Compensation for ‘novel’ medial patellofemoral ligament repair surgery

Our specialist orthopaedic claims subteam has settled a case involving negligent surgical treatment for patellofemoral arthritis.

Our client was a very fit woman whose main social and leisure activity was attending the gym. She had been experiencing some knee pain for a few years and, after seeing her GP, was referred to an orthopaedic surgeon. The surgeon diagnosed some longstanding anatomical abnormalities and explained that this was causing maltracking of her patella and resulting arthritis, but no surgical treatment would be able to offer a cure. She therefore resigned herself to a period of reduced activity and physiotherapy.

Subsequently, on the recommendation of a friend, she went to see another surgeon who was considered to be ‘very forward thinking’. He offered her a new technique, with a 95% success rate for curing problems similar to her own, which unsurprisingly our client was happy to accept. In reality, our expert evidence is that this is vastly in excess of a realistic prospect of any surgery for her problems.  

In addition, during the procedure, the surgeon used a technique which was not recognised in any medical literature or peer reviewed. He looped an artificial ligament over the top of the patella and sutured it to the lateral (outside) aspect of her patella. He then used sutures to fix this ligament to the kneecap. The recognised technique for this type of surgery would be to fix the ligament to the medial (inside) aspect of the kneecap, using screws directly into the bone for security.

As a result, the operation was not successful, and our client continued with inflammatory symptoms in the knee. After several reviews with the surgeon, he offered to revise the ligament, and reattach it to the medial aspect of the patella. Again, our client was promised a likelihood of success far in excess of reality, and so she went ahead with the operation. During this revision operation, infection was introduced into the wound, and this then caused significant damage to the knee joint. Our client was referred to a specialist knee surgeon who removed the artificial ligament and the metalwork in the knee. This was followed by a series of four further operations to flush out the knee, intravenous antibiotics, and prolonged periods of hospitalisation.

Our client was left with a severely damaged knee and requires a total knee replacement, although her treating surgeons are reluctant to perform this while there is the potential for residual infection to remain in the knee.

She approached us in 2015. The defendant initially made no response at all, so court proceedings were issued protectively. The defendant’s defence union became involved and the case continued to be robustly defended until around two weeks before trial, when an offer was made to settle the claim. While our client was prepared to go to trial given the strength of the expert evidence, we were able to agree a settlement shortly beforehand for £145,000.

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