Osteotomy years after childhood osteomyelitis

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Heike had an opening wedge distal femoral osteotomy a year ago.

She has had an interesting time with her knee. Aged 6 she developed severe osteomyelitis are both her proximal tibia and distal femur, and and as a result had a growth arrest. She went on to have lengthening procedures in Germany as a teenager and since this time has had significant pain, particularly medially, which got to the point where she had severe start up pain and struggled to get out of a chair. She could only walk short distances and she had to hold on going up and down the stairs.

Aged 50 at the time, her referring surgeon felt that the only possible next option for her was an osteotomy or a total knee replacement. Because of my expertise she was referred to me and I felt we could go for an osteotomy. The main problem was the medial osteoarthritis, and the planning showed me that we need to do the correction in the femur with an opening wedge - which I carried out a year ago.

Before the operation we had 15° of varus and 10° of fixed flexion - in other words Heike struggled to straighten her leg . Since the surgery she now can get her knee flat and no longer has her fixed flexion deformity. I’m happy to report that the alignment leg is now straight. 


More importantly I’m delighted to say that she now has no pain and even went on a walking holiday a few months back.

This case Is a real testament to the power of osteotomy surgery, and we really do need to consider it in patients who have been told their options are limited to just total knee replacement - which often isn’t the case. 

Patient Testimonial

As I had osteomyelitis as a child and numerous surgeries thereafter, including lengthening of the leg, I started to suffer from knee pain about 6 years ago. This got gradually worse and I was diagnosed with osteoarthritis.
"In the last year before the surgery, I was unable to walk downhill unaided, walking downstairs without holding on to a handrail and suffered from pains in the whole leg during the night. Also, my range of movement was limited and the knee was very stiff after longer periods of sitting in a chair at work, for example.
"After my GP referred me to a knee-specialist at the Saxon Clinic, he suggested that I might be the ideal candidate for an osteotomy, a procedure that was carried out in Germany quite frequently but not so much here in the UK. The closest hospital where the surgery would be carried out was Basingstoke and he agreed to write to Prof Wilson for further assessment.
"My expectations were for me to be pain-free. My expectations have not only been met, they have been exceeded: my knee is no longer bent, my range of movement has increased significantly, Prof Wilson was able to reduce the difference in my leg length by a further 7mm, I am no longer waking up during the night due to pains in my leg and my leg feels stronger. I am hoping that once the metal plates have been removed, that this will further increase strength building and range of movement.
"I did a lot of research after I was told about this treatment and Prof Wilson himself provided extensive information and weblinks to look into the subject as it isn’t a small procedure. As my osteotomy was carried out on the femur, the recovery process was longer than I expected and it took at least 6-7 months until everything was back to normal. Prof Wilson provided thorough information into the whole process of the surgery, the results that have been achieved and what to be expected during recovery. He was always happy to answer any questions I had and was available either for face to face meetings or calls. I was provided with a lot of information, weblinks, case study results and other data before committing to the surgery. Before and after the surgery, I felt thoroughly looked after and was given Prof Wilson’s email address if I had any questions or worries during my recovery. I did not have to make use of this but just knowing that I could was hugely comforting. I did not expect to be completely pain free but the fact that I am, together with the other benefits I gained with the surgery, make me very, very happy!"

Heike

Patient

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