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  • Michelle Middleton Case Study

    My Knee Surgery

    Michelle Middleton
    Treated by: Jon Smith
    Procedure: BioPoly partial knee resurfacing

    “I was pain-free virtually straight away.”

    No patient – and no knee surgeon – contemplates knee surgery frivolously. It’s always a sober decision, made after all other options have been exhausted, when knee pain becomes pronounced. Yet few patients can have had such a long journey towards successful knee surgery as Michelle Middleton.

    Around 11 years ago, Michelle found her knee was repeatedly giving way. “I went to the GP because I felt like the town drunk,” she describes.

    The initial diagnosis was a twisted patella. Things worsened and a cartilage tear was identified. Only after an op to repair the cartilage was Michelle informed by her then-surgeon that, on opening up the knee, he had found there wasn’t any cartilage to repair.

    Michelle worked in a nursery. Being on her knees was part of the job, and doing the job was becoming ever more painful. Her employers were becoming frustrated with the time off she needed and, just to compound issues, Michelle’s young family were sporty and she couldn’t join in any of their activities.

    Clinical cul-de-sac

    Hope came in the form of a new clinical trial and Michelle was referred onto the scheme.

    “I went to Warrington for microfracture surgery, which involved drilling small holes in the bone,” she explains. “I went on holiday later that year when something popped in the knee. I spoke to the trial team on my return and they said ‘well, sorry, but you’ll need another op’.”

    “I returned for another microfracture procedure, but whilst I was in recovery the trial surgeon wrote to me to explain that new research had shown the procedure to be ineffective.”

    By 2011 Michelle was desperate. “I was in agony and I wasn’t sleeping. I’d had to give up working in the nursery and had switched jobs to a high school. By the end of the week I was a barely functioning zombie. Driving was becoming harder and I needed help from family to get around.”

    Now transferred back across the Pennines, she was offered a cartilage transplant but the effect was minimal. Still in her 30s, she was considered too young for a knee replacement, because replacements (of the time) were expected to last only around a decade – and that would have meant multiple replacements throughout the rest of her life.

    Since 2011, Michelle had been left to manage things “as best as I can”, heavily reliant on high strength painkillers.

    The BioPoly implant

    One night in February 2016, things came to a head. “I got out of bed and faceplanted completely as I’d lost all sensation in my right leg.” Michelle’s GP sent for an MRI scan, which identified disc degeneration in the spine, a result of years spent overcompensating for her knee.

    “At this point I had already been referred to Mr Smith,” Michelle recalls, “and when the issue with my back arose he suggested proceeding with the BioPoly implant.”

    The BioPoly implant is an innovative device aimed at preserving joints and restoring function in young adults. It uses a naturally occurring biomolecule found in joint fluid to enable the bones of the leg to glide together at the knee joint, rather than grind. Michelle had the operation on the NHS in April 2017.

    “Of all the (many) operations I’ve had, this was the best”

    “I went in on the Wednesday. I had the op around midday, under a general anaesthetic, and was in for 30 or 40 minutes. I was taken back up to the ward afterwards and Mr Smith came to see me within a couple of hours.

    “’Right, get up!’” he said, smiling. And I just said, ‘ok then’. I was straight onto crutches, bearing weight on my foot almost immediately. In fact I walked myself down to x-ray before I was discharged a day after my op.

    “It was uncomfortable for the first couple of nights – but after that there just wasn’t any pain at all. And all that medication I’d been on – I just stopped overnight. It was like solving a jigsaw puzzle. Mr Smith was the one who finally found the missing piece.

    “Don’t get me wrong, I won’t be doing any marathons, but the fact I went from being in a lot of pain to no pain was such a bonus. I was pain free virtually straight away, and quickly able to do things I hadn’t done for years.

    “I wish it had been done earlier”

    It has been a very long and painful road for Michelle, and the years of delay have had consequences: “Today my back remains an issue, and I do get occasional aches in the knee, but if the pain I had for years was a 10+ this is a 2 or 3 at most.”

    So would she recommend Jon Smith?

    “100% yes! It’s his overall care. I went back for my one year check-up and I said ‘my knee’s brilliant but my back’s sore’ and he was straight on the dictaphone. I did my rehabilitation at Dewsbury with his physiotherapy team and he referred me back to the team for my back straightaway – and that’s not his area! He didn’t have to do that.

    “His aftercare, even now, long after the op, is fantastic.”

    To speak to Jon Smith, or our team about your knee consultation, please contact us.