Back in January, I received a call. It was the surgeon’s secretary, ‘We have a match for you.’ A donor cartilage had finally been found. I’d been on the register for around 18 months, and was one of the last patients on the trial to find a suitable replacement. I was relieved.
I don’t know who my donor was. When I was initially told I had a match, I’d like to say that it didn’t seem right to ask, but in all honesty, it didn’t occur to me to ask. I imagined that it would be kept confidential, that it wasn’t something that you were told. When friends asked me about the identity of the donor, I felt callous for not knowing. I gave them the spiel from the hospital instead. Similar to donor organs, there is a window in which the cartilage had to be transplanted as it can only be put on ice for a few months. This is due to the fact it requires a limited blood supply. That’s all I knew.
My operation was scheduled towards the end of April, so I had time to strengthen up and wrap up things at work as best I could. As the countdown continued, I found myself trying to make the most of my two legs. This would be my fourth operation on this knee in ten years – I knew what I had waiting in store, and began dreading being on crutches again.
Everyone I spoke to said that it’d be worth it in the end. I repeated this too, but I needed some convincing. One defining moment came when I answered the trial questionnaire. It was full of questions about how my injury impacted my daily life, such as how I managed stairs, rising from kneeling down, and if I struggled getting out of the bath. The one that threw me was a list of physical activity where I had to choose my physical maximum. I was forced to select light housework, as I had been advised to stop running five years before. How had I allowed my quality of life to diminish so substantially? Popping Ibuprofen pills with breakfast was part of my morning routine.
When I first entered this medical trial, I was randomly placed on the non-surgical side and received extensive physiotherapy instead. Trips to Coventry University Hospital every three months became the norm, with MRI scans lasting over forty minutes at a time. The sterile white chamber, chilled and solitary, filled my head with drilling beeps. The machine scanned my knee with lasers that I had to fight the urge to look at. The scans monitored the deterioration of my bone surfaces which had ground themselves together in the absence of a shock absorber. On the bright side, they also measured me up for a suitable replacement piece of cartilage. Over the course of the year, I realised that surgery was my only option to return to my normal lifestyle and not face each day on painkillers.
It had been a long search for a match, and my twin sister had generously offered me hers. It was a noble gesture, but ultimately it wouldn’t have helped as she’d have to go on the list instead. We all need our cartilage to prevent more damage, and a full knee replacement is usually reserved for those who’ve hit fifty. What hadn’t quite sunken in at this point is that the donor would need to be deceased, and that they would also likely be young and a similar size to me.
I had to remind myself that just five years ago, when my remaining meniscal cartilage was removed, another surgeon had told me that my knee resembled that of an 80 year old. Arthritis-ridden at 22 years old hardly seemed fair, especially as I’d been fundraising all year and was due to lead a challenge group to Machu Picchu a few months later. I gritted my teeth, and tanked up on co-codamol to complete my trek.
At the time, cartilage replacement was not an option readily available on the NHS, so I was signed off the books once the torn cartilage was snipped out. Today, there are a few options: bovine (cow-sourced), artificial or in vitro (harvested in a laboratory), or a human meniscal transplant. The latter is the option that I was offered, and this was a procedure pioneered by my new surgeon.
The operation itself was a success (read about my post-surgery recovery here), and I’m heading back down to Coventry tomorrow to see the team. I’ll find out if the allograft is settling in and whether the transplant has been a success. Around a third of patients require a follow up operation, and I’m hoping I’m one of the lucky ones. My left knee has gone sideways, and knock-kneed sufferers often have to undergo further surgery, but I’m determined to get my muscles trained to pull it all back in line if I can. I want to get on with my life and not be tied down to this injury any longer.
I know how fortunate I am to be eligible for free healthcare on the NHS, and for participating in the trial. It’s given me a shot at recovering and undoing all the damage sustained from my hockey accident at 17 years old. Most of all, I want to thank the donor for my second chance. I promise to recycle all my bits and bobs when the time comes to give others the same opportunity.
If you’re in the UK, it takes just 2mins to register to donate here.
Information about my operation: http://www.timspalding.com/images/pdf/Meniscal-Transplantation-Overview%202015.pdf
Pictures taken 4 weeks post-surgery.