High tibial osteotomy (HTO) enables skier to enjoy life after an accident on the slopes

James damaged his knee in a skiing accident and needed a quick recovery to allow him to do his job and get back to his extreme sports

James Hobbs, who is in his late 20s, had a nasty ‘wipeout’ while skiing in Whistler and damaged his knee.

He tore his ACL and damaged the meniscus and the joint surface so Adrian performed an ACL reconstruction and stabilised the knee.

Adrian said: “However there was still clear, significant damage to the joint surface and meniscus. I did a chondroplasty to smooth off the damaged areas to the joint surfaces and a meniscal repair but sadly James continued to develop further pain.”

James had a consultation with Adrian and they discussed his treatment options. It was agreed Adrian would give James an injection to help with the pain and that his condition would be reviewed in six months.

However after six weeks the pain had increased significantly. James was unable to complete a day at work without pain killers and couldn’t take part in any of his hobbies including snowboarding and mountain biking.

Adrian said: “I knew James always felt very stable but he really began to struggle. He had a very physical job, and we tried injections and bracing, but it got to the point where the pain was so significant that he felt he wanted to do something more.”

James and Adrian agreed the best of course of action was a high tibial osteotomy (HTO) which took place in September 2017.

Following his research and the discussions with Adrian, James was expecting a painful recovery. However he woke up after surgery in some pain but this was addressed quickly and a few hours later he woke up in his patient room, pain-free and comfortable.

On Adrian’s recommendation, James rented a Game Ready for a month. A Game Ready is a cold therapy and intermittent compression system which James put on immediately after surgery.

He said: “Unless I was doing physiotherapy it was attached to my left leg for the whole month post op, and I believe it helped with swelling as I had virtually none. I didn’t need the higher level of pain relief and was able to stop all pain relief five days post-op.”

Adrian said that it was interesting that James had no pain – only some slight discomfort when he woke up in recovery.

He said: “James just took regular painkillers as I suggested, but required very little in those initial few days and only took relief for 5 days and then stopped altogether. When I saw him two weeks after surgery he had no swelling, no pain.”

James advised people who are considering an HTO ‘to go for it’ as it is not as scary as information on the internet can make it seem.

He said: “Trust an experienced surgeon like Prof Wilson and have physiotherapy before the op if possible, as I believe this helped me a lot. At 6 weeks post-op I could complete 30 straight leg raises with no pain whereas pre-op I could only manage 15, due to the pain.”

Nov 2017


Adrian sees patients in London, Hampshire and Windsor.

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