• Mr Benjamin Nelki
• Miss Emma Gibson

Mr Benjamin Nelki - Anterior Cruciate Ligament Reconstruction

Ben is a recruitment consultant aged twenty five and is a competitive soccer player. In 1997, Ben was referred by his father, a general practitioner, following an acute injury to his right knee. An MRI scan was arranged which revealed the anterior cruciate ligament to be ruptured. Ben therefore underwent an arthroscopy and anterior cruciate ligament reconstruction.

When reviewed by Mr Johnson six months following surgery Ben had a full range of pain free motion, he had no symptoms and had returned to cycling and jogging. He was advised to return to competitive soccer following a further three months of rehabilitation which he successfully did.

Ben was referred to Mr Johnson on a second occasion in March 2003 having injured his right knee again whilst playing competitive soccer. He presented to Mr Johnson complaining of pain, tenderness and swelling in the knee and appeared to have a torn medial meniscus. An MRI scan confirmed this and Ben underwent an arthroscopy and repair of the medial meniscus of the right knee in May 2003.

Three months later at a final review clinical examination showed that the knee was entirely stable and there was no tenderness around the knee or site of meniscal repair. He was advised to continue with his exercises such as jogging and cycling and to return to normal competitive soccer in six weeks.

Mr Nelki said "Taking part in any sport before the operation was impossible as the knee gave me a lot of pain. The operation itself was straightforward and I was able to return to my previous level of activity relatively quickly. The ligament operation and subsequent cartilage operation have given me the confidence to continue with sport at a competitive level and I have had no further problems."

Mr Johnson comments:

"Ben represents the success which can be gained from specialized techniques in knee surgery. Initially an arthroscopic reconstruction of the anterior cruciate ligament was undertaken. This was a complete success allowing Ben to return to competitive soccer. In fact when he had a further injury this did not affect the ACL ligament graft or stability of the knee at all. The meniscus tear was able to be repaired rather than removed, using specialized instrumentation this was undertaken arthroscopically or by a "key hole" technique. Repairing a meniscus tear is an advantage as it helps to stabilize the knee and prevent degeneration and arthritis which might otherwise develop over the course of time."

Miss Emma Gibson - Anterior Cruciate Ligament Reconstruction

Miss Emma Gibson is a thirty eight year old horsewoman. Emma was initially referred to Mr Johnson in February 2000 by her physiotherapist in Wells having fallen from a horse six months previously and had been suffering from intermittent pain, swelling and significant instability in the left knee.

An MRI scan was arranged which revealed a tear of the medial meniscus and underlying anterior cruciate ligament rupture. Emma is a competitive horse rider and the season was due to commence therefore Mr Johnson initially advised a simple arthroscopy and meniscectomy and delayed the arrangements for an anterior cruciate ligament reconstruction to take place after the end of the competitive season.

Emma underwent an arthroscopy and meniscectomy of her left knee in March 2000. When reviewed in clinic by Mr Johnson three weeks following surgery she had made excellent progress, she had a full range of motion, there was a minimal effusion and she had returned to horse riding. However as was predicted she noticed some instability of the knee.

Emma returned to see Mr Johnson in October 2001 having recently tripped and experienced a further instability episode. An arthroscopic anterior cruciate ligament reconstruction, medial meniscectomy and chondroplasty was undertaken in November 2001. The anterior cruciate ligament tear was reconstructed with an arthroscopic patella tendon technique. Arthroscopy did reveal some significant damage to the articular surface of the knee. Mr Johnson informed Emma that at a later date she would require an osteochondral transplantation to reconstruct the damaged articular surface and prevent osteoarthritis.

Emma returned to riding six weeks after surgery and to competitions after three months. She was kept under regular review by Mr Johnson. When seen in July 2002 the anterior cruciate ligament reconstruction was intact and the knee was stable and the osteochondral transplanted area appeared satisfactory. By this stage Emma had returned to full competitive horse riding and had been successful in qualifying for the Horse of the Year show.

Emma was reviewed by Mr Johnson in January 2003 a year following anterior cruciate ligament reconstruction and osteochondral transplantation. She had an excellent year competing on her three horses and had won several competitions. She was complaining of continuing symptoms of pain and crepitus in the knee when riding with the knee flexed. Mr Johnson therefore advised an arthroscopy and debridement of the left knee to check on the integrity of the articular surface and this took place in February 2003. The arthroscopy confirmed patello-femoral chondromalacia as the cause of the continuing anterior knee pain.

Emma attended for a final review in February 2003. She was doing well and reported that she had returned to competitive eventing.

How to arrange an appointment with Mr. Johnson

Your first appointment is usually arranged with Mr Johnson at the Bristol Nuffield Hospital at St Mary's. It is a modern well-equipped hospital with 36 private bedrooms and two operating theatres, and offers a full range of services.

+ How to arrange your first appointment

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