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'Surgeons grew me a new knee'

By Cathy Terrell for CNN

Cathy Terrell: "I'm able to teach sports like I did before. It feels fantastic."




Medical research
Technology (general)

(CNN) -- British sports teacher Cathy Terrell's crippling leg injury nearly ruined her career until a pioneering surgical technique allowed scientists to "grow" a new knee joint. This is her story:

My knee was first injured when I was 17, on a school ski trip. I was on a drag lift when someone got stuck in front of me. They didn't stop the lift so I swerved to avoid the fallen person and my skis got stuck in deep snow. I got pulled over the top of my boots and the only thing that could give way was my knee, which it did.

It was excruciatingly painful and put me in plaster for a few months. But even after the cast came off, the problem got progressively worse and my kneecap would dislocate at the drop of a hat.

Because I have had 32 dislocations over 20 years, my cartilage -- which is the knee's shock absorber -- has been worn away. Effectively my kneecap was bone rubbing on bone.

Doctors tried all sorts to stop it dislocating and I had eight operations. I had two screws put in my shin and surgeons redirected some ligaments so that my patella (kneecap) was pulled in a slightly different direction.

That stopped the dislocation, but because my cartilage had already worn away, I would ultimately have had to have a complete knee replacement.

This presented problems with my work as a physical education teacher. I had to give up playing hockey and basketball. I teach geography as well, but only a little bit and I was getting to the stage where I was thinking I'd have to go into the classroom full-time and give up the P.E., which I would have hated doing.

So I looked on the Internet and discovered some research in Sweden on this new operation -- a chondrocyte implant. My surgeon put me in touch with someone at Nottingham's City Hospital who was about to start a trial into the new procedure.

According to the research I read, the success rate of the operation was 83 percent. An 83 percent chance of teaching P.E. again was worth it.

The first operation is a minor one. They go through a keyhole and take out some healthy cartilage from where it is not going to be missed. They also take 100 milliliters of blood and send it off to a lab in Sweden.

Within a suspension of your own blood they grow new cartilage cells. They get sent a few cells and they send back millions on what is called a matrix -- fine webbing.

The growing can take anything from four to six weeks depending on how many cells the patient needs. Mine took five weeks as I had two sites. One of them quite unusual because it was right at the top of the kneecap. There was one big hole of about two centimeters and a smaller one.

When the new cells were delivered in February 2004 I had the next operation. They opened up the whole knee, dislocated the kneecap and attached the matrix webbing with what is essentially glue. Then they put me back together.

For the next 10 days I was in a splint. This was the most excruciating time and you can't do anything because you have to wait for the implant to attach itself and start growing. You have to be very, very careful and in fact you can't do any high impact exercise for 12 months.

I had four months of physio, mostly in a hydrotherapy pool. It was quite frustrating as they have to keep reining you in; you start to feel better and you think it's okay, but you can't do anything that will cause the kneecap to move too violently because it would disrupt the implant.

After four months I was back to work. I was restricted in what I could do, but it felt fine. In fact it had never been better.

Because I'd had eight previous surgeries, the doctors said it was never going to be perfect, but I'm not on painkillers any more and I'm now coaching the University of Nottingham basketball team.

I'm able to teach sports like I did before, I play netball games against the kids, it feels fantastic. Now I'm just waiting to have my other knee done.

Photo reproduced with permission from the Nottingham Evening Postexternal link

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