Orthopaedic Surgery l Trauma
l Hip Surgery l Spine Surgery
l Foot Surgery
I have benefited from
formal training in knee arthroscopy and have mastered the
use of powered instruments, meniscal repair, knee ligament
reconstructions, and fracture fixation techniques.
I have a wide experience
of anterior cruciate ligament surgery and have used bone patellar
tendon bone and hamstrings fixed by numerous methods. I
have been particularly interested in posterior cruciate ligament
reconstruction and have experience of arthroscopic and single
and two incision techniques, and use reconstructions using
bone patellar tendon bone, quadriceps tendon, hamstrings and
allograft using single and double bundle techniques with or
without a ligament augmentation device.
I am also interested
in the treatment of complex instabilities of the knee with
multiple ligament damage, posterolateral corner damage or
in a mal-aligned lower limb requiring proximal tibial osteotomy
as part of the treatment of the instability. I
have experience of the operative treatment of patellar malalignment,
trochlear dysplasia and recurrent dislocations.
I have experience of the treatment of knee osteoarthritis by distal femoral and proximal tibial osteotomies using opening and closing wedge techniques and hemicallatosis by external fixator. I have been shown osteocondral autograft transfer techniques but my experience was fortunately limited to cadaveric specimens. However, in clinical practice I prefer using microfracture techniques due to the lack of donor site morbidity. I am trained in the use of autologous chondrocyte implantation techniques, and enrolled in the MRC trial of its use for chondral lesions, participating in the ACTIVE Trial from 2006-8. From 2008-9, I took part in the SUMMIT Trial of of Articular Cartilage Repair Using Matrix-induced Autologous Chondrocyte Implantation (MACI) mini-open technique versus microfracture. Genzyme’s MACI® is the most commonly performed second-generation Cartilage regeneration procedure.
Since 2009, I have been a consultant to Genzyme and I am now a member of the Medical Advisory Board to Genzyme Worldwide that held its first meeting in Zurich recently helping to define the operative technique for arthroscopic MACI insertion.
I have developed an arthroscopic technique for the management of patello-femoral instability due to trochlear dysplasia (malformation of the kneecap joint)which was a world first, previous techniques involved a formal open surgical approach which were far more painful for the patients and took longer to recover from. The outcomes of my first five cases with up to three year follow-up are to be presented to BASK in Cardiff and at ISAKOS in Brazil and EFORT in Copenhagen next year. The paper describing the technique and its early outcomes is being written in collaboration with Prof John Fairclough of the University of Cardiff.
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I have been trained in primary arthroplasty of
the hip and have used a number of cemented, cementless, and hybrid
systems. During my training I gained much experience in revision
surgery for aseptic and infected loosening, and the management of
periprosthetic fractures. I have learned techniques to manage acetabular
and femoral bony deficiencies. I have assisted at proximal femoral
osteotomies for the management of osteoarthritis, and carried out
Ficat decompression for early avascular necrosis.
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I have had exposure to elective spinal surgery
both during the pre-fellowship neurosurgical attachment, in Raigmore
Hospital and during my attachment to the Tayside Regional Spinal
Surgery Unit. I have carried out cervical and lumbar prolapsed disc
and spinal decompression surgery, and have experience of cervical,
thoracic and lumbar spine fusions. My current practice with neck
and back pain is limited to the assessment, investigation, diagnosis
and conservative management of these problems. For the 3% of patients
who fail conservative, non-operative treatment I would refer them
onto my Consultant Spine Surgery Colleagues.
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I have treated problems of the foot and ankle
by orthotic and operative means including surgical management of
common problems of the forefoot such as painful bunions, hallux
valgus, hallux rigidus and hammer toe deformities.
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