Behind the BBC Documentary with Mr. Amir Qureshi

How did this come about?

I had a patient whose condition was worsening to the point where we decided a particularly complex procedure was needed, in order to reduce their pain as quickly and safely as possible. The documentary makers were looking for interesting or challenging cases at the hospital to demonstrate the varied nature of surgery, and this seemed like a good fit.

What was the procedure?

This was an osteotomy patient. An osteotomy is where a bone is reshaped or resized in cases where a deformity or other condition means that a joint is not working as it should. As you can imagine, having a joint in the leg not working can be really debilitating - and this patient had the condition in both of their legs. So they were already in pain, and it was getting worse.

And why was it so complex?

Because both of their legs required treatment, I sought plenty of advice, and decided with the help of colleagues that the safest approach would be to operate on both legs in one go. Our concern was that only operating on one leg would mean that while it healed the other leg would be taking even more weight, causing a breakage and making the situation much worse.

How do you prepare for something like this?

Any osteotomy requires a lot of preparation - and a lot of collaboration - long before picking up a scalpel. We planned meticulously and spoke to numerous engineers in different companies in order to find the most suitable jigs. Those are templates that are used in the operation to make things as accurate as possible. Again, these jigs are not just thrown together in a hurry. They involve CT scans to make a 3D model of the patient’s bones and joints, which are then used to make bespoke templates for that individual.

How did the surgery go?

It all went well and my patient is now making a good recovery. It was a nine-hour operation in total, which required a lot of patience and concentration, and ultimately it would not have been possible without all that preparation beforehand.

Did this procedure represent something quite unusual for you?

Yes and no. I had never done so many in one go, but every procedure is just as important to the patient. Other common procedures I’ll do include bone realignment and meniscus repair - that’s the cartilage around the knee. Meniscus repairs are my biggest area of speciality and almost half of these procedures at University Hospital Southampton are performed by me.

What do meniscus repairs involve?

It’s actually something that’s changed in recent years, and we’re at the forefront of new developments as well. For many years, an injured meniscus would just be cut out which would help short term but create instabilities and increase the risk of arthritis, so it’s better to replace the cartilage.

I run one of the few cartilage centres in the UK - we can provide a biological solution to cartilage injury, by taking some unneeded cartilage from the patient, growing it in the lab, and inserting it where it is needed. This really is the gold standard of cartilage replacement, and it’s a good example of using different medical specialities to care for a patient - so it’s not just about the traditional surgical realignment or reshaping, but also about a biological solution.