Archives: Testimonials

I had a meniscal transplant operation last May by Mr Ian McDermott and I cannot thank Mr McDermott enough.

Many years ago I had my cartilage removed in my left knee and over the years with bone on bone rubbing against each other it left me in pain with restrictive movement so I had had micro fracturing which had been successful for four years. However with the life expectancy of this operation up I endured many months of not being able to sleep due to the constant pain in my knee which was not relieved by pain killers. My cycling had to stop and I had even got to the stage of only being able to walk very short distances (less than half a mile) before I would have to sit down in agony.

Sharon’s medial compartment of her knee, with a completely missing (previously excised elsewhere) medial meniscus, and with progressive articular cartilage damage developing (early degeneration / arthritis)

The excruciating pain in my knee has now gone and the only pain I get is a stinging sensation from time to time which does not cause me any issues.

Sharon’s medial compartment at the end of the meniscal transplantation procedure, with a new medial meniscus inserted in the knee.

I would thoroughly recommend this operation to anyone and the best advice I could give is be patient. I was told the recovery was a good nine months and this was the case but I have gone from not being able to sleep due to constant pain to being virtually pain free and able to walk on a daily basis along with cycling three times a week, something I would never have been able to do 18 months ago.

Having had an ACL reconstruction on my left knee 9 years ago, I encountered further problems when my knee began to give way, causing damage to my meniscus. My ACL graft had stretched and was no longer functioning. Consequently, during a physio session, my knee gave way causing a bucket handle tear in my meniscus, resulting in surgery to remove it.

I understood I had three options:

1. Do nothing and risk early onset arthritis, further wear to my joints as a result of the lack of meniscus, and continuous instability due to my lack of functioning ACL;
2. ACL reconstruction using a donor tendon;
3. ACL reconstruction and meniscus allograft from a donor.

The latter option with the meniscus allograft was a daunting prospect. Ian McDermott was recommended to me by another orthopaedic surgeon.

I visited Ian to discuss my options, the different procedures and likely future outcomes. Ian is incredibly knowledgeable, and his understanding of emerging medical practices was evident. What struck me the most was how far medicine has evolved since my first ACL reconstruction in 2006.

Ian’s explanation of the procedure involved with the meniscal allograft and the subsequent restrictions on my sporting lifestyle were detailed yet straight-talking. I was left under no illusion that the meniscal allograft would be a painful process, with a long recovery period and I would need to be absolutely serious about my physio following the operation. Most concerning for me was the ban on sport, particularly as I sail competitively most weekends. Another major concern was the length of the immediate recovery period, with no or very little weight bearing, and a requirement to have my leg elevated most of the time.

Ian was happy to answer any of my questions, and he took the time to explain every aspect of the procedure, using language I could understand. His diagrams were especially useful, to help me to ecognize the process.

After some serious deliberation, debates, indecision (and some differences of opinion!) with family, I chose to proceed with the ACL reconstruction and meniscal allograft, undertaken in a single operation. My decision was based largely on the likelihood of further damage to my joints if I did not proceed.

The operation went well and the procedure and recovery were far better than I had expected. Ian had prepared me for the worst, but the pain levels were manageable throughout; the nerve block and morphine masked a lot of the initial pain. I felt very nauseous following the operation, but this soon subsided and I stayed in hospital for two nights, which felt reassuring given the extent of the surgery. Once out of hospital, I was on tramadol for a while, which made me feel pretty awful, so I ditched that as quickly as possible.

The recovery, although tedious and restrictive, was bearable, and was easier than I had anticipated. The range of motion in my knee brace was adjusted by Ian every time I saw him, to ensure that my new meniscus had time to heal. Netflix certainly helped the boredom during the initial couple of months, and I had a Game Ready ice machine which assisted in the reduction of any swelling.

Ian recommended a fantastic physio, who I trust implicitly, and with both of their continued support, I have made significant progress. My physio even watched the surgery, so that she fully understood the procedure. This was important to me, given the small number of meniscal allografts undertaken in this country to date.

Now, one year on, I am swimming front crawl, going to the gym 2-3 times a week and I’ve even just been walking in the mountains in Scotland. I hope to get back into pilates within the next month, too. I miss the sailing, skiing, surfing and other adventurous sports, but I had come to the ecognize n that I wouldn’t be able to participate in them anyway, given the state of my knee.

I ecognize there’s still a long way to go to build up my strength, and my knee will never be ‘better’ but I am very glad I’ve had the surgery and can carry out my day-to-day life without the constant instability in my knee that I had before.

I would highly recommend Ian to anybody contemplating knee surgery. His professionalism, attention to detail and knowledge (and experience) of current medical research gave me the confidence to go ahead.

Louise Ayling August 2015

While I was living in London to pursue a Master’s degree at the London School of Economics & Political Science, I found Ian at the 31 Old Broad Street practice. My knee had been bothering me quite a bit in the weeks prior and I was feeling increasingly concerned about its state. Over the two and a half year period before moving to London I had undergone five knee operations in Singapore: two medial meniscus repairs, two partial meniscectomies, and one ACL reconstruction. The initial injury was caused during a minor motorbike accident in Bali where I resided at the time. The subsequent injuries were all somewhat random, minor, unlucky incidents. I was fairly convinced that I had a strange affinity for medial meniscus problems, especially since I’d had three medial meniscus operations on my other knee when I was younger (due to football injuries).

Upon arrival at 31 Old Broad Street I felt at ease: the receptionists were friendly and warm, and I was immediately brought back to Ian’s office. During our initial visit I explained my somewhat long and complicated history while Ian listened and took copious notes. After examining the knee he decided that the next step would be to have an MRI to gain further clarity on the state of my knee. I scheduled the MRI for a few days later and returned to see Ian later that same day. The MRI confirmed Ian’s suspicion that I no longer had any functional medial meniscus left. Upon hearing this I assumed he would immediately recommend a meniscal allograft transplantation. His approach, however, was much more grounded in educating me on meniscal allograft transplantations than on convincing me as to why I needed one. While I exhibited the characteristics of a “good candidate,” he was very clear that the decision to pursue the path had to come from me: due to the long recovery time and physiotherapy commitment required it is not a decision to take lightly. He was also very balanced in his review of the advantages and limitations of the operation: certainly having a meniscus is better than not having one at all, but the cadaver meniscus would never be as strong as my original had been, and I would have to accept and acknowledge this as I engaged in physical activity moving forward. I found his approach, driven by thoughtful and clear education, refreshing. Ultimately I decided that I could commit to the lengthy recovery process in hopes that my knee pain would decline and that I would avoid future arthritis.

Ian and his team worked diligently to coordinate with the tissue bank in the U.S., my insurance company, and the London Bridge Hospital. It was impossible to predict with certainty as to when a tissue match would be secured, but Ian and his team kept me informed and as soon as a tissue was found they confirmed the operation day and time.

When I arrived at the hospital and checked in, Ian visited my room to go over the specifics of the procedure one more time. Again I sincerely appreciated that he took the time to thoughtfully explain everything and answer questions. The anesthesiologist also came by to review the procedure and post-op pain management regimen. Before I knew it the operation was over and I was back in my hospital room with a knee brace on. Everything had gone well and I was now able to relax, watch movies, and surf the internet while recovering at the hospital overnight.

Once back at my flat I spent the first week resting and recuperating. The swelling and pain levels were helped by my frequent use of the Game Ready machine, yet another one of Ian’s fabulous recommendations.

Walking with crutches (non-weight-bearing) for six weeks was certainly not easy, but I managed to get around London just fine. I saw Ian two weeks post-op and he was very pleased with my low level of swelling (thanks, Game Ready!) and minimal muscle atrophy. At the six week follow-up he adjusted my knee brace to allow for further range-of-motion and recommended a timeline for increasing weight- bearing and reducing my use of crutches. He also put me in touch with a nearby physiotherapist. The physiotherapist, Robert Kavanagh, was absolutely superb and I worked with him 2-3 times per week for several months. The combination of Rob’s encouragement and advice, coupled with Ian’s ongoing support via email were great and exactly what I needed to ensure a slow but steady and successful recovery. It wasn’t always easy: getting the range of motion back and beginning to build up muscle mass in my leg was difficult and at times quite

painful. But I listed to Rob and Ian and wholeheartedly trusted them to provide sound advice and care. I also did my best to be patient and to accept that seeing results takes time. At Ian’s suggestion, I rented a Kneehab XP to assist in my quadriceps strengthening, and I found it to be a good complement to my ongoing physiotherapy exercises. At my three-month post-op appointment, Ian was complementary of my impressive progress. I continued with physiotherapy though completed most of it on my own. By the five-month point I was walking and hiking with minimal to no pain.

Hiking in Greece 5 months after the operation.