In December 2023, after having issues with knee pain, sixty-year-old Paul Stone from Perth became the first patient in Scotland to undergo daycase Conformis Knee Replacement surgery at Kings Park Hospital.
As someone who likes to keep himself busy, Paul was a keen rugby player before snowboarding became his main sporting activity. Living such an active lifestyle increased the wear and tear on his knees and more recently, following any physical activity, Paul was left with debilitating pain which gradually got worse over time.
“I’ve had issues with my knee before. When I was a teenager, I played rugby at a high level. Unfortunately, I picked up several injuries which resulted in my knee cartilage being removed. Problems resurfaced once I retired and started to be more active again. That's when the problems got really bad,” Mr Stone said. "Even walking a short distance became unbearable. I had severe cramping pain in my thigh and calf which was difficult to cope with. I was living in pain which contributed to my mood deteriorating. It took a toll on my wife and family and I feel sorry for them as I was pretty grumpy sometimes."
Paul decided he no longer wanted to live in pain and decided to seek specialist advice. After doing some research, he arranged to have an appointment in September 2023 with Mr Gavin Love, a Consultant Orthopaedic Surgeon and leading specialist in the groundbreaking Conformis surgical technique. Mr Love explained, “Conformis knee replacement is a bespoke treatment for osteoarthritis of the knee, which has significant advantages over a standard “off-the-shelf” knee replacement. It replaces the moving parts of the knee joints using the latest technology in scans combined with modern metal fabrication techniques to produce a replacement knee that fits each person perfectly.”
Mr Stone praised Mr Love for the time and effort that was spent during the initial consultation where they devised a treatment plan to relieve his systems.
“Mr Love was immediately friendly and reassuring. He made detailed records and was aware from my initial email to him that I had researched the Conformis technique and thought that this might be the most appropriate to my needs. He agreed and we discussed having this performed under a local anaesthetic (spinal block) and as a daycase procedure,” Mr Stone explained.
Following the initial consultation, a CT scan was arranged. This was forwarded to the manufacturer in Boston to allow production of the new custom replacement knee and patient-specific instrumentation using 3D techniques, which takes around 8 weeks. Mr Stone commented, “Mr Love and I discussed the need for careful preparation before a day-surgery approach could be a viable option. He was aware that I was a regular attendee at a gym and also had a personal trainer who had helped with my previous knee replacement recovery several years previously. With Mr Love’s encouragement, we were able to tailor my training to strengthen my leg in preparation for the operation.”
After the manufacturing process was complete, Mr Love arranged for Mr Stone to have his knee-replacement operation which was conducted on December 4, 2023. Speaking about how he was feeling ahead of surgery, Paul said, “I felt really good on the day of the operation; I was relaxed and confident in my decision. After the operation, I had no discomfort because of the local anaesthetic that had been used. The whole process from start to finish at Kings Park Hospital was first-class, I was kept up to date as things progressed. My pre-operative visits with members of the nursing staff were very easy and the nurses could not have been more friendly or reassuring. A special mention must go to the radiographer who I saw on two occasions and was simply excellent, with such a welcoming and informative approach.”
Commenting on Mr Stone, Mr Love Love said, “Paul was the ideal patient for a daycase Conformis knee replacement; he is highly motivated and had realistic expectations of what he wanted to achieve by having the operation. Conformis knee replacement is a huge leap forward in knee replacement technology. Based on a CT scan of the patient's knee, a 3D model built on this data is used to manufacture a custom-made patient-specific implant, designed to exactly match the size, shape, contours and alignment of the natural knee. The result is a significant improvement in patient satisfaction rate from 80% to 94% compared to a standard "off the shelf" knee replacement. Conformis has been available in the UK for a decade, and the latest results in the UK National Joint Registry are industry leading.”
Following the operation, Mr Stone was only kept in hospital for a few hours before being discharged to continue his recovery at home. He continues to have regular check-ups with his physiotherapist.
“My recovery has been very good, and I was able to move from my crutches to walking sticks after just a week. After another week, I was walking unaided, but carefully, and I was able to drive at three weeks. My physio was surprised by my rapid early recovery and continued to work with my trainer to maintain this momentum. It is now just over nine weeks after the operation, and although I have had a couple of brief setbacks caused by my own lack of patience, I feel a lot more comfortable than I did before the surgery. I still have to be cautious about what activities I take on, and walking downstairs can be uncomfortable.”
Asked what advice he would give to someone who is in a similar position to him, Mr Stone said, “My advice would be to have confidence in the surgeon, the hospital staff and the procedure. I would also strongly advise effective physical preparation with the guidance of a physiotherapist or appropriate trainer as I’m sure this helped with my ability to respond to the post-operative recovery requirements. It is also important to keep up this training activity, even though it takes time and effort to manage this.”
Mr Stone continues to live relatively pain-free following his treatment and is happy with the outcome of his experience. He is set to travel to the French Alps for a skiing holiday in six weeks time and is often out in the Perthshire countryside with his family. Mr Stone remarkably managed to take a four-mile walk, just five weeks after surgery.