New surgical techniques benefit 16-year-old Max and relieve his complex knee problems.
Aged 16, Max injured his knee in November 2018, playing rugby. He landed awkwardly on a straight left knee and felt a pop. Max visited his physio who, concerned about the swelling around his knee, recommended that he should have an MRI scan. The results showed a lot of damage to the knee and the need for surgery.
On the recommendation of two physiotherapists who had treated Max previously and having researched him online and read his patients’ stories on his website, Max’s parents decided to consult Professor Adrian Wilson. On their first visit to Professor Wilson, he clearly explained the nature of the injury and what he could do to repair it, which gave them great confidence in him. Two weeks later, the operation look place.
The MRI scans had confirmed a complete rupture of the anterior cruciate ligament (ACL), with the condition of the remaining tissue too poor to be repaired, so a biological ACL (tendon graft) was performed with the new ACL was run inside the old ACL which would act as a jacket for the new ACL. This type of reconstruction, a Samba (Selective Antero Medial Bundle Augmentation) is felt to provide quicker healing and better results.
Max’s hyperlaxity (joints that can move beyond the normal range of motion) meant that Professor Wilson also performed an anterolateral ligament reconstruction (ALL), a relatively new procedure often performed on children. One hamstring tendon had been used for the ACL reconstruction with the other used in this new reconstruction of the ALL. His medial collateral ligament (MCL) (inner side of the knee) had also been injured so an internal brace of the MCL was performed.
The knee’s joint surfaces were pristine but both menisci (cartilage where joints meet) were badly damaged. The medial (inner side) meniscus was damaged right at the back, a so-called RAMP lesion. This was repaired using new techniques and should result in a normal medial meniscus once healed. On the lateral (outer) side, again the joint surfaces were perfect, but the entire lateral meniscal root was detached. This was repaired using an innovative technique which involved drilling a small tunnel and passing sutures through the root and pulling it down and fixing it to the front of the shin bone.
The operation was more complicated than Max’s parents expected but Professor Wilson clearly explained everything he had done, gave them extensive surgery notes and they were very pleased with Max’s care and support during his recovery.
Max’s parents advise others with similar problems to seek advice and treatment as soon as possible and to get an MRI scan, adding that it’s unwise to let symptoms such as intermittent knee pain to go unchecked.
Max’s mum, Sarah, says: “Max’s recovery has been outstanding so far and there is no doubt that this was due to the early and highly skilful intervention by Professor Wilson. Moreover, the post-operation rehabilitation package had been fully joined up between Professor Wilson and the physios in Winchester to ensure Max’s recovery is as quick and sustainable as possible. Max’s recovery is exceeding expectations, the help and advice we have received has been brilliant.”
Professor Wilson says: “Eight weeks after this complex operation, I am delighted to say Max has made an incredible recovery with no pain, full movement and a beautifully stable knee. It is a real triumph to the new concept and technology that we are now employing in ligament surgery and meniscal pathology.”