Prof Adrian Wilson performs a total knee replacements on a young, 50 year old patient with severe arthritis
As a 19 year old, Susan fractured both femurs, her pelvis, back and dislocated her left hip. The result of this was ongoing pain, particularly in her hip, which resulted in her needing to have a hip replacement operation in 2006, 20 years after the accident.
This solved one of Susan’s issues, however her right knee became progressively more painful over the next 10 years due to severe arthritis. This meant that eventually she could only walk for 10 minutes or so before having to stop due to the pain, coupled with swelling and instability.
An X-ray organised by Susan’s GP showed that she had bone-on-bone osteoarthritis of the knee. She selected Professor Wilson as she wanted to be seen by a consultant who specialised in knees and was an expert in their field.
At Susan’s initial consultation, Adrian reviewed Susan’s X-rays. Due to the significant varus and a fixed flexion of 15 degrees as well as limited flexion, an osteotomy, which is usually a good option for younger patients, was not suitable. Adrian explained all the options and outcomes and answered all Susan’s questions. They discussed other less invasive options such as injections, however they both felt that the only real option for Susan was a total knee replacement.
Susan explains: “I had very little in the way of expectations. I could hardly walk (maybe 100 metres max), couldn’t do stairs and found hills very difficult, I was just existing as every step was painful – even with prescription drugs. I was hoping for an osteotomy but in the end that wasn’t an option so I had to have a total knee replacement. I hoped that after the surgery I would be able to walk without pain, I wasn’t looking to be able to walk miles just to be able to carry on living.”
Following the operation, Susan was off regular pain medication within 6 weeks and only took the occasional paracetamol when she went to her physiotherapy appointments. A year following surgery she now regularly walks over 10,000 steps per day, does a 55-58 minute walk Monday – Friday and a 1 ½ hour walk on most Saturdays and Sundays.
She summarises her experience with Adrian: “Prior to the surgery I just existed, the surgery has given me my life back. My expectations have been exceeded. I never believed I’d ever be able to do this following the surgery.”
Susan’s advice to other patients with similar problems: “Do the exercises they recommend prior to surgery, do the exercises post-surgery, even if you don’t think they are doing any good. The Game Ready ice machine was wonderful for swelling (once I got used to the freezing cold).”
Adrian summarises: “I am delighted that Susan has got such an excellent result from a total knee replacement A total knee replacement in patients as young as Susan (she was 49 at the time) are not entered into lightly, however they do show that in a young individual it is possible to get an excellent result to the point that people do feel that they have got their lives back – which is where Susan feels she is today.”