One of our patients, Mark Abbott, explains how a severe knee injury at the age of 18 resulted in daily struggles with knee pain and mobility for the duration of his adult life. However, following a consultation with knee surgeon Mr Nev Davies last year, Mark was finally given hope that there may be a way for him to regain his quality of life.
“It was one fateful day in November 1993, when at the age of 18 my life took an unexpected turn. I was playing Rugby for my School’s first 15 team and a misjudged tackle caused my ACL to snap. Having seen my local GP the following morning, I was advised to rest for a week and let the swelling go down. After a week had gone by, I fell down a large flight of stairs at school as my leg completely gave way. Battered and bruised, my knee locked out at 90 degrees and would not move.
Two weeks later, having been operated on by a well-known orthopaedic surgeon in Swindon, I was told there was nothing further that could be done. My sport was my world, and this was a crushing blow for a fit 18-year-old, who had previously competed in athletics at national level. Since that day, I have had to learn how to manage my knee, work out what I can achieve and how best to reduce the pain and swelling.
In 1993, there was extraordinarily little available in terms of cryotherapy and I had to resort to either ice in a tea towel or a trusty old packet of peas. Ten years later in 2003, I underwent an ACL reconstruction with mosaicplasty. Again the trusty old bag of peas and iced tea towel came out to reduce the swelling and ease my pain.
By 2019, I had reached a point where my knee was beginning to adversely affect my quality of life. I was unable to run, play football with my son or walk any distance without pain and suffering. The swelling would last for days after any sort of activity. In late September I found an excellent consultant – Mr Nev Davies. Nev looked at my history and I could see by the way he was talking that he is accustomed to thinking outside of the box. He restored my faith in medicine and I was sure he would be able to improve my quality of life.
In November 2019, the first phase of my surgery began with Nev operating on my right knee to remove the screws holding my first ACL reconstruction together. A bone transplant was inserted to plug the hole that was left, and I underwent a period of rehabilitation. Prior to the Covid lockdown in March 2020, I met with Nev to discuss the next phase of my treatment plan.
MRI scans helped to show the failure of my first ACL reconstruction, resulting in my right leg going bandy. The inside section of my knee joint was wearing quickly, which was causing me all the pain and inflammation. Unless something was done, at the age of 44 I was heading for a knee replacement (sooner rather than later).
Nev’s recommendation was for me to undergo another ACL reconstruction with a high tibial osteotomy to realign my knee. During the summer on Nev’s advice, I underwent some remote physiotherapy sessions to ensure I was in as good place as possible prior to the operation. I spoke to Nev a few days before my operation to check that everything was still going ahead due to the ever changing Covid situation. During the call, Nev advised me to look at hiring a Physiolab cryotherapy machine. He advised it may assist me with reducing the swelling and inflammation of my knee following the operation. Immediately after our call ended, I ordered the unit and it arrived the following morning. The initial hire was for 4 weeks – I felt happy, confident and set to go.
The Physiolab unit arrived in a plastic crate, securely held in place with padding to prevent damage. The cost of a 4 week recovery package was £305 after discount. The cost included both delivery and collection of the unit. My initial thoughts were ‘wow, this is an amazing piece of equipment’. It is supplied with full instructions on how to use and has a range of pre-set programmes already installed, making the operation of the unit extremely easy. Simply connect the power supply and pipework as directed, and you are ready to go!
My wife ordered in 3x2kg bags of ice and between these bags and our ice making refrigerator I have so far had enough ice. I can undertake 1 x 30-minute session of cryotherapy on each leg back to back in the morning on one box of ice. I tend to undergo the second session late afternoon/early evening depending on my family life.
The Physiolab unit has a leg wrap which goes around your knee and is secured in place via extremely strong Velcro. The treatment is not uncomfortable and within 7 days of using the unit, I found that the swelling on my leg had reduced by 50%! Taking out the cost of the carriage, each 30-minute session on each leg costs me £2.50 equating to £10 a day. So far this has been money well spent.
If comparing my rehabilitation time this time around to my first ACL reconstruction, I can categorically say it has been seriously reduced because of the Physiolab machine. I had a physiotherapy appointment exactly 7 days after my operation and my knee was only 5 degrees off being fully extended. It took weeks to get to that point last time because of the swelling!
My rehabilitation stage now is at the point where I am starting to reintroduce outdoor walking into part of my daily routine. At 10 days post-op, I was able to walk for 20 minutes up a slight incline and on the flat. When I arrived home, I did have some discomfort around my knee, but I immediately applied the Physiolab and this helped to soothe the joint and reduce any discomfort.
At 12 days post-op, I woke for the first time with minimal pain in my leg. The healing process was well on its way. I also saw Nev, who was pleased to see the swelling had reduced. He reiterated that my operation was a success and the x-rays confirmed this. Having observed the swelling reduction in the days beforehand, it was clear to see that muscle definition was slowly returning to my leg. In the afternoon, I went for another walk and adopted the correct walking technique Nev advised me to use. Straight away I doubled the distance I had walked on Saturday and my knee felt settled. Upon returning home I commenced my second cryotherapy session of the day to help the healing process.
On day 14 (two weeks post op), I had another physio appointment. My knee was able to reach zero degrees when straight and 115 degrees when bent. This meant I was able to complete phase 1 of the physio rehab. The only thing stopping me was slight swelling to the knee joint where the high tibial osteotomy is. By this stage, I had managed to reduce my codeine consumption by 50%, as the Physiolab helped me to with reducing any swelling and discomfort in the joint after exercising.
By day 15, it was time for me to to remove my plasters and inspect the damage. My first impression was that of amazement. Despite the enormity of the operation I had, the incision marks were small and neat. Over time I am sure these will disappear. I was pleased to see that Nev was able to operate using the original incision from my first ACL operation. Below are some photos of my left leg where the hamstring ligaments were harvested from and below that picture are two photos of my right leg – ACL/High tibial osteotomy.”
Left leg (where hamstring ligaments were harvested from)
Right leg (where the ACL/HTO was performed)
We’re excited to follow Mark’s progress as he continues his rehab in the critical few weeks following surgery. If you think Physiolab could assist your patients with their post-surgical recovery, please contact us today.