Tom's story

Tom loves competing in endurance events and if he is not racing he is completing long distance training sessions at least four times a week near his home in Warton-on-Thames. His fitness regime included cycling approximately 100 miles a week, 5 mile runs and regular swimming. In September 2017 he noticed some mild knee pain on squatting and playing 5-a-side football. The following month, he decided to run the Royal Parks half marathon alongside his wife who was taking part for the first time. Whilst heading to a drink station to collect water for her, he dodged a near collision with another runner, which led to a jarring and sharp twinge in his right knee. Tom continued to finish the race, however, throughout the next 24 hours he was experiencing increased pain, problems walking and severe swelling.

Initial consultation

He ignored the pain for a few more days in the hope his knee might heal itself, but soon decided it was time to call BUPA and arrange to meet with a Physio. He visited a Physio once a week for a month, but to his disappointment there was no progression in his knee and they both agreed that Tom would need to see a specialist for alternative treatment. His physio recommended that he should see Dr Jon Houghton, Consultant in Sports Medicine and Rheumatology at Fortius Clinic.
Tom visited the City Clinic for his first consultation, where Dr Houghton diagnosed a likely meniscus tear and arranged for him to have an MRI scan which confirmed the diagnosis. After discussing the potential options including more rehabilitation, injections or surgery, Tom elected for a PRP (Platelet Rich Plasma) injection. Tom was instructed to rest for 10 days and continue on a physiotherapy rehabilitation programme following this to see the best results. 
 

A few months later

A few months later the pain was much better, but Tom still could not perform a full squat and struggled to run more than a few miles, which became very frustrating as he had several endurance events booked up in the summer months and little hope of training or competing. He arranged to see Dr Houghton for a second consultation, and following another MRI, he was referred to one of our knee surgical specialists as the tear had worsened.

The excellent multidisciplinary teamwork within the group meant that Tom was able to have a consultation the following day with a knee surgeon.

Surgery was the best option

Tom was slightly anxious of what was to come but found Kash Akhtar to be very reassuring. Kash found that Tom was unable to bend his knee fully and that going into a deep squat or a crouching position caused him sharp pain. Kash performed specific meniscus examination tests that confirmed a medial meniscal tear that was causing mechanical symptoms. He compared the two MRI scans with Tom and demonstrated that the PRP injection had reduced the intensity of the inflammation in his knee but the tear had extended and become more complex in nature. There was also some irregularity of the cartilage on the femur that was related to the meniscus tear. Kash offered Tom the options of continued conservative treatment, a repeat injection or a knee arthroscopy. However, he explained to Tom that given the symptoms had been present for over six months and he was still struggling to exercise, he was most likely to benefit from undergoing an arthroscopic procedure, particularly if he wished to return to elite fitness and compete at a high level. 

He made me feel comfortable with this decision

Tom said, “On my first consultation Mr Akhtar made me feel very comfortable and clearly articulated the potential scenarios if I underwent the operation, which gave me confidence to pursue the operation”. The surgery was to be a day case keyhole procedure where Kash would assess the meniscus tear and repair it if at all possible, otherwise it would be minimally trimmed if needed. Tom explained, “At this point I had dealt with the pain for six months and I was determined to find a solution. I left the consultation feeling confident that surgery would be the correct decision for me”.

In April 2018 Tom underwent surgery at the Fortius Surgical Centre in Marylebone. The operation went very smoothly, lasted only 20 minutes and he was back home a few hours after the operation.  

Recovery went smoothly

Tom stopped taking painkillers within two days of surgery and quickly came off the crutches. Two weeks following surgery, Tom was on a physiotherapy rehabilitation programme and religiously working on his exercises for a couple of hours every day. Tom relates, “I had a follow up consultation after two weeks and Kash showed me what he did as he had videoed the procedure, which gave me confidence that he did a top-class job”. By three weeks into his recovery, Tom was slowly introducing cycles and three mile runs, and to his relief his knee was pain free.

Tom completes 105 miles of the Tour de France

Tom was slowly introducing cycles and three mile runs, and to his relief his knee was pain free. He was then able to cycle 350 miles within six weeks of surgery. His progress continued to improve and at the end of May, whilst on holiday with his children, Tom managed to run several 10k with no problems and was regaining the strength in his right knee again. His summer of events suddenly seemed possible once more and he was excited at the thought of competing again. 


Three months after his operation, Tom finished 105 miles of the Tour de France. He subsequently completed an Ironman in Hamburg and more recently a marathon in London. We are so impressed with his recovery and determination. Well done Tom!