Osteotomy improving quality of life

I was told I had osteoarthritis in my left knee when I was 38. Up until that point I had been very active; running, gym sessions, step and circuit classes and I loved walking. I was told by the doctor there was nothing that could be done, just pain relief and in my 60's I could have a knee replacement.

I couldn't believe it - over 20 years on pain relief - it just didn't make sense!

I stopped running and most of my gym classes at that point and just kept walking and swimming. When I was 44 I decided enough was enough. I couldn't walk more than 10 min, every step was agony, either a pain which felt like an electric shock going through my knee or it felt like a bit of plastic was stuck below my kneecap preventing me from bending or straightening it. I couldn't get through a night without waking up in agony just to turn over, getting out of bed was horrendous and I had to hold onto a wall, and I put a lot of weight on due to my inactivity.

All in all I was miserable and was at the point of wishing my leg was amputated just to get some relief. My mental health was at an all time low due to the pain, my weight, my lack of stress relief which had always been exercise and of course the lack of sleep.

Orthopaedic Referral

I went back to the doctor to see what they could do and was once again told nothing so I demanded to be referred on to an orthopaedic surgeon. Thankfully I was referred to Professor Wilson and after MRI scans etc was told I was a good candidate for an HTO (high tibial osteotomy). I did a lot of research, reading blogs, looking at web sites he recommended and decided to go ahead with the operation. The American blogs I had read did initially put me off, but when I compared their operations with reviews about my potential operation I realised what I would be having was in a different league to the ones over there. There was no leg brace, and I would be up and walking the following day etc.

High Tibial Osteotomy

I was up and walking the following day but I wasn't one of the 2/3rds of patients who have little or no pain after the operation, but the pain I had was manageable with pain relief in conjunction with the GameReady leg cooler. I found doing the physio exercises and hydrotherapy were what really helped me get my muscle strength and walking back to a good standard. I also found 1:2:1 Pilates really helped in the latter stages and got rid of my limp.

I would say at 3 months I was in a good mental health state and getting back to weight training and cycling. I did have some set backs, but they were due to me rushing the healing process because I felt so good.I can highly recommend this operation and would have it again; after 10 months I had the plate removed and I'm now 11 months post op. I am walking 4 miles a day, in no pain, I don't feel like my leg will give way and I have my life back. It took just a few months to change my life and I thoroughly believe was worth the effort.

Sarah says it is chalk and cheese compared to how she did feel. She is planning a scuba diving trip in Ibiza and wants to just get on with her life again. She sat there today pain free, with a knee that allowed her to perform at a high level of function.

"It is a very nice feeling in the clinic when we see these patients that are so disabled and we get them back to good levels of activity with these biological procedures. That is just a great testament to what we are trying to do with osteotomy. And also I think there are so many bad messages coming out, particularly from the States - when patients are immobilised for long periods of time in braces, the surgery is very painful, they are having a large extensive approach and just not following these new ideas and techniques that we have developed in Europe. It will change - America is beginning to wake up to it and I am sure with the good results that are coming out of my unit and other similar units, and with testimonials on the internet from people like Sarah who can really change the face of osteotomy and make it a much more popular procedure - which it should be."

Adrian Wilson 
Knee surgeon
adrian wilson

This lady was referred to me by another consultant orthopaedic surgeon. She has had problems since she was 13 years of age, at 30 she took up running and did well until at 38 she suddenly had acute onset of severe pain that never really left her. Although she could walk reasonably well she was very inactive as a result, with night pain, constant swelling, constant instability, constant catching. She said she would not even be able to run across a road. So she went to her GP and was told that the only thing was pain killers.

She saw an article in the Independent about new ways of doing knee replacement and went on to get an opinion from an orthopaedic specialist local to where she lives. He took one look at her and referred her to me because of my interest in osteotomy. She was indeed an excellent candidate.

When I worked her up she was in slight varus on the medial side with a failing medial compartment on MRI scan.

When I went into the knee the patellofemoral and lateral compartments were perfect but the inner compartment had grade IV changes both on the femur and on the tibia, which means that there were patches of bare bone on both the femur and the tibia, but a reasonable meniscus actually. So she literally was the perfect candidate.

Picture taken during surgery, showing the exposed bone on the rounded condyle of the femur. You can see the crescentic meniscus at the bottom part of the picture.

She underwent the osteotomy.

11 months later I took the plate out as it was causing some irritation - which is something that I do as a routine. And she felt good before she had the plate out and now she feels fantastic.

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