Surgical intervention at this stage was an option, but because of her pre-existing arthritis, Miranda was likely to need a knee replacement in a few years. To avoid two operations in relatively close succession, Miranda and Mr Shah agreed to continue with conservative treatment until Miranda was ready for a knee replacement.

Once Miranda’s fracture had stabilized a few months later, Mr Shah proceeded with a total knee replacement. Miranda was committed to her postoperative exercises and physiotherapy, which contributed to an excellent outcome. We were delighted to hear that she was back on the slopes by Christmas.