HTO with ChondroGide Patch

I recently had a high tibial osteotomy and a ChondroGide patch to repair an area of damaged joint cartilage in my knee.

I had no knowledge of this medical area at the time that I realised I had a problem. So when the Insurance company sent me a list of surgeons and asked me which one I wanted to use,  I didn’t know where to start to be honest. I did a bit of online research and I found it difficult to base a judgement of the individual surgeons on the information provided, so I then basically Googled 'Best Knee Surgeons in the UK' and Adrian came up in the search !

I made contact myself and then told the insurance company who I wanted to use.  Reassuringly, in the run up to and post-surgery, speaking to nurses and physios they all said he was the best….

Even then, I was really nervous and down in the dumps because I had really got in to my running and loved skiing, and the prognosis seemed suddenly "well, it’s a big procedure and you will not run again and this will hopefully allow you to walk the dog and remain active, hopefully ski..." – which did not sound like too much of a great result to me, if I am being honest….

High Tibial Osteotomy and patch

Having been initially despondent after being diagnosed and given my immediate prognosis, Adrian and his team undertook a high tibial osteotomy and a ChondroGide patch to repair my cartilage defect.

high tibial osteotomy

Showing osteotomy plate

Although the initial 3 to 4 weeks post operation were a challenge (lots of physio and being non weight bearing) I recovered at a remarkably quick rate. I was back home working after 1 week and was back driving after 8 weeks but most importantly I was walking without pain and discomfort.

Since the surgery my expectations have been surpassed, although I have decided to stop running to protect the work that was done. However,  I can now play football again with my children and run around on the beach on holiday etcetera, which I could not prior to the procedure. 

Now I am out on my mountain bike a few times each week, regular Pilates classes and busy in the garden back to cricket coaching and playing, and back to trekking in the Lake District with my brother – oh, and I did get back skiing after 5 months (although I did take it easily to start with!)

To others with similar problems, I would definitely recommend the surgery, but be prepared to put in the hours with the physio and make sure you get a GameReady and use it for the first two weeks (ideally all the time) – it really helped minimise the swelling and accelerated my recovery. 

It all massively surpassed my own expectations and I am enjoying a very active life again!

It is now a year since surgery and I will be having my plate out in a few weeks.

Adrian Wilson

Adrian Wilson

"Martin is a 45 year old gentleman who presented to me back in April 2017 having had pain since the autumn of 2016. It began as a heavy sensation and then became pain with running and then pain started to interfere with his sleep. As he really enjoys skiing he found that this had started to become difficult, and he had medial knee pain which was making him limp. So he had gone from being someone who was extremely active and fit at 45 to someone who was walking around with a limp, unable to really do very much at all.
"His MRI scan showed a full thickness chondral defect affecting his medial femoral condyle of approximately 12x12 mm, and was in varus.
"In this case I realigned with a high tibial osteotomy, but also opened the knee and did a cartilage patch to deal with the defect. I have been very impressed with these ChondroGide patches. The technology has been around for a good ten years - perhaps even longer - and what we do is a very tidy microfracture, or nanofracture to the bone once we have prepared the joint surface, and then we lay the patch which is made of naturally occurring collagen and has a very unique bi-layer structure. The technique is called AMIC - Autologous Matrix-Induced Chondrogenesis - and it is 'single step'. The cartilage patch or collagen matrix is laid over the top and this acts as a tarpaulin over the top of the nanofracture or microfracture that we carry out, and it keeps the stem cells that come out of the patient's bone in a contained fashion. In association with realignment surgery I have been very impressed with the results. Martin's surgery went well and his recovery was spectacular. He left hospital within a day or two and was pain-free pretty much from the word go. I think that is testament to the new technique that we have been able to develop with the new osteotomy techniques that I have been fortunate to help to bring in. When I did the surgery it was 20x20 mm and full-thickness after I cleaned the edges and got down to the bone, removing the so-called 'calcified layer' and then carried out a microfracture using a tiny little needle and then laid the patch over the top and glued it in with fibrin glue. He did extremely well as I have said and was up and about in no time, and over the last 12 months he has got back to very high levels of activity, being able to ski again the same year, and he tells me he is back running with his children. He recently went to Tanzania and did the most amazing things there. He is now able to run down a beach with his kids as opposed to limping, which is what he was experiencing prior to surgery.
"It is a great story of using modern techniques such as AMIC together with osteotomy to get a truly great result."

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