Julian is a very interesting case where I ended up straightening his leg via osteotomy many years after a knee replacement.
He was 56 when he first came to see me. He was a very active gentleman but had severe valgus osteoarthritis - in other words he was knock-kneed with worn out lateral compartments. His main problem when he came to see me was pain in his right knee.
He had had a total knee replacement on the left in 2003, from which he did OK, but he was not so very happy because his left leg was at least knock-kneed as it was before that procedure and he felt that this was quite limiting in terms of what he was able to do.
After some discussion and review of the planning long-leg films that we do for an osteotomy, we agreed on a 'double-level' correction in his right knee - in other words we had to correct in both the femur and the tibia. I explained this to him and what an osteotomy involved as it was something that he was keen to look at as a biological alternative to having his right knee replaced which he was not all that keen to do.
He underwent the surgery on the right and things went very well, and I later removed the plates and I am delighted to say that he got an excellent result from the procedures on that side. He then asked me if there was anything that could be done on the left given that he was in severe valgus on that side also.
After reviewing the planning films for that side I felt it was possible to get his leg straight by doing a single-level correction around the knee replacement - which obviously was very difficult to do, but it is something that I have had experience with and seen good results.
So he underwent this procedure under my care in 2016 and I am delighted to say that he has also had a very good result with this and now has a beautifully straight leg on the left with the knee replacement still in situ.
Once more this shows the power of osteotomy in how we can use this biological procedure as an alternative to knee replacement, or when there has been a problem with a knee replacement resulting in a severe mal-alignment we can still use the osteotomy surgery to deal with this.