Major knee surgery to Ironman


"I had always been a bit of a runner - the odd 10k, Reading Half Marathon, but not really serious. Then one day (Sept 2013) everything went wrong.

 "I was messing around with a friend on their trials bike when I lost control, going at no more than 10miles per hour or so, and rode into a patch of dense saplings. I came off the bike and lay there winded for a couple of minutes. Nothing broken I thought, everything seems ok - until I stood up - when both my knees gave way in a very unnatural manner, bending outwards in a way that they had not done before. I realised after that the saplings had caught both my feet and twisted them around behind my leg when I rode into them. I nearly threw up at that point! Strangely enough I was not in much pain.

"I managed to get to Basingstoke A&E, where they said there was nothing wrong, but they gave me an appointment to the fracture clinic the next day. The doctor at the fracture clinic took some x-rays and then referred me straight to Mr Wilson at Hampshire Knee. Mr Wilson had more x-rays and an MRI scan performed. "I'm worried about my running" I said. "So you should be!" said Mr Wilson, "you have severely damaged both your knees". It turns out that I had ruptured my ACL, MCL and ALL on my right knee, and my ACL and MCL on my left knee. Luckily there was not much cartilage damage.

"Mr WIlson explained that I would need reconstructive surgery on both knees, which was quite rare, normally injuries were to one leg only. The traditional procedure would mean operating on each leg individually with a period of keeping the leg immobile after each operation - effectively meaning that I would be confined to a wheelchair for a significant period of time. This would have been a problem for me - I have a busy career in the semiconductor industry that requires a lot of international travel. Mr Wilson explained that some of the new surgical techniques that he had pioneered would allow him to operate on both knees at the same time, and would give the knees enough strength that I would be able to walk on them straightaway - albeit with the help of crutches initially.

Bilateral simultaneous surgery

"I agreed to go ahead with his suggestion, and Mr Wilson operated on 11th Nov 2013. I awoke the next morning, the operation had gone on for 5 hours with a lot of damage to repair. To my amazement I was moving around on crutches that day, and out of hospital a day later.The recovery process was tough, but at least I was mobile, able to drive within a couple of weeks and get back to work. Felicity at Hampshire Knee helped me with physio and I kept up with all of the exercises. I was determined to run again, although I was advised not to to avoid further damage to my knees.

"It took a long time. First re-learning to walk properly, then kneeling and jumping, then eventually running/walking. I had entered the Royal Parks Half marathon in September 2014, but had to pull out - I wasn't ready (although I was running 5k by then). I went skiing in Feb 2015,15 months after surgery. My knees hurt, but I managed to ski all day.

"I would say it took me 2 years from the surgery until my knees were back to 100% - Sept 2015. Longer than I had optimistically thought. I had learned to run again, and with better technique than I had before my injuries. I was back to half-marathons and even some longer distance endurance races. My new technique allowed me to run faster than before. I was also skiing, cycling and everything that I used to do before. My knees seemed ok, no pain.

"I hope that they will continue to work for me and do not deteriorate. I hope that the Mr Wilson's reconstruction is more anatomically correct than previous surgical methods and that will allow my knees to work as long as they would have done without the injury.

Ironman challenge 3 years later...

"In November 2016, 3 years after surgery one of my friends asked my if I had ever considered competing in an Ironman. This is a long-distance triathlon consisting of a 2.4 mile swim, 112 mile bike and 26.2 mile run. Typically it take s between about 9 hours and 15 hours to complete the race. I thought I would give it a try and entered Barcelona Ironman. The race date was Sept 2017, so I had 9 months to learn to swim properly and build up my bike fitness whilst holding onto my running capability. A long summer of training 12-15 hours per week ensued. I completed the race in 11 hours 30 minutes, almost 4 years after my original accident. Pretty good for someone who thought that they would never run again!

"I feel very grateful to Mr Wilson and his team. I was well looked after and informed. The new surgical techniques meant minimal disruption to my life. The repair seems to be robust - over 4 years on my knees are stronger than ever and I am able to subject them to a regime of extreme sports without any discomfort."

Adrian Wilson

Mark really had very spectacular injuries to both knees. It is quite common to injure both the ACL (anterior cruciate ligament) and the MCL (medial collateral ligament) and frequently we will allow people to heal up in terms of the MCL by bracing for a period of six weeks, and then once the MCL is healed we then turn our attention to the ACL. With the MCL, if we are going to go down this conservative management route, we tend to brace the knee flexed - that is, slightly bent - for the first two weeks and then slowly bring the leg out straight over the next four weeks, such that by six weeks the patients are achieving full extension, that is, they can get their leg fully fully straight. This does work quite well. As I was beginning to pioneer the idea of FiberTape to reinforce ligament reconstruction, Gordon Mackay was pioneering 'internal brace' concepts with allowing ligaments to heal by using FiberTape appropriately positioned across a joint to give it sufficient support such that the torn ligament can heal with early rehab and early mobilisation. Gordon Mackay first applied this to the ankle, and very soon after to the knee with the MCL. This actually makes a lot of sense for the very badly torn MCL where the ability of that to heal, and using the internal brace works extremely well.

When you tear your ACL we have now of course the option of the internal brace to do a 'repair' but in Mark's case we actually went for a reconstruction of the ACL and then the internal brace for the MCL for both knees. In the more severely injured knee we also carried out an ALL (anterolateral ligament) reconstruction.

It was a big ordeal for Mark to go through to have both knees reconstructed at the same time, but he did extremely well, and I think it is testament to this new technique that he was able to get back on his feet so quickly. I allowed him fully early mobilisation and he regained function early, and he has obviously gone on to do extreme sport after his bilateral complex knee reconstructions.

I am delighted that he has done so well.


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