BSc MCh (Orth) FRCS (Orth) FRCS (Ed) Dip, Sports Med FFSEM
Hon. Professor, Division of Surgery, University College London
Clinical Research Lead, UCLH Orthopaedics
Divisional Clinical Director of Surgery UCH
Director, Institute of Sport, Exercise and Health, UCLH
Programme Director, UCH Rotation
Assistant Responsible Officer, UCH
Associate Education Director, UCLP
British Medical Association (BMA)
Medical Protection Society (MPS)
Royal Society of Medicine (RSM)
British Association of Sport and Exercise Medicine (BAESM)
British Orthopaedic Sports Trauma Association (BOSTA)
British Association of Clinical Anatomists (BACA)
Seddon Society at The Royal National Orthopaedic Hospital
British Orthopaedic Association (BOA)
Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT)
British Trauma Society (BTS)
British Hip Society (BHS)
British Association of Surgery of the Knee (BASK)
AO Alumni Association
American Academy of Orthopaedic Surgeons (AAOS)
Orthopaedic Research Society (ORS)
European Hip Society (EHS)
London Consultants’ Association (LCA)
Member of Council, Institute of Sports Medicine
Independent Doctor’s Forum (IDF)
Board Member Federation of Independent Practitioners (FIPO)
International Society of Hip Arthroscopy (IHSA)
2014-present Vice-president, British Hip Society
2013-2014 President, Orthopaedic Section, Royal Society of Medicine
2013–present Editor in Chief, Bone and Joint Journal (JBJS-B)
2013-present Chair, Grants Committee, British Orthopaedic Association
2011-present Steering Group, National Ligament Registry
2010-present Strategic Board, National Centre for Sport and Exercise Medicine
2009-present Executive Committee, British Orthopaedic Sports Trauma Association
2007-present Executive Board. FIPO
2005-present Research Committee Member, British Orthopaedic Association
2005-2011 Webmaster & Executive Committee Member, British Hip Society
2002-2005 Chair of Preadmission Committee, University College London Hospitals
2001-2012 Chairman Module Management Group, University College London
2013-present Editor in Chief, Bone and Joint Journal
2008-present Editorial Board, The Journal Of Bone and Joint Surgery
2006-present Editorial Board, Annals of the Royal College of Surgeons
2005-present Reviewer, Annals of the Royal College of Surgeons
2005-present Reviewer, Hip International
2004-present Reviewer, British Journal of Sports Medicine
2003-present Reviewer, Journal of Bone and Joint Surgery
2003-present Editorial Board, Journal of Arthroplasty
2003-present Reviewer, Journal of Arthroplasty
2003-present Reviewer, Clinical Orthopaedics and Related Research
2001-present Editorial Consultant, Sports Injury Bulletin
2001-present Reviewer, Injury
2000-present Orthopaedic Editor, Hospital Medicine
2008-2010 Editorial Consultant, Advances in Orthopaedics
My aim is to undertake clinical and basic science research at a level of international excellence.
I am almost unique in the UK as a clinical academic who combines a large volume clinical practice involving more than 100 0 operations per year, with renowned research in the fields of hip and knee implant and joint preservation surgery.
My area of research has high value for patients, healthcare providers and industry because the implantation of orthopaedic devices is increasingly exponentially (in 2012, >1 million hip and 1 million knee replacements were performed worldwide and 80,000 of each in the UK). There is considerable commercialisation potential in the field of better functioning and longer lasting hip replacements over the next 20 years. The global market for hip and knee replacement was worth $11.4 billion dollars in 2008, and this is estimated to increase by 673% for knee and 173% for hip implants by 2030. Revision surgery is becoming more common and more complex and can be minimised through better joint preserving surgery at a young age, good implant design, appropriate surgery and patient selection. My research will continue to be aimed at deferring the need for joint replacement, optimising function after joint arthroplasty, increasing the longevity of orthopaedic implants, evaluating the outcomes of patients with these implants, and reducing the number of failure that require revision surgery. This will benefit our patients and the UK economy.
I have spent the last 15 years setting up a variety of outcome modules and outcome studies after ACL reconstruction, total hip and total knee replacement as well as revision surgery at University College London Hospitals and the Princess Grace Hospital.
I have set up collaborations with anaesthetic, ITU and neuropsychology colleagues. At present there are studies ongoing into risk assessment and risk scoring in joint arthroplasty patients, into expectations both in disease specific situations and in relation to surgical intervention for sports knee reconstructions as well as arthroplasties and revisions, into quality of life prior and after surgery and functional measures both in primary and revision joint replacement.
I have instituted a programme of data collection within integrated care pathways, data bases and studies that have allowed us to collate and follow-up a number of cohorts in order to study sports injuries, knee and hip reconstructions and joint replacement outcomes and we are in the process of evaluating psychometric data, inflammatory markers and functional tests in the early post-operative period to correlate with medium term and longer term outcomes.
I have published on the use of the POMS scoring system looking at peri-operative morbidity and its impact on the economics of hospital admission and hospital stay.
I am now in a position to look at quality of life measures and functional measures in relation to primary and revision joint replacement and compare these.
I have treated over 150 patients with peri-prosthetic infections which have been very carefully recorded and data based and have been treated according to a standardised protocol which will be ready for publication within the next year. This has included a prospective randomised study of static versus mobile spacers for infected TKR. I have introduced an algorithm for single stage revision for infection that has been adopted internationally.
I have set up research focused on knee joint preservation. We have selected cohorts for over ten years of clinical details, imaging, operative details and scores on patients with acute knee injuries and their subsequent treatment, including meniscal repair, meniscal resection, meniscal replacement, ligament reconstruction and osteotomies. I now have a large set of cohorts that we are starting to analyse in an effort to understand knee joint preservation and, ultimately, the impact of sports’ injuries, and the associated surgery on subsequent osteo-arthritis. These cohorts and their analysis, in collaboration with other centres, will form part of the ARUK national centre for sport and osteo-arthritis.
I have set up a system for embedded data collection at the ISEH whereby all patients coming through will have body composition analysis, provide basic demographics and all the exercise equipment and testing equipment will collect data so that we can analyse changes over time.
I have used research funds obtained to set up an RSA imaging system to look at the musculo-skeletal system before and after surgery and evaluate new implants. I have also set up an imaging modality within the ISEH that allows us to under fluoroscopy and understand joint kinematics better than we have done in the past. We have also set up a biomechanics laboratory in ISEH that will allow us to evaluate outcomes functionally as well as by questionnaire and PROMS.
The system that I have set up collates cohorts of certain phenotypes with solid datasets for future interrogation. I have developed a unique referral practice for pelvic avulsion injuries and a large referral practice for injuries and early osteo-arthritis of the hip and knee to specialist clinics and will allow the analysis of these cohorts and associated data sets in order to determine significant biomarkers for healing, functional recovery and disease progression, and to help us to clarify appropriate interventions for these problems.
I fund and supervise eight research Fellows at any one time , each of whom has their own project within my research theme, which will continue into higher degrees or be passed on to the next set of Fellows.