Knee and hip replacement
When arthritis has worn a joint down to the point where walking, stairs and sleep are all affected, joint replacement gives back a pain-free, usable joint.
- Total knee replacement for advanced arthritis
- Partial (unicompartmental) knee replacement when only one side is worn
- Total hip replacement, including for avascular necrosis
- Revision surgery for an old, loosened implant
- Rehabilitation planned before the date of surgery, not after
Read about: Knee arthritis, Hip arthritis
Arthroscopy and sports injuries
Keyhole surgery through small cuts, with a camera inside the joint. Less pain, a shorter hospital stay and a quicker return to sport or work.
- ACL and other ligament reconstruction
- Meniscus (cartilage) repair and trimming
- Rotator cuff repair and shoulder impingement
- Recurrent shoulder dislocation
- Ankle and wrist arthroscopy
Read about: ACL and ligament injury, Meniscal (cartilage) tear, Shoulder dislocation and instability, Rotator cuff pain, Frozen shoulder, Tennis elbow, Golfer's elbow, Ankle sprain, Achilles tendon pain, Kneecap pain, Shin pain with running
Biological joint preservation
Not every painful joint needs replacing. In early arthritis the aim is to protect your own cartilage and delay or avoid surgery altogether.
- Injection therapy for early arthritis
- Cartilage and bone-marrow procedures
- Alignment correction to take load off a damaged area
- Structured strengthening programmes
Read about: Knee arthritis, Hip arthritis, Kneecap pain, Thumb base arthritis
Published research on this
Fractures and complex trauma
From a child's forearm fracture to multiple injuries after a road accident, fractures are treated to restore alignment and get you moving again quickly.
- Plaster, splinting and closed reduction
- Plate, screw and nail fixation
- Fractures around joints
- Non-union and malunion of old fractures
- Hip fractures in elderly patients, treated early to avoid bed complications
Read about: After a fracture, Neck pain after a road accident
Spine, back and neck pain
Most back and neck pain settles without surgery. The first job is to find out exactly what is causing it.
- Low back pain and postural strain
- Sciatica and slipped disc
- Cervical spondylosis and neck pain
- Osteoporotic spine fractures
- Guided injections when medication is not enough
Read about: Low back pain, Neck pain, Sciatica, Spinal stenosis, Neck pain after a road accident, Ankylosing spondylitis
Nerve and tendon problems
A squeezed nerve or an overloaded tendon accounts for a great deal of everyday hand, foot and hip pain. These are assessed and treated at the clinic, and most settle without an operation once the cause has been identified.
- Numbness, tingling or night pain in the hand, from a nerve compressed at the wrist
- Pins and needles in the little and ring fingers, from a nerve compressed at the elbow
- Pain on the thumb side of the wrist, and fingers that catch or lock when bent
- Heel and arch pain that is at its worst on the first few steps of the day
- Burning pain or numbness between the toes
- Pain over the outer side of the hip, often worse when lying on that side
Read about: Carpal tunnel syndrome, Cubital tunnel syndrome, De Quervain's — thumb-side wrist pain, Trigger finger, Morton's neuroma, Heel pain, Pain on the side of the hip, Ganglion (wrist lump)
Deformity correction
Correcting bone alignment restores function and takes abnormal load off the joints above and below.
- Bow legs and knock knees
- Malunited old fractures
- Limb length difference
- Post-polio and post-infection deformity
Read about: Bunion (hallux valgus), Hammer, claw and mallet toe, Dupuytren's contracture
Published research on this
Children's bone and joint problems
Growing bones behave differently from adult bones, and many childhood concerns settle on their own with the right monitoring.
- Fractures in growing children
- Bow legs, knock knees and flat foot
- Limping and gait concerns
- Congenital problems such as club foot
Osteoporosis and bone health
Weak bones are treatable. Picking this up before the first fracture is far better than after it.
- Bone density assessment and interpretation
- Medication and vitamin D correction
- Fall prevention advice for older adults
- Follow-up after a fragility fracture
Read about: Osteoporosis, Vitamin D deficiency and bone pain, After a fracture, Rheumatoid arthritis, Gout
