Sport surgeon defies doctors' ageist attitude

Published on Saturday 4 April 2009 19:56

FROM her home in Edinburgh, Anne Baird looks up daily to see the impressive summit of Arthur's Seat and treasures the dream of walking around the base of the hill again.

That would be a major challenge for anyone in their late seventies, especially with a damaged knee that the National Health Service decrees to be inoperable, but Baird is a very determined woman.

As she prepares to celebrate her 78th birthday tomorrow, she can finally look forward to that walk in Holyrood Park and to taking up an old hobby: dancing with her husband Norman.

Thanks to an NHS surgeon who is determined to challenge the ageist attitudes of some of his colleagues, Baird has become the oldest woman in Britain – possibly the world – to have a knee reconstruction operation that is more usually performed on highly paid sports stars.

She said: "I wanted to be able to dance again, and play a bit of gentle tennis, and now I am looking forward to walking round Arthur's Seat."

In a reconstruction, surgeons graft tendons, usually from elsewhere in the leg, to replace damaged cruciate ligaments. It is entirely different from a knee replacement, in which the whole joint is removed and an artificial one implanted.

The reconstruction operation is rarely performed by the NHS on anyone over the age of 40. Baird had hers done privately at Ross Hall Hospital, Glasgow, by sports orthopaedic surgeon Gordon MacKay.

MacKay – MD FRCS (Orthopaedics) – has operated on many famous footballers and rugby players, such as Ian Durrant of Rangers and former Scotland and British Lions captain Gavin Hastings.

The 44-year-old, director of the Sports Physiotherapy Advanced Centre of Excellence (SPACE) clinic in Edinburgh, said: "Usually in this type of ligament injury, you wouldn't be considered for this operation beyond a certain age. You would be left with an unstable knee and told to tone things down.

"But unfortunately in that situation you lose all the benefits of being active, and these benefits become more important as you get older.

"I worked in a sports surgery in Australia and there was no place for that approach there. If you were active and enjoyed sport, you have every right to expect help to get back to the same level of activity, whether you were 25 or 65.

"But I have never done this operation on anyone of Anne's age, and I have checked and I haven't heard of it being done anywhere. It was all down to Anne's determination to have her independence back that we offered her the operation."

It was when her knee began to give way underneath her regularly that Baird, who originally hails from Yorkshire, decided on the operation, as she was determined to maintain an active lifestyle.

Baird and her husband, who have two children, ran a business together. She had always been active, and enjoyed tennis and skiing, which she took up in her forties. The couple moved to Edinburgh 14 years ago, by which time she had already experienced knee problems.

She said: "I had an accident about 20 years ago when I dislocated both knees while skiing. I recovered from that and was able to dance, play tennis and water-ski.

"But the knee gradually got worse and I couldn't depend on it, and I didn't want to get to the stage where I would always have to use a stick.

"I thought it is no use living until you are 78 and not being able to walk – I couldn't do that. I knew there was a risk, but I decided to take it.

"After all, there is no fun if you're not active."

In the operation, her hamstrings were harvested from other parts of her leg, and the knee was rebuilt using them to replace the cruciate ligaments. Following extensive rehabilitation and physiotherapy, the joint is now stable and she is able to bend the knee quite significantly. It is only a matter of time and more physiotherapy before she achieves her ambition to dance.

Each day she follows a 50-minute exercise routine, and undergoes regular physiotherapy sessions at the clinic. There have been no problems with muscle growth and the scarring on her leg is minimal.

She said: "I can already move about well and it is gradually coming on, and it's certainly much better than when the knee would give way as I was coming downstairs – I had a few catastrophes then."

Gordon MacKay said: "We are experimenting ourselves in terms of what pace we should set for someone in their seventies, but Anne is doing exceptionally well. She has already done away with her crutches."

MacKay feels the Scottish Government and the NHS send out mixed messages by preaching that the elderly should stay active but refuse reconstruction surgery to anyone over 40.

He said: "Exercise is seen as vital to combat all sorts of illnesses such as heart disease and diabetes, and what we have done here with Anne sends out a positive message about what can be done with this operation. If it is feasible, regardless of your age it should be done.

"I am sure there will be doctors and surgeons reading this over their breakfast and tut-tutting and rolling their eyes, and thinking I am off my trolley even considering this for someone of this age, but to me it seems logical."

Baird firmly backs MacKay's stance: "When you have something wrong, you should get it put right. I know the NHS wouldn't do the operation on anybody over 40. Well, 40 is no age these days, and it's a nonsense that it doesn't get done."