Exclusive interview: Andy Williams, knee surgeon to the stars, maps out road back for Virgil van Dijk

If Virgil van Dijk is seeking solace as he confronts the long, painful path to recovery from his serious knee ligament injury, Andy Williams is probably the man to provide it.

Williams is regarded as the world’s foremost surgeon when it comes to ACL and knee injuries and there is not a professional footballer who has not heard of him. The 56-year-old has saved countless careers including Van Dijk's current and former team-mates at Liverpool - Alex Oxlade-Chamberlain and Danny Ings - Newcastle's new £20 million signing Callum Wilson, whom he operated on four times, and England rugby wing Jonny May.

It remains to be seen whether Williams will be involved in Van Dijk's recovery, but whilst this interview took place before the Dutchman's ill-fated collision with Jordan Pickford at Everton last Saturday, his words provide a blueprint on how to manage a recovery.

Trust is fundamental to the relationship between patient and doctor, and Williams has earned it from his clients - so much so that everyone mentioned by him in our interview at the Fortius Clinic where he works in central London gave consent for their cases to be discussed.

Williams cares about his patients - sometimes to his own detriment. He was running on a treadmill when he heard that Ings had scored his first goal for Liverpool since recovering from his knee injury. “I punched the air and nearly fell off," he recalls. "Everyone was looking at me wondering what was going on.”

Williams remembers Ings' injuries with the same photographic memory as strikers recall favourite goals. In Ings' case, there was an anterior cruciate ligament rupture.

Ings recovered, as sportspeople who use Williams tend to do. There is, he admits, an element of psychology, to his work. “Most sports people are generally upbeat and positive which makes them a joy to work with. The problem is they are unrealistic. They always think they can beat nature so if you tell them ‘six months’ they reckon they will be back in three.

"One club doctor said, ‘Andy, the problem with you is that you are so honest with them’. I saw a player with his agent and the agent thought I was not confident enough because I said there was a risk of re-breaking the new ACL. There is this sort of bravado in football but you have to be straight.

“The other thing is to realise that they are very sad, worried and emotional. A lot of the guys are in a foreign country. They are brave people but if they are missing the game, missing the camaraderie, some of them do get depressed. There are one or two footballers who have significant mental issues and one I know took an overdose three weeks after his ACL operation. He recovered and became a Premier League footballer, highly intelligent, but there was something in him that made him very vulnerable.”

One of Williams’ most famous cases is that of Oxlade-Chamberlain, who suffered multiple injuries in a Champions League semi-final in April 2018. “He blew his ACL and the outside of his knee – it was horrendous. I am always honest so I said to him, ‘Look, without question this could be career-threatening. But I have been doing this a very long time and my return to play record for this injury is 90 per cent at the same level and the average time is 13 months out.’ It was a remarkable case but he’s showing signs that he will get back to a full return. He went through hell and back. He’s got balls."

Another aspect of managing expectations for his clients comes with explaining how long it will take them to regain the form and fitness at which they were operating before injury struck. "With a standard ACL they improve for 18 months to two years. They might be back on the pitch in eight months but they are not right; they are slow; they haven’t got that spark. But second season back they can. I tell the players, ‘You are going to get quite depressed, you will think you have lost it. You are back but you won’t be right until the second season’."

Oxlade-Chamberlain's knee injury explained

Williams is similarly impressed by May, the winger whose injuries, back in late 2015, were even worse than Oxlade-Chamberlain’s. “He’s had three ligament injuries and he dislocated his knee,” Williams says. "He’s a speed merchant and Jonny is quicker now than he was prior to injury. That’s not down to me – I removed two hamstring tendons [from] both legs, and a patellar tendon from the front to do his three ligaments. After that, it’s all him and his commitment to training. He would be in his bedroom and you could hear him screaming to get his leg moving and he would lock the door to stop anyone coming in. He’s an extraordinary professional.”

For Williams preparing to operate is a bit like a footballer preparing for a game. “Like a lot of players I visualise my surgery before I do it,” he says. “If it’s a complex case the biggest thing is time pressure so sometimes the evening before I will draw the anatomy, especially if I have to go in in an unusual way – such as the back of the knee, layer by layer.

“I draw it, go to bed and close my eyes and go through the whole operation from positioning the patient asleep, set up, what I do first, second, third. Because if you don’t have your order planned you waste time and you often do the surgery with a tourniquet on which gives you two hours after which the lack of blood supply will damage the muscle, the nerves and you can ruin a limb. With the actual surgery I am usually at great peace even though it’s a risky business.”

Not all of Williams' clients have the same careful attitude to procedure. He recalls one instance of being asked to bypass a full medical check on a player who had signed for a club on transfer deadline day because his new employers wanted to parade him on the pitch at half-time of their game that night.

Then again, as Williams points out, there is an element of risk with every footballer given the rigours of their industry. "I remember doing the medical on one record signing for a club and you could hear one of his knees move. Someone from the club asked how it was, and I said: 'Like most players he’s got this and this.’ He said: ‘What do you mean? You realise this is the biggest signing in British history and your head is on the block?’

"All I could say was: ‘Well, he’s got this and this but he has played every game this season bar one and there is no inflammation. He’s probably fine.' And, of course, he was. But all footballers, to some extent, are damaged goods.”