Knee replacement - negligent surgery

and

HEYWOOD, MIDDLETON and ROCHDALE PRIMARY CARE TRUST

Background to the Claim

48 year old DH attended her GP in February 2003 complaining of increasing pain in both knees. An X - ray showed arthritic changes.

Despite a number of steroid injections to both knees over the next 2 years DH became quite debilitated by the continuing pain and in September 2005 she was referred to an orthopaedic consultant (Mr A). He diagnosed fairly severe osteo-arthritis of both knees and put her on the waiting list for bilateral total knee replacement.

After some months DH was called for a pre-op assessment to the Greater Manchester Surgical Centre and on 4 February 2006 she underwent a left uni-compartmental knee replacement even though a total knee replacement had been advised by Mr A.

Following the surgery the pain in the left knee was worse than ever and the leg appeared to be mis-aligned, giving the physiotherapists considerable cause for concern. In May 2006 her GP referred her to another orthopaedic consultant (Mr C).

Mr C's report stated " The X ray confirms the previous insertion of a medial uni-compartmental knee replacement and quite clearly the femoral component of this has been inserted in a mal-aligned position resulting in an eccentric loading of the component and the valgus mal-alignment of the left leg. I would agree with Mr A's initial assessment that this lady requires a total knee replacement to alleviate her symptoms".

On 31 October 2006 Mr C performed revision surgery by way of a left total knee replacement and noted that "there was obvious loosening of the previously inserted uni-compartment knee prosthesis".

Particulars of Injury

DH underwent an unnecessary operation and is left with continuing pain and discomfort in the left knee and also restricted extension despite 2 attempts at manipulation under anaesthetic. This severely affects her mobility and her quality of life. She cannot walk for long distances or stand for prolonged periods and is consequently restricted in her employment opportunities.

She used to exercise regularly but this is no longer possible because of the pain and the fact that the knee sometimes locks without warning. She feels that her personality has changed since the surgery and she now rarely goes out or socialises.

As she is still a relatively young woman DH will require 2 revision operations in her lifetime, which will be complicated by the fact that she has already undergone revision surgery. The first revision is likely to be in 10 years time, still during her normal working life.

Also, the mismanagement of the surgery to her left knee has resulted in a considerable delay in replacing her right knee, resulting in continuing pain discomfort and restricted mobility. DH had initially hoped to have both knee joints replaced at the same time.

Case for the Claimant

Had DH been properly advised as to the risks of undergoing uni-compartmental knee replacement (i.e. increased failure rate) she would not have consented to such a procedure. She would have chosen to have a total knee replacement as initially advised by Mr A.

However, had the operation at the Greater Manchester Surgical Centre been undertaken correctly and competently it is very likely that DH would not have suffered the consequential complications.

In either of these scenarios DH would have returned to a reasonable level of mobility (sufficient to return to work) within 12 weeks of the surgery and would have been able to walk without an aid by 6 months. She would have been left with no long term pain and discomfort.

She would have and gone on to have the right knee replaced during her recuperation period from the left knee surgery, and, on the balance of probabilities, would have required only one revision of the knee during her lifetime.

Case for the Defendant

In a letter dated 25 April 2008 the defendant admitted breach of duty in the following terms:

"For the purpose of these proceedings only it is accepted that your client's left uni-compartmental knee replacement, carried out by the Greater Manchester Surgical Centre, on 4 February 2006, fell below the standard expected. Your client would in any event have required a total knee replacement 10 years later, but our client accepts that the mal-positioning of the prosthesis caused the need for a total knee replacement 10 years earlier and also 9 months of additional pain and suffering."

Court Proceedings

In December 2009, following the exchange of expert evidence, a negotiated settlement was agreed in the sum of £370,452 plus £67,500 interim payment.

Legal Representatives

For the Claimant

Eddie Jones

JMW Solicitors

1, Byrom Place

Spinningfields

Manchester

M3 3HG

For the Defendant

Kennedys Solicitors