In the treatment of your osteoarthritis we will discuss the pros and cons of the following procedures I offer:

• Partial Knee Replacement / Uni-Knee
• Bi-compartment knee replacement (Bespoke Knee Replacement)
• Total Knee Replacement (Persoanlised Jigs)
• Personalised Custom Made Knee Replacement

Hip Osteoarthritis can be treated surgically with a total hip replacement (THR). During your consultation we will discuss the pros and cons of the following:

• Cemented THR
• Uncemented THR
• Hybrid THR

The final decision will be based on your anatomy, age, bone quality and level of function in an effort to give you the best chance of longevity of your new hip.

Shoulder replacment surgery has undergone many changes in recent years with new technologies emerging and improved techniques of use. I offer the following treatment options for your shoulder osteoarthritis:

• Hemi-arthroplasty (Half-sholder replacement)
• Anatomic Total Shoulder Replacement
• Reverse Total Shoulder Replacement

During your consultation we will review your imaging, the quality of your tendons and decide on the best treatment option for you.

Anterior Cruciate Ligament (ACL) rupture is a common imjury.  Reconstruction is a well established treatment option with a number of techniques in use. No two patients or athletes are the same and one or more of the following will suit you more than others:

• Hamstring Autograft
• Bone-tendon-Bone Autograft
• Quads Tendon Autograft
• ACL Allograft Reconstruction
• Lateral Extra-Articular Tenodesis (LET)

The final decision will be made with you based on your sport or activities of choice, your position of play, previous surgeries and quality of graft at the time of surgery.

Patellar (Kneecap) dislocation is generally treated without surgery. In a small group of patients who have exhausted non-surgical treatment, a medial patello-femoral ligament (MPFL) reconstuction is a surgical option.

This involves taking a hamstring tendon and reattaching it to your patella and your femur. This is often performed in combination with other bony and soft tissue procedures known as a Tibial Tubercle Osteotomy (TTO).

Your patella (kneecap) can be unstable for a number of reasons including trauma, altered femur shape, altered patellar shape, increased tendon length or a combination of the above.

In a small group of patients who have exhausted non-operative management their patella can be stabilised by moving where the tendon inserts. This is known as a Tibial Tubercel Osteotomy (TTO). This is often performed with an MPFL reconstruction.

Meniscal or cartilage injury of the knee is a common sporting injury. Some cases will require repair whilst others will have better outcomes by removing part of the meniscus (menisectomy).

You can injure your meniscus as an isolated injury or in combination with other knee injuries, most commonly the MCL or the ACL.

During your consultation we will discuss your surgical options and the implications for your recovery based on the options available at the time.

The hamstrings can be injured at the upper end of your posterior thigh. If the tear is in the true tendon-bone interface these can be reattached.

Not all cases need to be attached and this depends on the number of tendons involved, the amount of distance between the tendon end and the bone and how well you are performing/recovering prior to our consultation.

During your consultation we will review your imaging and discuss the options available to you, up to and including surgical reattachment.

Lower limb alignment is a common cause of pain, discomfort and concern for patients. Mal-alignment can result in focused osteoarthritis and correction of this mal-alignment can avoid or delay the need for a knee replacement.

The mal-aligment can be in one, two or three planes and can be corrected in stages or in a single sitting. The surgery involved will depend on your aligment profile and can include a combination of the following:

• High tibial Osteotomy (HTO)
• Distal Femoral Osteotomy (DFO)
• De-rotational osteotomy (DRO)

The shoulder joint is a ball-and-socket joint that is very shallow and therefore more prone to instability. Most cases of instability can be treated without surgery and generally get better with focused physiotherapy.

In patients who have structural defects in their shoulder and who have exhausted their physio rehabilitation there are a number of surgical options available.

• Labral Repair and stabilisation
• HAGL repair
• Capsular shift
• Bone block (Latarjet Procedure)

The Latarjet procedure is a specific type of bone-block procedure for stabilisation of the shoulder.

We move the coracoid process to the front of the glenoid to increase the surface area of the glenoid and provide a soft tissue 'hammock' or 'sling' to the head of your humerus.

This procedure is generally reserved for those with some bone missing from their glenoid from dislocations but also in those at high risk of repeated dislocations from their sport or occupation.

The acromio-clavicular joint (ACJ) is often injured in athletes from a fall directly onto the corner of their shoulder.

These will often settle on their own over the course of 6-8 weeks. A number of the more severe injuries will require surgery to restore the stability of the joint and promote normal shoulder function.

This can be achieved by the following:

• Repair 
• Reconstruction

During your consultation we will discuss the available options based on time since injury, previous surgery/injury to the same area and your wishes for future function and performance.

The rotator cuff tendons of the shoulder are made up of 

• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres Minor

The rotator cuff is generally torn over time and degenerative tears or 'wear and tear' are most commonly seen with arthritis of your AC joint and narrowing of your subacromial space. The rotator cuff repair will be performed along with a Sub-acromial decompression and sometimes with an excision of your ACJ to relieve symptoms.

During your consultation we will discuss your images and your options available to you based on the characteristics of your tear, your previous function, muscle and tendon quality and your goals for recovery.

In the younger patient, the rotator cuff tendons are more commonly injured through trauma. The most commonly injured tendon in this group is the subscapularis tendon.

This tendon can be reattached through key-hole or open surgery.

The space between your acromion and your humeral head is known as the subacromial space.

This space allows your rotator cuff tendons to travel to and attach onto your humerus. The bursa can become inflamed and the AC joint can become arthritis, making the sapce smaller. This is known as shoulder impingement.

This can be treated with or without surgery depending on your anatomy and the degree of impingement. The surgical management of this condition is performed through key-hole surgery, shaving the bone and ligaments in the area to allow the tendons to travel more freely.

During your consultation we will discuss your imaging, symptoms, occupation, activity changes and management options to find the correct approach for you to resotre function.

The distal biceps tendon at the elbow is often injured during forced straightening of the elbow. This can be caused by heavy lifting at work, in the gym or through sporting activity.

The distal biceps tendon allows you to perform the 'bottle opening' movement at the wrist and is not the main tendon for flexing your elbow.

Many patients will not find the cosmetic appearnce of their upper arm acceptable after a biceps tendon injury.

During your consultation we will discuss your imaging, surgical options, expected post-operative function and recovery pathway and whether surgical management is the right choice for you or not.

The collar bone (clavicle) is commonly broken during a fall and most commonly from a bicycle or high energy tackle in sport.

Some patients will elect to undergo surgery to realign the bone. During this surgery we will apply a plate and screws to the bone and restore the alignment.

During your consultation we will discuss your imaging, your expected level of function post-operatively and whether surgery or non-operative is the correct choice for you.

The radial head is commonly injured during a fall where the patient braces themselves with a locked elbow, forcing the radial head to be impacted against the humerus.

Many cases will return to normal function without surgery. In a small group of patients surgery is indicated by way of:

• Radial Head Fixation
• Radial head replacement
• Elbow stabilisation (ligaments)

During your consultation we will discuss your injury, imaging, options of fixation vs. replacement and any additional stabilisation that might be required.

Steroid or cortisone injections are commonly used for the treatment of inflammation of joints and tendons. We use steroid and local anaesthetic to relieve your pain and reduce your inflammation. These should be used as a supportive measure for your treatment and in conjunction with appropriate rehabilitation programs.

These can have varying results depending on your condition and are not without risk.

During your consultation we will discuss the pros and cons of such injections and whether or not these are a suitable option for your condition.

Hyaluronic acid injections are a relatively new addition to our options for treating joint pain and discomfort. These do not contain steroid.

Different injections have different components but generally speaking they act as a lubricant, drawing water into the joint from the surrounding tissue and allowing for smoother movement of your joint.

During your consultation we will discuss whether or not these are a suitable treatment option for you and your condition.

PRP injections involve taking some of your own blood in the office, spinning this in a purpose made bottle to separate the cells to extract the plasma and platelets and then injecting this into your site of pain.

This has been shown to be beneficial in the treatment of both joint and tendon inflammation.

As with all therapies this should be used in the correct patient, at the correct time and will depend on your condition.