Marked pain relief despite bilateral simltaneous HTO

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Paul had a simultaneous bilateral high tibial osteotomy combined with Lipogems treatment to both knees.

He was referred to me as a tertiary referral from a fellow orthopaedic knee specialist who knows of my interest in osteotomy surgery.

Paul had a bilateral issue, the left being worse than the right. His X-rays confirmed that he had Grade IV osteoarthritis in both medial compartments but the rest of the knee on both sides was in good shape. He was in quite significant varus (bow-leggedness).

He is a very busy gentleman and when we went through the options I explained that he was a very good candidate for osteotomy surgery and indeed regenerative treatments. One issue for Paul being so busy was that he was reluctant to have two separate interventions that would require him to rehab on two separate occasions. Given how fit and active he was we went for bilateral simultaneous high tibial osteotomy surgery, doing both of the procedures simultaneously.

Bilateral simultaneous HTO & Lipogems

Paul sailed through the surgery. We then followed up with Lipogems treatment to both knees. This is an injection of fragmented and cleaned fat. The pericytes within the fat are precursors of stem cells that then go on to form mesenchymal stem cells which become active and have a regenerative capacity.

I am delighted to say that the combination of both the regenerative treatment and the realignment surgery has left Paul in a very good position. Prior to the surgery he could only walk very short distances and had pain which he rated as 8-9/10 on a VAS scale. Now if he has a very busy day - and he has quite a physical job - it is 1/10 at worst.

I am delighted that he has done so well with this combination of treatments. Bilateral simultaneous high tibial osteotomy surgery is not done in many centres but we do offer this in appropriate patients.

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