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  • John Simpson Case Study

    My Knee Surgery

    John Simpson
    Treated by: Nick London
    Procedure: Partial meniscectomy and chondroplasty

    “Nick… has saved my triathlete career”

    We were delighted to hear from John, who got back in touch a couple of years after his last operation to tell us that he has since become English triathlon champion in his age group, and competed at the European and World Championships.

    Discovering triathlons

    John Simpson has always been active. He was a keen squash player until he turned 50, when an injury nudged him towards running. Over the following decade or so he built up his capabilities to the point where he could compete in 10Ks and then marathons. A further injury led him to his local swimming pool, where he decided it was time to build up his front crawl skills.

    Once fully recovered from his injury, he realised he was two thirds of the way through the disciplines required for a triathlon, and he completed his first one 5 or 6 years ago.

    Meniscal tears

    John, a member of Wetherby Runners and Triathletes, and of T3, the Tadcaster triathlon group, has weathered his fair share of injuries. His first meniscal tear happened in 2011, although quite what caused it is now a distant memory.

    Yorkshire Knee Clinic’s Prof. Nick London carried out the partial meniscectomy (removal of the torn part of the meniscus) via arthroscopy (keyhole knee surgery) in the November/December. “I started to train about six weeks later, in the New Year,” recalls John. “I did the London Marathon that spring. The following year I did the marathon again in my best ever time. I was expecting to be declining by then but I was getting faster!”

    John remained symptom-free for the best part of the following five years, by which time he had progressed to full standard distance triathlons and a half iron man event, but in 2016, John was competing at the Sundowner Triathlon at Allerthorpe Lakeland Park – and later lifeguarding a 10k open water swim at the Blue Lagoon in Womersley – when he injured the knee again.

    “I had done a half iron man event, then the following weekend I spent three hours on a paddleboard, lifeguarding. I think the combination of such an intense event followed by the unnatural stresses (for such a long time) on the board caused another tear.”

    John gave the injury a few weeks of rest in the hope it would heal, but it didn’t. “The injury meant I couldn’t run properly. There was tightness at the front and back of the knee. After two or three miles it would feel very restrictive.”

    John returned to see Nick, but a repeat knee arthroscopy was not a foregone conclusion. The procedure is ineffective as a treatment for osteoarthritis so is unlikely to be approved where severe wear is present, and is performed rarely in older patients.

    As Nick notes: “We sometime get criticism for performing arthroscopic surgery for meniscal tears in older patients but with the correct indication and in the absence of severe wear (OA) we usually achieve excellent outcomes.”

    In John’s case, Nick identified that the issue was a meniscal tear and, as he noted at the time “a tear’s a tear whether you’re 20 or 60”. AXA, John’s insurer, agreed and funded the treatment – a second partial meniscectomy and chondroplasty – at the Duchy Hospital in Harrogate.

       > Discover more about meniscal cartilage tears

    “It was absolutely brilliant service,” John says. “I was in theatre for maybe 40 minutes. I came out with a big bandage on, but after about 6 hours the bandage was off and there were just a couple of plasters. I was walking around freely within a day. I didn’t take any painkillers, not even a paracetamol.”

    Back up to speed

    Within a week, John was back on the bike. “I wasn’t allowed to run for six weeks but I could do physio work and take it easy on the bike. The great thing for me was that there wasn’t time to lose muscle mass, so I didn’t feel as though I was starting from scratch.”

    John saw Nick a few weeks after the op, who advised against any high impact activity for six weeks, before gradually building back up to competition levels. Since returning to full fitness, John hasn’t looked back.

    “I’ve gone from local competitions to international and I became English national champion,” he explains. Although John had already qualified for the European Triathlon Championships before his operation, his recovery enabled him to compete in Kitzbühel, where he finished 19th in his age group. A year later, with a full year of competition under his belt, he finished 8th in Estonia.

    In 2018, John was on Australia’s Gold Coast for the World Championships and next he’s back at the Europeans (in the Netherlands) and the Worlds (in Switzerland).

    Career saver

    John is hugely grateful to AXA Insurance for saying yes to funding the procedure and to Nick for “putting himself on the line a little by pressing for this op. I just wanted to thank him, because once you have a knee replacement you can’t run and that would have killed my career completely. Nick approving the op has saved my triathlete career.

    “Nick gets sportspeople. He understands that sport isn’t incidental. You’re putting a lot of time and effort into it and success is important to you – and he wants to support that success.

    “You don’t feel as if he’s going to treat you like a pensioner and that’s something that’s true of everyone at Yorkshire Knee Clinic. They have a reputation for treating sports injuries (although I imagine few of their sports patients will be in their 60s) and they’ve made a huge difference to me.”

    “I just want to say thank you. I don’t know how long I will be able to keep training and competing at this level but without Nick’s help I would not have been able to represent my country in age group competitions which has been a fantastic experience.”

    To speak to Prof. Nick London about your sporting knee pain, please contact us.

       > Discover more about Knee arthroscopy (keyhole surgery)