Patient Stories & Case Studies

My Meniscal Transplant Story

I was a keen runner in my youth competing at a national level in both Athletics and Cross Country and I had never had any inkling of knee problems prior to this. I had surgery in 2019 to remove part of my meniscus on both my left and right knees however this did not solve my knee problem and I was left in some quite serious pain. After struggling with work and normal activities I decided to seek a second opinion by a local surgeon who told me I had an early arthritic knee and that I should now live a sedentary lifestyle from now forwards. He also wrote a letter to my employer to inform them that an office environment would be better suited to my knee problem. At the ripe age of 23 this was devastating prospect as I was not fit to do my job role within the Petrochemical Industry and I was struggling to even complete daily tasks.

I was not able to physically walk 100m without extreme swelling and struggled to sleep due to the agonising pain. I did not feel the local surgeons understood the torture I went through on a daily basis, just to complete basic tasks, and the excruciating pain I was experiencing as a young athlete. One thing that stands out in my mind at the time of writing this was that I was having to go downstairs backwards and sometimes sleep downstairs due to the pain and swelling in my knee. It is fair to say my prospects did not look bright at all ….

It was at this point came across Meniscaltransplant.com and I started to study the prospect of a meniscal transplant. In July 2020 I went to see the specialist at the Nuffield Warwickshire and I had never felt more supported by the whole team. After feeling like my voice was being ignored this was such a relief to have a surgeon providing numerous solutions to my knee problem which I was previously told by local surgeons was incurable. I then waited for my donor Meniscus.

My Surgery

In December 2020 I underwent meniscus transplant to my right knee and a meniscus repair to my left knee at the same time. The hospital staff at Nuffield Warwickshire were fantastic and from the from start to finish and I have never felt more supported and positive to make a recovery. I was not in a lot of pain post operation however I did have some extreme swelling in my transplanted knee which I was honestly not expecting to be so severe. I didn’t have any complications at all apart from some bruising and swelling which I raised with the Nuffield and I was phoned with reassurance. I am truly overwhelmed by the support from all the staff which played a key role in my surgery and post operative care.

After around 4 weeks I was riding a bike comfortably and at 6 weeks I was given the green light to be able to walk again. To my amazement I was completely pain free from this point onwards on my transplanted knee and with the hard work of my long-time physio Dallas at northyorkshirephysiotherapy I have managed to reach the 1 year point injury free. At 3 months I returned to work and road cycling with an average mileage of around 200-250 miles a week. I am told this is well above average recovery. At the 1-year mark I have been discharged and I am stunned by how completely normal my knee feels and I am now back to a post operative level of fitness. This includes running 10K, 70-mile bike rides, going to the gym daily and I am currently training for a Triathlon – though I recognise that is ambitious.

My Result

I was 23-year-old athlete facing the threat of possibly losing my career until I learnt about meniscal transplant. I am now a 24-year-old with a new lease of life thanks to being fortunate enough to have been given the opportunity to have this procedure. 3 years on I run 5K as fast as ever, I work on an oil rig, and so value my knee.  I would like to personally thank my physio at northyorkshirephysiotherapy and my surgeon Tim Spalding and his whole team at the Nuffield Warwickshire for giving me my life back and allowing me to continue to compete again in sports.

This is the single best decision I have ever made in my life and it is my pleasure to share these details about my massive success story.

Kaye was an active 40 year old playing competitive netball numerous times a week. She also enjoyed climbing, salsa dancing and horse-riding, until 2011 when she injured knee **SPECIFIC INJURY DETAIL** during a netball game. From the time of injury she experienced grinding and swelling and on occasions her knee would ‘lock’. Kaye had surgery on her knee in Blackburn and due to the level of damage from the injury she had a large amount of her left lateral meniscus removed.

Following her surgery in 2011 Kaye was advised to refrain from any sports and activity to prevent further ‘wear and tear’ to her already slightly damaged bone surfaces. Kaye described her feelings at this point, ‘I felt my whole life had fallen apart. As a sporty lady the prospect of walking with a stick and being struck with arthritis was an image I struggled with’.

In 2014, a work colleague suggested Kaye seek another opinion on her knee and she visited Mr Spalding in Warwickshire to discuss the possibility of meniscal transplant surgery. Kaye was keen to get back to some sort of activity and decided to go ahead with a meniscal allograft transplant. Being an active woman focussed on her own recovery, Kaye embraced a pre-operative exercise regime to build the strength in her leg muscles. The surgery went well and the rehabilitation programme commenced under guidance of specialist physiotherapists.

Kaye remembers ‘Recovery was hard, but I was surprised to find that in some ways it was better than the recovery I had after the total menisectomy. I prayed the graft would take, and I worked hard at rehabilitation. I couldn’t believe how well I was doing. At eight weeks I was full weight bearing, walking without any limp. At twelve weeks, I was cycling and gradually building up the bend in my leg.’

Twelve months on from surgery, Kaye is continuing to progress ‘I have no pain, no restriction and full range of movement.’ Highlights to date since her surgery include climbing a cliff face in Scotland, a few games of tennis, joining in on parents vs children’s rugby charity game and a walking holiday to Fife. Above all, ‘I have my knee back and can do the things I love’

What were the main problems you had with your knee before your surgery?

Before surgery I experienced a lot of pain down the left side of my leg below my knee. It would often impact me when working out at the gym and my knee would become really swollen after exercise or a lot of walking. Generally my knee would be quite painful on a day to day basis and would often catch or lock. Prior to this surgery, I had 3 separate arthroscopy procedures all completed in my local hospitals. Each time it felt like it was just getting worse. My expectations were to improve my general daily activity, be able to work out in the gym without constant pain, swelling and to reduce the amount of future surgery as this will be ongoing for myself for a number of years.

How did you find the surgery and rehabilitation process?

Initially I struggled with the TROM leg brace weighing down on my leg and I was unable to manage the stairs for a couple of weeks, because of this I moved back home with my parents as they have downstairs facilities, toilet etc. Due to the length of my surgery I was very weak and it took some time to build my strength back up, things like walking around the local supermarket on crutches were very tiring, so I couldn’t be out for long periods of time during my initial recovery period. I attended physio 2-3 times per week to help build my strength back up as quickly as possible. Another thing that I struggled with was gaining full extension (getting my leg to go fully straight). This was because as well as the Lateral Meniscal Transplant I also had a Distal Femoral Varus Osteotomy procedure which meant that I was non weight bearing for 6 weeks and during this time my leg was also locked in a leg brace at 20-90 degrees. I returned back to work after 15 weeks off still on crutches and wearing my TROM leg brace. 3 weeks later I returned to Rugby hospital to have my leg put in a straight cast for a couple of weeks to obtain full extension. This was extremely difficult on a daily basis as I was in a straight cast from the top of my thigh to my ankle, the cast would drop down and rub on the top of my foot which was very sore as the cast was sharp at the bottom. During this time I was still going to work on reduced hours. After the straight cast was removed I was given another TROM leg brace and further rehabilitation to stop my leg from springing back and losing full extension. Looking back now I wish that I had gone into the straight cast earlier before being signed back to work as I had to rely on my partner and family to take me to and from work and colleagues to help me around the building whilst I was at work. My leg is still getting stronger and I am continuing with my rehabilitation. I have also had further surgery 17 months after my Lateral Meniscal Transplant to remove the TOMOFIX locking plate that was put in during the Distal Femoral Varus Osteotomy procedure as this was catching on tendons and causing me a lot of pain because the TOMOFIX locking plate had to be put lower down than usual due to the deformity in my knee (flat on one side). When Mr Spalding removed my TOMOFIX locking plate he also did an arthroscopy to take a look at the Lateral Meniscal Transplant to see how things were looking post-surgery. Overall he was extremely pleased with how the Lateral Meniscal Transplant was sitting.

How is your knee now?

I am pleased that I have had the surgery as my day to day activity has improved and I am able to do more in the gym now than previously without any swelling. I still get some pain and discomfort at times but nowhere near as bad as it was prior to surgery. Mr Spalding and his team have been absolutely fantastic throughout the whole process from meeting them to see if I would be suitable for the operation to post operation follow ups etc. Mr Spalding and his team have made me feel confident throughout as their knowledge and expertise is incredible.

Is there anything you wish you had known prior to the surgery?

Knowing the facts and figures for the TOMOFIX locking plate failure rates. Also knowing the possibility of being put in a straight leg cast if full extension wasn’t achieved by a set timescale.

What were the main problems you had with your knee before your surgery?

Before the surgery, I suffered from constant knee pain. My knee hurt every single moment of my life, when I sat, when I walked, when I slept. It woke me up at night. I struggled to walk up the stairs; sitting on bended or crossed legs, running and jumping was impossible for me for most of my life. I struggled to walk short distances. I had to take many pain killers. I often felt sensations of grinding or cracking in my bad knee, although it hadn’t locked, it had seemed to be stiff and very unpleasant. had limped as well. I had four arthroscopies which left me with many adhesions and extra pain and discomfort.

How did you find the surgery and rehabilitation process?

The surgery was absolutely fine. Although, I was really scared of it, I went through it without any complications or unbearable pain.

The hospitalization was very quick; after the surgery I felt well, despite having a brace on my bad leg. The swelling on my knee was not as huge as I thought it will be. Soon I was shown how to operate the brace and how to move with it around.

I saw my surgeon few days after my surgery and then again few weeks later. I could contact him via email or phone. I felt safe. I did not struggle with the pain so I did not even finish my prescribed painkillers.

I had some more difficulties with rehabilitation. I wasn’t an easy patient as I had problem with rotating my bad leg. However, I had the best physiotherapist in the entire world. I was taught how to walk properly in order to release me from additional pain. This process was very slow and I was progressing slowly but surely.

How is your knee now?

At the present moment, I am pain free. I am more active. I do not feel depressed anymore because of the constant pain. I sleep well at night. I can kneel and I can cross legs. I feel more confident when I walk as my leg is stable and doesn’t bend on uneven surface. I do not need to focus on my knee any more when walking as I can rely on it. Squats, walking up and down stairs is not a problem for me. I am feeling very grateful and I would highly recommend any person to go for the meniscal transplant as you can get your life back! To me it means more activity. Although I decided not to be second Usain Bolt as I want to look after my knee in order to have the best outcome after the transplant surgery, I still can cycle, walk about, play badminton and attend he fitness classes keeping in mind to exercise gently.

Is there anything you wish you had known prior to the surgery?

I truly wish I had known how fabulous opportunity I have been given to have this surgery.

What were the main problems you had with your knee before your surgery?

Minimal cartilage left following minor surgery in 1996.
Permanent swelling and stiffness, unable to run or jump and occasional locking of the knee with significant pain.

How did you find the surgery and rehabilitation process?

I didn’t have any significant problems following the surgery itself, the pain relief was effective and I only had a couple of uncomfortable night’s sleep in the first week or so. I was able to sleep in the spare room by myself for the majority of the first few weeks of recovery, which I think was helpful and would recommend to others having the surgery if it’s feasible.
I quite enjoyed the non-weight bearing element of the recovery, watching a lot of TV series and movies rather than being at work! Although appreciate this would be more frustrating with a less supportive employer or for the self-employed. The biggest challenge in this regard was the reliance on other members of the family in preparing meals and dealing with children and the extra stress for my wife in having another dependent.
It was certainly very odd having a completely straight leg for the first few weeks post-surgery and more challenging to manoeuvre on crutches than if you’re able to bend the knee but I had no problems with the brace, which worked well.
It was harder than I thought it would be to put weight through my foot again after being non-weight bearing for so long but this was more of a mental barrier and quickly passed. Rehabilitation was inevitably somewhat frustrating but I saw gradual progress aside from a couple of falls on slippery surfaces. In terms of others having similar operations I wouldn’t underestimate how long it takes to have full 360 degree confidence/stability in the knee again, whilst it might feel fine working in straight lines up and downhill and on uneven surfaces if your foot slips it takes a long time to be able to catch yourself quickly and regain your footing. My falls were on a white line in a car park and some moss on a wooden bridge, both flat surfaces and catching me completely unaware.

How is your knee now?

Definitely glad it was done, I don’t have any pain and there is minimal swelling within the knee and without the operation my problems would only have been getting worse!
I’m avoiding running, based on the advice that it is only likely to accelerate future wear on the implant, but aside from that I can pretty much do what I want to do. Moreover, I would be confident in running linearly if I had to, the only thing that I wouldn’t be confident in is sharp changes of direction and that is probably down to a lack of practice and no requirement to do so.
The only thing that I am still conscious of on a day to day basis is going downstairs where the movement within the knee still isn’t as smooth as would be ideal. Having said that I’m still noticing improvements in that regard, along with comfort at extreme range of movements – sitting on heels for example.
I’m sure I could have been in my current position with my knee sooner, given more time in the day, and in terms of others having the operation they need to be realistic in their expectations. They are only likely to get the recovery timelines you see in professional athletes if you are able to have a full time focus on rehab and that is pretty unlikely for the majority.
In addition, my recovery after the first six months or so has also been more about the compensations you create elsewhere in your body than the knee itself, tightness in the lower back because the knee hasn’t worked quite has smoothly as the other side for a long time, changes to the way you walk etc. That inevitably takes time to correct and I’d encourage others to work hard on putting equal amounts of weight through both feet as well as working on hip and ankle mobility even before having the operation.
One final point is that I have done quite a bit of leg strength recovery on a watt bike, which has been great in the sense that you can monitor output on each leg, and I’m aware that you encourage the use of cycling as part of the rehab. The one thing that I noticed with cycling was the tension that I built up in my IT band. For the first year after my operation I didn’t actually try to reduce any stiffness that directly linked to the knee, on the basis that my body was generating a certain amount of stiffness to protect the knee whilst it recovered. However, the stiffness in my IT band is now the main thing that is preventing my knee from working as smoothly as I would ultimately like, when walking downstairs etc as noted above. I’m not sure if this is something that you’ve heard of/considered before but I mention it as it has probably been the hardest thing for me to balance as part of my recovery.

Is there anything you wish you had known prior to the surgery?

The only thing that I can think of is that I had a bit more swellingthan would have been ideal at the point that I started to weight bear again. I got rid of this quite quickly using a Game Ready and it would have been great to know about this at the outset so that I could have used it sooner. It’s not going to be for everybody because it’s reasonable expensive to rent and I think you typically do this on a monthly basis. Using it as late as I did I probably only got around 10 days of benefit from it.

Miss RB, a physiotherapist and high level volleyball player, presented with increasing problems in her left knee, having had a medial meniscal tear and ACL reconstruction at aged 16.

She subsequently presented at aged 26 with a torn right anterior cruciate ligament and had a successful reconstruction, but over the course of the next few years was held back more and more with her left knee.  Investigations revealed almost complete absence of a medial meniscus and very early degenerative changes on the x-ray.  There was no malalignment and no scope for realignment osteotomy to help the situation.  Following discussion about the pros and cons of different treatment, particularly her inability to return to volleyball due to pain and swelling, we decided to perform a medial meniscal allograft.  This procedure was performed in June 2011.

Recovery and rehabilitation were long and arduous, but she has settled down to a good level of function and returned to sport, and has since gone on to have an active life and to start a family.

PLEASE SEE A COPY OF A LETTER FROM MISS RB BELOW:

Dear Mr Wilson (Chris),

I wanted to drop you a line to thank you primarily, and to update you on my progress.

It has been 7 years now since you performed my cartilage allograft. I could only walk 1/4 mile before surgery and was looking at the prospect of starting to use a stick, I was struggling to work as a physiotherapist. After a few initial problems (I put this down to impatience and inability to know my
limits and insufficient recovery time) I have made great progress; I can now run up to 5kms with no ill effect. I can walk an unlimited distance and regularly walk 12km plus on the Pembrokeshire costal path, and I work full time as the cardio-respiratory lead physiotherapist for Hywel Dda UHB, which is at times a physically demanding job where I often walk up to 10kms a day with no ill effect.

I can play beach volleyball and can play up to 6 hours a day (although I accept it will swell and I won’t be able to walk properly without limping for up to 2 weeks after), it’s still worth it! I have been able to adopt a little boy, a thing I could never have done’with my physical limitation prior to surgery and
often carry him to nursery again I would never have been able to do this.

I wanted more than anything to convey my gratitude, to you and the donor. O a, so extremely gratefull, you have helped me get my life back, my career and add to my family. Thank you so very much I would be willing to talk to any of your patients or anyone else you saw fit to help them.

I hope you are really well.

Best regards and thank you

At the time of my injury in July 2012, I was a serving Police Officer with 26 years service and engaged on Specialist duties at the London Olympics.

During a down period, I went for a run around Hyde Park, where I unfortunately twisted my right knee. The initial feeling over the next week or so was a burning sensation in my right knee and slight stiffness but nothing that prevented me from carrying out my duties.

However, on my return home at the end of August, I had an MRI scan which revealed a tear to the meniscus of my right knee.

Two attempts using non invasive arthroscopic surgery to shave the meniscus failed to eleviate the symptoms, which had by now increased to include increased swelling and burning to the affected area, stiffness and occasional painful locking of the joint.

My mobility, including driving had been reduced quite considerably and even walking up and downstairs, was painful.

The two options I had were a knee replacement or a meniscus allograft transplant from a human donor.

With the meniscus transplant being non invasive and carried out by means of arthroscopy, I chose this option.

I had always been very active and fit, both in work and during my off duty time. Running, biking, walking, hiking and any outdoor activities were a regular part of my life.

I was then referred to Mr Chandratreya, as he was one of the few consultants in the country who performs meniscal allograft routinely. I was advised by him to engage in as much pre-op exercise to build up as much muscle in the quads, calfs, which would reduce the amount of post op rehabilitation.

Most of this was carried out in my local pool and involved lots of walking with a buoyancy waistcoat being worn, squatting in the water and lots of other recommended exercises. The non weight bearing regime certainly helped and during the dark days prior to my surgery, gave me something to focus on and also to keep my weight down too!

Post op Recovery

The procedure was conducted in January 2014 and went without any complications. Following 3 nights in Hospital, I was allowed home.

I had no significant problems, pain relief was mostly effective and was required for about 3 weeks and certainly helped on a few uncomfortable nights.

My knee brace was locked for the first 6 weeks in the straight position, with no bending, so mobility was very restricted.

Due to this, my wife and I decided that I would stay in the guest bedroom, where I could rest/recover and live at my own pace. I also had a fear that my wife or visitors would knock my knee, so this room became my sanctuary. I would also advise that the procedure and the amounts of medication that you will be taking leave you very tired, so I was able to rest/sleep at my pace and without impacting on other family members too much.

You will also be totally reliant on being provided with all your meals, refreshments, needs by family and will become a master of eating from a tray.

I was also very lucky that I had by this time retired from the Police Service, so I had no employer pressure to return to work.

Adjustment of the knee brace was made at 8 weeks, where a slight bend was introduced for my new knee, although this was still on crutches which remained with me for 12 weeks.

Rehabilitation

Please don’t underestimate how hard and slow this was.

I carried out all of the exercises that were given to me, at home for a few weeks and then in organised sessions with physiotherapists at my local hospital and swimming pool under the strict instructions of Mr. Chandratreya.

Within 10 months, I was walking, swimming, riding my mountain bike and walking up and downstairs pain free and without any swelling or other symptoms. I can run in a straight line but not turning sharply.

This procedure has given me my life back and the result has far outweighed and exceeded my expectations.

Since my successful meniscus allograft transplant, I started my own Security Consultancy and have travelled all over the world.

I’ve hiked over 2 steep sections of the Great Wall of China, painfree!

Seoul, South Korea. The ancient city walls and hiked the rain forests in Puerto Rico and hiked in Kentucky too.

I’m back working and get to travel all over the world. Hiking is my new favourite pastime.