking forward to.”

November 2019