‘A senior surgeon who pays great attention to detail and is very self-driven and organised.’. Raghbir Khakha, a knee surgeon at Guy’s and St Thomas’ Hospital and The Wellington Hospital, says robotic surgery is not the ‘Holy Grail’, but can help improve the fit. The Good Doctors Guide: Meet the best knee replacement surgeons and learn what exercises to do before your operation. ‘He gets very good results and is the sort of person you’d want to operate on you,’ reveals another of his peers. Click on NHS Choices to see what both staff and patients think. Most artificial knees are cemented into the ends of the thigh and shin bones for greater stability. Click here to submit your comments to us. But patients still struggling with pain six months or so later should have no qualms about returning to their consultant to be investigated, says Andrew Porteous, a knee surgeon at Southmead Hospital in Bristol. ‘He’s very straightforward and if he feels knee replacement will not work for you, he will say so and spare you lots of unnecessary investigations,’ says another. ‘It is not uncommon to be off your crutches at two weeks and walking normally by four to six, compared with a total knee replacement where you are off crutches by six to eight weeks,’ says Professor Adrian Wilson, a knee specialist at Winchester University and The Wellington Hospital in London. PRIVATE: Nuffield Health Exeter Hospital. University Hospital Llandough, University Hospital of Wales, WHAT THEY SAY ABOUT HIM: ‘Technically gifted with a massive caseload because he gets so many referrals,’ says one surgeon. Epidural injection. Jill Biden and Kamala hug at Medal of Honor ceremony after new book revealed first lady thought VP should 'go f*** herself' after debate attack on JoeÂ, 'We're back! ‘He’s also very nice, straight-talking chap with particular expertise in partial knees for younger patients with a history of dislocation.’, ‘Patients shouldn’t be afraid of asking their surgeon about the number of knee replacements they carry out,’ says Professor Phil Turner, a knee surgeon at the NHS Stepping Hill Hospital in Stockport and vice-president of the British Orthopaedic Association. Almost all knee replacement operations — which take around an hour — are carried out through a 10 in incision down the front of the knee. We want to hear from you on how to improve our service and provide the best care possible. He completed his basic surgical training at the Manchester Royal Infirmary. You can also check The National Joint Registry, which has information on over two million joint replacement operations in England, Wales and Northern Ireland since 2002. There are options to try before surgery, ask your surgeon if you are suitable. ‘And he is getting very good results with it. ‘He tailors his surgery to the needs of his patients and is a firm advocate of partial knee replacement where appropriate — his view is that a lot more knee replacement patients could benefit from partial knees.’. Covid may be on the rise in England amid spread of Indian variant: R rate creeps up and is now at least 0.9... Indian Covid variant may already be dominant in Britain and has grown 'exponentially' since March, SAGE... As a survey suggests people need more support to manage the daily impact of diabetes management, 2 women... UK's daily Covid cases creep up by nearly a third in a week to 2,829 amid rapid spread of Indian variant -... 'Every day is different and I'm passionate about our patients': Pharmacists reveal why they should be your... Scientists spot a new type of coronavirus that originated in DOGS and can infect humans. WHAT THEY SAY ABOUT HIM: ‘A lovely man and excellent technically, very good with patients, he is very thorough and pays great attention to detail,’ says one. It also provides data on the number of knee replacements, revisions and mortality rates by hospital. A recent study in BMJ Open suggested that half of patients needing a knee replacement could be suitable for a partial replacement. ‘Persistent pain after a knee replacement can occur, and when it does it can be a significant problem,’ says Mark Wilkinson, a professor of orthopaedics at Sheffield University who operates at Claremont Hospital in Sheffield. WHAT THEY SAY ABOUT HIM: ‘Gifted technically and down to earth, he gets on well with his patients and is a great communicator.’. So how do you avoid the pitfalls and pinpoint the very best knee replacement surgeon? Here, we guide you through the different types of implants on offer. The test of a good surgeon is how you deal with the difficult cases and absolutely nothing fazes him. The experienced team at Orthopaedic Riga will help guide you through the Byzantine process of securing reimbursement from NHS. Arthroscopy — keyhole surgery to clear debris in the knee — used to be common for osteoarthritis, but is now rapidly in decline as NICE has said it doesn’t help. He’s not interested in fads. A total knee replacement may also involve replacing the under-surface of your kneecap with a smooth plastic dome. They are essential for keeping the joint stable. Robin Allum - Wexham Park Hospital, Slough. Working out what NHS organisation is best for you is not as simple as finding out whether a hospital is ‘good’ or ‘bad’. How much does NHS - Physicians & Surgeons in the United Kingdom pay? They will assess your ability to manage activities of daily living and help you regain Paul Allen - Princess Alexandra Hospital, Harlow. The Department of Health recognises the benefits of specialised orthopaedic centres and in 2014 NHS England commissioned NEOS to host a regional specialised orthopaedic network (EMSON). 312 Fulwood Road, Sheffield S10 3BR Directions. At this top level everyone is dexterous, but he manages to stay cool even with the most challenging cases,’ says one. Indeed, research shows that a good relationship with your doctor can improve the chances of a successful outcome. There are several versions of this operation and 60 different prostheses can be used. He does a lot of revision [when the implant has failed and has to be replaced] and complex work,’ says one surgeon. Obesity is partly blamed for the boost in demand from younger patients; a joint overloaded with excess weight will wear out faster. WHAT THEY SAY ABOUT HIM: ‘He is measured, hard-working, considerate and highly skilled in all aspects of knee replacement,’ one of his peers reveals. ‘Typically, this will be a mix of exercise, physiotherapy, weight loss and painkillers with the objective of trying to reduce patients’ pain and improve knee function sufficiently to avoid or stall knee replacement surgery. Knee ligament surgery (ACL reconstruction) Knee replacement (partial) Knee replacement (total) Knee replacement revision. WHAT THEY SAY ABOUT HIM: ‘Loads of experience and he does everything from primaries, in other words the first knee replacement, to revisions, when implants fail and have to be re-done,’ says a fellow surgeon. Also a very nice guy.’. That’s where this unique series of guides, running every day this week in the Mail, can help. It runs diagonally through the inside of the knee and gives the knee joint stability. The Daily Mail has asked consultants who they would refer loved ones too ‘He has a fantastic reputation which is well-deserved and his patients are fond of him.’. Enter a consultant name or speciality to continue. You must also consider practical reasons for not travelling too far; if you need hospital treatment, you may not want to be hundreds of miles away from family and friends. PRIVATE: Spire ¬Cardiff Hospital, BMI Werndale Hospital, London Orthopaedic Clinic. Mr. Ganapathi Hip & Knee surgeon North Wales, specialist hip and knee surgeon. This facility is one of the… WHAT THEY SAY ABOUT HIM: ‘Technically a really excellent surgeon who does both partial and total knee replacements and primary [first] knee replacement and lots of revision surgery [where the implant fails and has to be replaced]. ROBOTIC SURGERY: Patients are given similar or the same prostheses as with traditional surgery, but a robotic arm improves the accuracy of it, according to a 2016 study in the Journal of Bone and Joint Registry. We’ve canvassed the views of more than 260 consultants across seven specialties from around the country, and asked them this very simple, but key, question: If your own nearest and dearest were to need treatment in your field, to whom would you refer them — and why? This is the most common type of knee replacement surgery, used in 75 per cent of cases. Note that many of the specialists in our guides work in private practice, too, so seeing them privately may also be an option. Because the operation is less invasive than total replacement, as less bone is removed, recovery is quicker and the knee functions better afterwards. Published: 18:18 EDT, 6 June 2018 | Updated: 12:48 EDT, 7 June 2018. Delay too long and you risk making patients miserable, housebound and potentially suffering more muscle-wasting and deformity — resulting in more complicated surgery and a more challenging rehabilitation. LigamentS: Keep or sacrifice? 2. © 2020 University Hospitals of Leicester NHS Trust, Consultant Orthopaedic Staff - Listed by Main Speciality, Ashford, A/Prof Robert U - Consultant Orthopaedic & Musculoskeletal Tumour Surgeon, Boyd, Kevin - Consultant Orthopaedic Surgeon, Chatterji, Urjit - Consultant Orthopaedic Surgeon, Davison, John - Consultant Orthopaedic Surgeon, Esler, Colin - Consultant Orthopaedic Surgeon, Godsiff, Steven - Consultant Orthopaedic Surgeon, Korim, Tawfiq - Consultant Trauma and Orthopaedic Surgeon, Lammin, Kimberly - Consultant Orthopaedic Surgeon, Pathak, Pankaj - Associate Specialist Orthopaedic Surgeon, Tandon, Subash - Consultant Orthopaedic Surgeon, Taylor, Grahame - Consultant Orthopaedic Surgeon. Tim Wilton - Royal Derby Hospital. The Oxford University study found that when partial replacements are carried out by surgeons who do lots of them, the outcomes are better than total knee replacements — and it’s cheaper for the NHS. Best among NHS trusts were South Warwickshire and Wye Valley. ‘Think of this as a pre-emptive strike,’ says Professor Andrew Toms, an orthopaedic surgeon at the hospital. Chatterji, Urjit - Consultant Orthopaedic Surgeon. Mr. Sanjiv Jari is a consultant orthopaedic and sports medicine surgeon in Manchester. He does things because they work and have been shown to work over a long period of time,’ reveals one surgeon. The best are high-volume surgeons, who do a large number of operations, and are expert in both partial and total replacements, so you get the full range of options. Knee Replacement surgeons rated by their peers, WHAT THEY SAY ABOUT HIM: ‘A leader in knee replacement. But how do you find a specialist who fits the bill? Some knee implants retain the posterior cruciate ligament (PCL) which runs from the back of the shin to the bottom of the thigh; others involve removing it (as the implant is differently shaped) to give the knee the equivalent stability. WHAT THEY SAY ABOUT HIM: ‘A quietly spoken, gentle man who has the most phenomenal work capacity and who does no private work. So they will do X-rays and say, “These don’t look too bad, off you go.”, ‘In instances like that, the patient should go back to their GP and ask for a referral to a regional centre.’. Orthopaedic surgery is the branch of surgery concerned with the prevention, diagnosis and treatment of diseases and injuries of the musculoskeletal system. This is then moved to the side so the surgeon can get to the knee joint behind it. At our topmost position sits the no 1 top UK hospital Royal Berkshire NHS Foundation Trust. And osteoarthritis — wear and tear of the joint that causes pain and deformity — is the reason for virtually all cases. Most specialist knee replacement surgeons will be doing a least 150 a year.’, Ask your surgeon about his or her revision rate (where a failed implant needs replacing). But another factor is that ‘the current generation of people aged 40-65 are less tolerant of putting up with a painful knee,’ says Richard Spencer Jones, a knee replacement surgeon at The Robert Jones and Agnes Hunt Orthopaedic Hospital in Shropshire. Here are some real life examples of how other people worked out their The quality of the surgical teams in Riga as well as the quality of the facilities are every bit the equal of the best NHS hospital for hip replacement, knee replacement or ACL surgery. He said: “It is extremely exciting to be the first NHS hospital in Scotland to be able to offer robotic arm assisted partial and total knee replacements to NHS patients as part of routine care. A recent review of 25 studies in The BMJ concluded that the procedure offers no ‘important benefits’, as it neither reduces pain nor improves function and mobility, and carries risks of pain, swelling and difficulty putting weight on the leg. The advantage of partial replacement is that it is a smaller operation which preserves the ligaments, so the chances are it will feel more like a normal knee; with total knee replacement one or both of the main (cruciate) ligaments are sacrificed. The future, he says, is still conventional implants using standard instruments. In a total knee replacement, both sides of your knee joint are replaced. In smaller towns and rural areas, often it is more generalist surgeons that are required. Ligaments are bands of fibrous tissue that connect bones to each other. When you see him operate, he makes everything look so easy. And we like to hug': Jen Psaki confirms the White House is returning to normal and is open to more 'warm and fuzzy' events. WHAT THEY SAY ABOUT HIM: ‘Very empathetic, level-headed and what we in medicine refer to as a good pair of hands. He has a very good bedside manner and I know my relative would be in good hands with him.’, PRIVATE: Rivers Hospital in Hertfordshire, The Chelmsford Hospital.Â. 21. ‘Choosing the right (best) surgeon for your knee operation is by far the most important decision that you can take.’ The advances in knee surgery are tremendous, and the surgical techniques intricate and demanding. Peter James was named as one of the top 10 consultant knee surgeons in the UK by the Daily Mail and Andrew Manktelow received similar recognition for hip surgery. He was brought in to clear the waiting lists in orthopaedics in Northern Ireland and has made it his life’s work, but unfortunately this has faltered in recent years due to further demand and no additional funding to pay for it,’ comments one. However, if the surgeon only does a small number of partial operations, the outcomes are worse than a total replacement. But one of the drawbacks is that surgeons who do few of them get worse results than with a total knee replacement (see box overleaf). GOP says Biden's infrastructure package reduction from $2.2T to $1.7T is still 'well above' what they'll consider and negotiations have drifted 'further apart'Â, Biden administration has released more than 61,000 migrants into the US - many WITHOUT court dates - since February as border system struggles to cope with arrival surge, Kiss and make up! If a surgeon is doing fewer than 20 a year, that’s not a good sign and patients should think about going elsewhere. Hospitals are putting on extra surgery sessions in the evenings and at weekends to tackle the NHS… It’s thought this reduces wear and tear, but there’s no evidence yet it’s better than fixed bearing for total replacement. Today, we focus on knee replacement surgery... Knee replacement surgery is the most common type of joint replacement operation in the UK, and the number of patients having the procedure is rising. Ashford, A/Prof Robert U - Consultant Orthopaedic & Musculoskeletal Tumour Surgeon. FEMALE IMPLANTS: Some artificial knee joints have been designed to more closely match the size and shape of an average woman’s knee. Those against argue that treating the arthritis in the main part of the knee is enough to treat the pain, and resurfacing the kneecap can cause problems of its own. ‘Wherever possible we advise joint preservation procedures such as osteotomy,’ he says.Â. Nick Ohly is a consultant orthopaedic surgeon at NHS Golden Jubilee and the first to treat patients using the Mako robot. TAILOR-MADE IMPLANTS: Scans and computer software are now being used to tailor the surgery, implant and even surgical tools to the individual patient’s anatomy. Patients can check their prospective surgeon’s profile on the National Joint Registry website to see how their surgeon’s caseload measures up against the average (see right). Because our providers participate in clinical trials and research studies, patients can experience groundbreaking care options from leaders in the field of orthopaedics. But there is little difference in results. Uncemented knees are more expensive, but the surgery is quicker, and some say it fits to the bone better. What you can ... Care UK specialist knee and hip surgeon John Va Faye. WHAT THEY SAY ABOUT HIM: ‘Quietly spoken, gentle and with a beautiful pair of hands — in other words he is technically gifted. Knee replacement falls into two main categories: partial knee replacement, where just one compartment of the arthritic knee is replaced; and total knee replacement, the choice for patients with widespread arthritis, where two or three compartments are replaced. ‘If after going through this, patients don’t feel they have improved, then I will operate,’ says Professor Toms. PRIVATE: Nuffield Health Tunbridge Wells Hospital, The Horder Centre in Crowborough. This includes more than 2,000 individual surgeons’ results and how they compare with the national average. During your hospital stay you will also be seen by an Occupational Therapist (O.T). This is not a guarantee that you will see a specific consultant — and there may be a waiting list for that specialist. Yet armed with this MRI, the patient will almost certainly find a surgeon prepared to operate.’. Peter James - Nottingham University Hospital. FIXED VS MOBILE: Normally, the plastic spacer in an implant is fixed to the metal plate on the end of the shin (a fixed-bearing joint) but, with a mobile-bearing joint, the spacer can rotate within a certain range on the plate, so it can ‘find its own position of comfort’, says Howard Ware, a knee surgeon at Chase Farm Hospital in London. Search the NHS website Search. We are no longer accepting comments on this article. 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Last modified on Fri 23 Apr 2021 14.23 EDT. Cemented OR uncemented? The case proceeded to trial and was successfully defended by the NHS. PRIVATE: Nuffield Health The Manor Hospital in Oxford. Mr Palmer has worked at the Western Sussex Hospitals NHS Foundation Trust, BMI Goring Hall Hospital in Worthing and the Nuffield Health Brighton Hospital for twenty years. 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Ilhan Omar to Hamas which her staff claims could lead to 'harassment and death threats'Â, The Nazis' worst nightmare: How a Jewish 'suicide squad' called X Troop was set up by Winston Churchill to wreak brutal revenge on Germany... and brought death and terror to the enemy - including Rommel, GOP sticks up 'I stand with Israel' posters in AOC's hallway in message to 'Hamas Caucus' and Squad members who say the ceasefire is NOT enough, 'My face was on fire.' We're one team with shared values providing the best care possible. Surgeons join investors to back ‘smart’ knee op device 0 21st May 2021 8:00 am by Tracy Williams medtech start-up whose sensor technology could improve outcomes for patients having knee replacement operations has raised £1.4m to bring its device to market. PRIVATE: Spire Bristol Hospital, Nuffield Health Bristol Hospital. Best Practice for Knee Arthroplasty Surgery Documentation Working in partnership with NHS Resolution. Professor Adrian Wilson, a knee specialist at The Wellington Hospital in London, says osteotomy is the ‘operation of choice’ for people who want to stay active. It’s a little-known fact, but under the NHS Constitution, patients in England have the right to choose where to receive their NHS treatment — which means you can ask to have your treatment in any hospital or clinic anywhere in the country, as long as it has the necessary expertise. The procedure takes 1 to 3 hours: Your surgeon makes a cut down the front of your knee to expose your kneecap. Private Secretary & Appointments: Natalie Phillips – 01978 268039. But there’s no research to show ‘gender specific’ implants last any longer or provide better function — most ‘off-the-shelf’ artificial joints come in a range of sizes anyway. David Beverland - Musgrave Park Hospital, Belfast. Kneecap replacement. Although movement can be better afterwards than with a total knee replacement, figures from the National Joint Registry suggest a partial replacement is also more likely to fail. He is not suggesting that we should be more robust about pain, rather that he fears the fallout from people swapping their own rickety knee for a replacement too soon, as ‘some of these people will live well into their 90s and that knee is likely to need replacing a couple more times — [these will be] increasingly challenging procedures with more risks and potential complications’. But it’s significantly more expensive — several thousands of pounds rather than £800 to £1,000 for an off-the-shelf knee. PRIVATE: Royal National Orthopaedic Hospital (private), The Wellington Hospital, both in London, Spire Bushey Hospital in Watford. 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The average NHS salary ranges from approximately £26,367 per year for General Practitioner to £86,031 per year for Paediatric Consultant. If arthritis affects only one side of the knee, it may be possible to have a partial knee replacement, where only the damaged bone is scraped out and replaced. PRIVATE: Nuffield Health Leeds Hospital, BMI The Duchy Hospital. UK Orthopaedic Surgery & Sports Medicine includes world-renowned, board-certified orthopaedic surgeons and specialists who are consistently named to the Best Doctors in America list. Surgeons at Southampton’s teaching hospitals have pioneered an early-stage operation to repair damaged knees without the need for a total replacement – halving recovery times. An artificial knee will never be as good as your own — most patients rate them about three-quarters as good, according to the charity Arthritis Research UK. He has now put the hospital on the map for knees in the same way,’ says one of his peers. Additional reporting by Rachel Ellis.Â. We have provided an indication of the cost of knee surgery based on the prices published by several of the major providers of private surgery. Chris Dodd - Nuffield Orthopaedic Centre, Oxford. Esler, Colin - Consultant Orthopaedic Surgeon. ‘Anything to reduce that risk makes sense, so I always resurface the kneecap,’ he says. You (and your doctor) can access the electronic national referral service, called the NHS e-Referral Service, which allows you to select your hospital or clinic as well as the date and time of your first appointment. The surgeon’s knee surgeon. 80-year-old Tony Perry from Easton near Norwich was told he needed knee replacement surgery in July 2019. ‘Unfortunately, if you do an MRI of the painful knee of someone in their 60s, you will definitely find some arthritis. All orthopaedic surgeons tend to agree that the timing of a procedure is critical in achieving the best result for patients. 3. It involves replacing joint surfaces at the end of the thighbone and top of the shinbone and inserting a plastic spacer in between; this acts like cartilage, helping the joint move freely. Search hospitals, surgical procedures or departments by selecting a tab below. ‘These techniques are available on the NHS as well as privately but are rarely used (less than 1 per cent of knee replacements) in the NHS because they’re more expensive, time-consuming and haven’t been shown to provide significantly better results’, says Howard Ware, a knee surgeon both in Chase Farm Hospital and The Wellington Hospital. If the PCL is retained, it should make the knee feel more ‘normal’, but is only suitable for those with ligaments strong enough. Surgeons are split 50:50 on whether this should be done. PRIVATE: Mr Beverland does not work privately. If yours has a higher-than-expected revision rate, ask why. The consultants who earned the most votes from their peers are the ones who made it into our guides — though patients should bear in mind that this is not a scientific study. Around 10 per cent will need a second operation after ten years compared with less than 5 per cent with full replacement. Mr. Sanjiv has extensive experience in performing arthritis surgery. The ACL is a tough band of tissue joining the thigh bone to the shin bone at the knee joint. He would not operate unless he felt it absolutely necessary,’ according to one of his peers.

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