CASE STUDY

A successful revision ACL reconstruction restores sixth-form student Josh’s knee to good health.

Following unsuccessful surgery on his anterior cruciate ligament (ACL), Josh needed revision reconstruction to return to his normal active lifestyle.

In 2016, sixth-form student Josh underwent an anterior cruciate ligament (ACL) surgery after twisting his left knee playing football, rupturing his anterior cruciate ligament (ACL) and tearing his medial meniscus. This procedure was not successful, so later that year he was referred to Professor Wilson, who was recommended by his original consultant, Mr Geza Kordas.

Josh’s mother, Bernadette, says: “Prior to meeting Professor Wilson, Josh had an ACL repair and 12 months of rehabilitation using physiotherapy. We researched Professor Wilson’s work so had high expectations that he would be experienced and knowledgeable in how to deal with the surgery Josh may need. We were impressed that Professor Wilson was confident in his ability and was sensitive to the previous journey Josh had been through.”

Professor Wilson noticed that Josh had significant wear and tear issues on the inner side of his knee joint and carried out a successful revision ACL reconstruction, in which he took some tissue from Josh’s right leg and rebuilt the ACL. He also performed what is called an anterolateral ligament reconstruction of the outer side of that knee. The surgery went smoothly, Josh recovered well, and his knee feels normal and he is capable of good levels of activity.

Unfortunately, during the initial twisting injury, Josh had not only torn his ACL but also badly damaged his medial meniscus (the main shock absorbing structure on the inside of the knee), which meant the forces exerted on this side of his joint would be much greater and eventually lead to arthritis. Usually, the onset of arthritis in young people who sustain injuries of this nature doesn’t occur until the patient is in their forties, but it some cases it can occur much earlier.

Should Josh require treatment in the future, Professor Wilson outlined further procedures to preserve his knee, including offloading the inner side of his knee with a minimally invasive osteotomy (knee realignment surgery) and replacing the lost meniscal tissue with a meniscal transplantation.

Josh’s case shows the importance of introducing a prevention programme to minimise the incidence of this type of meniscal injury, which is growing rapidly. Professor Wilson’s daughter tore her ACL aged 11 and consequently he has carefully monitored her activities because he is all-too-aware of the repercussions.

Berndatte, Josh’s mother, says: “In terms of advice for others, the Game Ready (hot and cold compression therapy) machine made a huge difference in Josh’s pain management; knowing we had Professor Wilson’s direct telephone number to contact him post-operatively was reassuring and we were kept fully informed. Josh was understandably anxious about surgery again but was completely reassured from the first meeting with Professor Wilson and felt that he had met someone with a wealth of experience who could offer him the best option in reconstructive surgery. Josh received wonderful care with great attention to detail. It does feel that Josh has recovered so much quicker this time even though the surgery was far more complex. The single biggest difference was that Josh was treated as an individual at all times.”

January 2019

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