A high tibial osteotomy performed by Professor Adrian Wilson successfully realigns Charlotte’s right knee.

As a result of an old ligament injury, Charlotte needed a solution to realign her right knee. A high tibial osteotomy provided the answer.

Following a serious skiing injury, Charlotte was treated by a colleague of Professor Wilson’s, undergoing an exploration and repair of the lateral/posterolateral (outer/rear outer) corner of her right knee, which on that occasion was not successful. She continued to have significant instability in her knee.

Early in 2018, when examining Charlotte, Professor Wilson found that she was displaying considerable looseness on the lateral (outer) side of her right knee as a result of her previous lateral collateral ligament (LCL) injury – the LCL is the thin band of tissue running along the outside of the knee, which connects the thighbone to the lower leg. The posterolateral (outside rear) corner passed the Dial Test (rotating and flexing), and the anterior cruciate ligament (ACL), medial collateral ligament (MCL) and posterior cruciate ligament (PCL) were all fine too. There was minimal deformation of the knee, but she was noticeably bow-legged. After discussion with Charlotte, Professor Wilson decided the best solution was an osteotomy, a procedure which involves inserting a bone wedge to realign the knee.

Before proceeding, Professor Wilson performed a brief tidy-up arthroscopy (keyhole surgery). The osteotomy went smoothly with Professor Wilson successfully inserting the femoral head allograft bone wedge into the knee.

Four weeks after the operation, Professor Wilson reviewed Charlotte. As a result of overdoing her physio a little – she was doing two hours a day – she had suffered a little discomfort in her knee, but after taking it easy for a few days this improved. She now had a beautifully straight leg; an excellent bend and her x-rays were all positive. With the healing process going well, Professor Wilson told Charlotte that he would be able to remove fixing plate sooner than expected.

The osteotomy has now completely healed, and Charlotte is back to a very high level of activity. Before her surgery, she had been struggling with simple activities such as walking, but now she is rollerblading and ice-skating to a good standard and is absolutely delighted with the outcome of her surgery, as is Professor Wilson.

Charlotte says: “My treatment has been outstanding all round and I’m extremely grateful to the whole team involved. It goes without saying that I am extremely grateful to Professor Wilson for all his hard work and I’m very glad that he recommended we stay locally for two weeks to access the excellent after care and expertise on offer. Without exception, all those I spoke to had nothing but very high praise for Professor Wilson, post-surgery, in some cases truly life changing; as with the lovely lady from South Africa who’d been through three osteotomies  and had a lot of pre-op pain until he rescued her after the first one failed but who now intends to play squash again and is pain-free – very inspiring to hear. Equally uplifting was the rugby player I met who told me he’s back on the field now and it’s feeling even stronger than his non-op leg now.”

February 2019


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