By James Donaldson
Consultant Orthopaedic Surgeon
Joint Reconstruction Unit
Patient-specific hip and knee replacements are a relatively modern concept and are increasingly being used in an effort to improve clinical and functional results and long-term implant survival.
Patient-specific instruments (PSI) are custom made on a case-by-case basis, specific to both the anatomy of the patient and the surgical plan created by the surgeon.
By Mr Panos Gikas
Consultant Orthopaedic and Sarcoma Surgeon
Honorary Lecturer, Department of Physics, UCL
Mr Panos Gikas is a Consultant Joint Reconstruction and Sarcoma Surgeon based at the Royal National Orthopaedic Hospital. He completed his medical and postgraduate training in London then completed a Seddon Travelling Fellowship in orthopaedic oncology at the Royal Prince Alfred Hospital in Sydney where he further developed his specialist skills in the management of bone and soft tissue tumours and complex joint reconstruction. In addition, he has also completed a clinical fellowship in Geneva in developing the use of the anterior muscle sparing approach to the hip joint before taking up a consultant post at the world-renowned Royal National Orthopaedic Hospital.
This was the question posed in a Daily Mail article "The Good Doctors Guide: Meet the best knee replacement surgeons"
And one of our top consultants was named...
By Mr Tahir Khan
Consultant Orthopaedic
Hip joint is pivotal to normal bipedal ambulation. Any deformity in the articulation leads to significant disability in young, active individuals. Patients with hip problems, typically complain of the following:
By Mr Panos Gikas
Consultant Orthopaedic and Sarcoma Surgeon
Honorary Lecturer, Department of Physics, UCL
Recently there has been an increase in interest in performing hip replacement surgery by less invasive means, and by smaller incisions. Some of these so called minimally invasive techniques however are only reduced skin incision techniques and are associated with the same muscle and/or tendon injury as “conventional” approaches.
By Dr Tacson Fernandez
Consultant in Chronic Pain Management
Lead Clinician for Neuromodulation
Lead Clinician for Acute Pain Management
People who through no fault of their own have their lives demolished by pain deserve our help. Professor Henry McQuay from Oxford clearly highlights the plight of chronic pain sufferers in his article in the BMJ 2008, “Help and hope at the bottom of the pile”1.
By Mr Robert Lee
Consultant Spinal Surgeon
Spinal adult degenerative deformity encompasses a wide range of pathologies including spondylolisthesis (slip of one vertebra on another), scoliosis (sideways curvature of the spine) and positive sagittal balance (unable to stand upright due to flattening of the curves in the spine). Often all three of these conditions can present in one patient. Patients present with severe back and in particular leg pain due to degeneration of the intervertebral discs leading to compression of the nerves and ‘sciatica’.
By Mr Tom Quick
Consultant Orthopaedic Surgeon
A 19th-century Bavarian doctor, Wilhelm Heinrich Erb, gave his name to a nerve injury which happens to babies during birth. Erb’s Palsy is a weakness of shoulder and elbow muscles.
Arm nerves come from the spine in the lower neck at C5, C6, C7, C8 and T1. These nerves come together at a major junction called the brachial plexus. During birth, as the child squeezes out of the mother’s pelvis, the neck can be over-stretched damaging the nerves. Injury can be mild, recovering rapidly and completely, nerves can be partially or totally snapped, or pulled clean from the spinal cord.
By Mr James Donaldson
Consultant Orthopaedic Surgeon
Articular cartilage is a thin layer of highly specialised tissue that provides a smooth, lubricated surface for joint movement and transmits forces to the underlying bone. Articular cartilage, however, has a limited capacity for healing and repair, which means that once the joint surface is damaged, the subsequent repair is limited. The resultant repair is often with a different type of cartilage – fibrocartilage, which lacks the same biochemical structure as normal articular cartilage and has been shown to break down more rapidly. The injured joint is therefore unlikely to return to its original structure and function, predisposing the patient to premature osteoarthritis.
