Susan is a really lovely 50-year old lady who was very unlucky and had a nasty road traffic accident aged 19 - so back in 1986 - fracturing both femurs, her pelvis, her back and a dislocation of her left hip.
She soldiered on for many years but in the end the hip became so severely arthritic and painful that she underwent a total hip replacement on the left side in 2006 and had a very good result from this.
The right knee had always been a problem following the accident but she slowly got to the point where she could only walk for 10 minutes before she had to take a break because of pain, swelling and instability, and she had significant night symptoms. This deterioration took place over a ten-year period.
On examination she had a very arthritic right knee with significant varus and a fixed flexion of 15 degrees as well as limited flexion. The X-rays were very impressive.
The only real option here was a total knee replacement.
These are not entered into lightly in individuals as young as Susan but 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. One year out she is measuring her steps every day and is comfortably walking 10,000 steps on a daily basis and climbs steps without any issue. She says her life has been pretty much on hold for ten years and was quite emotional about the fact that she is now doing so well. I am delighted that she has got such an excellent result from a total knee replacement - although as I say we need to be cautious about carrying out joint replacement in young individuals it can be life-changing.