Hips + Knees (Orthopaedics)

Hips + Knees (Orthopaedics) Clinicians

Professor Alister Hart

Professor Alister Hart sees Patients with hip and knee problems in consultation...
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Professor Nicola Maffulli

Professor Nicola Maffulli is widely recognised as one of the world's most eminent...
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Mr Dinesh Nathwani

Mr Dinesh Nathwani sees Patients with a variety of knee problems at TMCK. He...
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TMCK is proud to be home to two of the UK's foremost Consultant Orthopaedic Surgeons, both with a special interest in lower limb problems. 

Mr Dinesh Nathwani and Professeur Alister Hart work together in the same orthopaedic surgery unit at Imperial College Healthcare NHS Trust Charing Cross Hospital and perform private surgery both at London Clinic and Bupa Cromwell Hospital. 

They have a particular interest in the assessment of Patients with hip and knee pain and use CT scans + 3D computer analysis to help determine the exact shape of your bones and joints.  This technique enables them to better understand how to solve the problem, particularly through the accurate sizing and positioning of hip or knee replacements.  They are also world authorities on the 3D assessment of Patients with hip and knee replacements which are painful.   

How Are They Different From Other Orthopaedic Surgeons?  What sets them apart from others is that they regularly meet together, as a team, to discuss and review unusual clinical cases and the latest advances.  This enables them to deliver an efficient evidence based solution so that you benefit from the very latest achievements in modern medicine.  This is of course particularly useful when deciding which type of hip or knee replacement is the most suitable for you.

Which Hip Replacement Will Last The Longest?  Hip arthritis is the commonest cause of hip pain in Patients 50+.  It is most commonly due to wear and tear of your hip joint cartilage.  When the cartilage is completely worn out the only treatment is hip replacement or resurfacing.  Currently, surgeons do not know which type of hip replacement will last longest.  Metal on metal, ceramic on ceramic or metal on polyethylene.  There are also decisions to be made about uncemented or cemented, femoral head size and the type of surgery.  Each has advantages.  Metal on metal is the only solution for hip resurfacing.  Ceramic on ceramic has the best wear rate and biocompatibility.  Metal on polyethylene has the longest clinical use.  The decision about what will suit you best is made after a clinicial assessment, imaging scans and the very latest knowledge from medical research about risk factors and success rates. 

What To Do About Knee Pain.  Over 70,000 knee replacement operations are carried out every year and the number is increasing.  Most Patients are over 65 and slightly more than 50% are women.  You may not need a full knee replacement and may be suitable for smaller and better performing partial knee replacement.

The surgery is normally only appropriate if you have severe pain, serious mobility issues and if your arthritis is not responding to medication, physiotherapy and weightloss.  The earlier you have a knee replacement, the greater the chance that you will eventually need further surgery, but there is now some evidence that not waiting for your knee to become very stiff leads to a better result. 

What Are The Advantages And Disadvantages Of Knee Replacement?  Obviously, freedom from pain is the main benefit and you should find that you are more mobile as well.  About 9 out of 10 people say that they are happy with their new knees.  Everyday activities become much easier and exercise such as swimming, cycling, tennis or golf are also usually possible.  You may be aware of some clicking in the joint, but by far the majority of people rate their new joint at about 75% normal.  The good news is that most artifical knees will last for 20 years plus. 

So you can understand that it is really important to choose an experienced Orthopaedic Surgeon.  The type of replacement is decided on a case by case basis and this may involve discussion by the entire Precision Surgery Group.  The Group constantly reviews all the latest evidence.  They have between them performed over 3,000 hip and knee operations, many supported by 3D CT planning prior to surgery plus computer navigation. 

The web contains very useful information which will interest you.  Here is a small selection.