Complex bow leg problem in a younger man

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Chris is a 50 year old man who has had problems with his right knee for some time.

 When he presented he had moderately severe arthritis medially and quite significant varus alignment and couldn't straighten his knee. He had a 30 degree fixed flexion deformity (30 degrees away from straight) and he could flex up to about 120 degrees, so he was really stiff and as a result was walking around on a bent knee. This meant he could only walk a few hundred yards at the most, and it was making his job - which is quite physical - really difficult.

MUA, arthroscopic arthrolyis and meniscal repair

So I thought a total knee replacement would be a reasonable option, but given his young age I also talked about the other options of joint preserving procedures, and I decided to go for an arthroscopic arthrolysis - in other words an arthroscopy to remove all of the damaged tissue within the knee. He underwent that arthroscopic arthrolysis on the 8th of November 2017. I manipulated the knee and managed to get some movement back and then I carried out a typical arthroscopic release with a radiofrequency device, and found lots of dense scar tissue around the knee, which I was able to remove and got the knee to within 10 degrees of straight. There was some damage within the knee, particularly on the medial side, but interestingly there was a very significant tear of the lateral meniscus, which was hypermobile. In view of the fact that the lateral meniscus still had good tissue I actually did do a repair of the lateral meniscus, which I wasn't expecting to do.

Osteotomy

After all this Chris did well and he got back to a really quite good level of activity, but he still had medial knee pain and a fixed flexion deformity. So to address this I later carried out an osteotomy to take out the fixed flexion deformity and to straighten his leg. I am delighted to say having done this he has got back to virtually full extension, has a much better range of motion now, and he is virtually pain free.

It's a real pleasure to treat Chris as he is such a lovely chap, and I am delighted that he is doing so well.

Chris tells his story - 

I sustained a knee injury after a road traffic collision in 1984. After several operations and years of crutches I had recovered - but realised that my knee would eventually fail sometime when I'm older - and it did.

After surgery in 2013 my knee was no better.

I saw a few consultants over the next years looking for help who all said I was inoperable until one recommended Professor Wilson. I saw Professor Wilson who explained the good & the no so good of what he could do & I had a choice, stay as you are or operate. I had an arthroscopic procedure with a month recovery followed by an osteotomy 3 months later.

I can now put my full weight through my leg and rather than walking on tip toe can now put my heel down and am in a much better walking position without all the pain.

My advice to others is to stick to the advice when told to rest and complete all the physio exercise. Overall if I had to choose again, I wouldn't hesitate, I would go through these surgeries again.

Chris

Patient

Adrian Wilson

Adrian Wilson


Chris was referred to me by another specialist knee surgeon because of my interest in dealing with deformity and in particular realignment surgery.



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