GUIDE FUTURE RESEARCH FOR PROBLEMATIC KNEE REPLACEMENTS - INITIAL SURVEY COMPLETE!
Simon is an orthopaedic registrar and current NIHR Doctoral Research Fellow with an interest in improving orthopaedic treatment outcomes, care pathways and guidelines. Currently, he is undertaking a DPhil (PhD) aimed at improving the treatment of patients with meniscal tears of the knee and have established a patient and public involvement group in Oxford to support and guide this work.
Recently, Simon has helped to deliver a national treatment guideline for the management of meniscal tears, using consensus techniques, in collaboration with the British Association for Surgery of the Knee (BASK). He also has a clinical and academic interest in knee replacement outcomes and recognise the importance of optimising the care of the large and increasing number of people undergoing this procedure. The current James Lind Alliance initiative in this area aligns well with his research programme and my own experience of the benefits gained from patient and public involvement in prioritising and steering good quality, practice changing, research.
Abtin graduated from the University of London (Guy’s, King’s and St Thomas’ School of Medicine). During this time, he also completed an Intercalated BSc in Physiology and was awarded the prize for best performance in final year clinical examinations. After completing basic surgical training on the prestigious Hammersmith surgical rotation and the Royal National Orthopaedic Hospital (Stanmore), Abtin began his higher surgical training in trauma and orthopaedics on the Oxford programme in 2008.
He took three years out of programme in 2010 to undertake a PhD (DPhil) as the NIHR Biomedical Research Unit Fellow at the University of Oxford. His DPhil, titled “Improving Surgical Learning and Performance at Unicompartmental Knee Arthroplasty”, was supervised by Professors Jonathan Rees, David Murray, and Richie Gill. Abtin took up his post as NIHR Academic Clinical Lecturer at the University of Oxford in 2015
Dr Neil Artz is a senior lecturer in Physiotherapy at the University of the West of England. Neil has been a chartered physiotherapist for 16 years working within the NHS, professional sport, private practice and academia. Neil has 8 years of experience of knee replacement research after joining the Bristol Knee Group in 2010. Since this time, Neil has also worked on National Institute for Health Research funded projects with Bristol University and North Bristol NHS Trust investigating the benefits of group based physiotherapy following knee replacement. Prior to his knee replacement research, Neil completed his PhD investigating the effects of pain and mechanical loading on the sensorimotor function of the cervical spine and was a spinal extended scope practitioner within the NHS for 5 years.
Rachel Bray is a Research Nurse working at North Bristol NHS Trust. She trained as a Registered General Nurse in Bristol where she first developed her interest in Orthopaedic surgery and began her first post on a busy Trauma ward. Having taken the opportunity to work in Toronto for a year, where she worked on a mixed elective and trauma orthopaedic ward, Rachel returned to the UK and continued her interest in Orthopaedics. She completed the Orthopaedic nursing qualification and worked at the Avon Orthopaedic Centre in Bristol working in various roles within elective orthopaedics.
Rachel’s interests have since diversified to include orthopaedic research and clinical governance work. She has completed a Diploma in Research Methods at UWE and an MSc in Quality Improvements in Healthcare at Swansea University.
Rachel has a particular interest in knee surgery and has worked with the Bristol Knee Group since 2000. Her role encompasses monitoring the outcomes of patients following knee surgery, collecting & analysing data and co-ordinating a range of research studies.
Beverley C Hopwood MBBS MRCA MSc is an Associate Specialist who works half time as an anaesthetist and half time in Chronic Pain Management in the Royal Devon and Exeter Hospital, Devon, UK. As an anaesthetist she recognised that many patients continued to have problems long after surgery had been completed and she developed an interest in chronic pain management. Whilst doing a Masters in Pain Management she developed an interest in pain following knee replacement surgery and she based her prize winning dissertation around this.
This has been followed up by working with physiotherapy and knee surgical colleagues running specialist monthly clinics for patients with painful knee replacements to help optimise their pain management and avoid potentially unhelpful revision surgery.
Her personal success is helping an Orthopaedic Colleague become so aware of the complexity of post surgical pain that he has managed to get a paper published in a pain journal!
Mr Nick Howells is an NHS Consultant Orthopaedic Surgeon at the Avon Orthopaedic Centre at Southmead Hospital. His elective practice focuses on knee surgery including primary and revision knee replacement, cartilage and ligament injuries and management of early and advanced osteoarthritis.
Mr Howells completed his Undergraduate Medical training at Imperial College, London in 2003. His basic surgical training was in London and Oxford and his specialist orthopaedic training was on the Bristol Rotation. Mr Howells has completed two years of advanced fellowship training in knee surgery and trauma surgery in Australia. He undertook a fellowship at the internationally renowned Australian Institute of Musculoskeletal Surgery in Sydney under the supervision of Professor Leo Pinczewski gaining experience in all aspects of knee surgery, including the management of knee injuries in elite athletes. He then spent one year at the Royal Melbourne Hospital, one of the busiest major trauma centres in Australia, gaining experience in orthopaedic trauma surgery and knee surgery.
Johnny studied medicine at the University of Edinburgh and is now an orthopaedic registrar in Bristol. He has previously won a national Winston Churchill Scholarship and was selected as the inaugural leadership and management (FMLM) fellow at the Royal College of Surgeons, England. Johnny has gained further surgical experience during travelling fellowships under Brian Cole (Rush Sports, Chicago), Alan Getgood (Fowler-Kennedy Clinic, London Ontario) and Stewart Walsh (Unisports, Auckland). He is currently undertaking a PhD in the field of surgical innovation.
James started practicing as an orthopaedic consultant in Bristol in 2007. He holds elective NHS posts at The Avon Orthopaedic Centre, Southmead Hospital where he is the Specialty Director for Elective Orthopaedics.James graduated from Cambridge University, underwent basic surgical training in Oxford before working in knee and hip research in Newcastle. He then entered orthopaedic specialist training in the Wessex Deanery and won the EndoPlus Knee Prize in 2005. In 2006, he spent a Fellowship year in Sydney, Australia at the internationally renowned Australian Institute of Musculoskeletal Surgery, gaining valuable experience in sports injuries and joint replacement surgery under the supervision of Merv Cross. That same year he was awarded the British Association of Surgery for the Knee travelling fellowship.
James has a keen research and training interest and leads on a number of trials and contributes to others as a co-investigator. He works closely with his colleagues as a member of the Bristol Knee Group which carries out research and teaching related to knee surgery both in the UK and internationally. He is a member of both national and international collaborative consensus groups.James has a keen sporting interest, previously playing competitive squash, athletics and rugby, but now he tends to be more of a spectator, but still coaches rugby and still plays recreational squash and loves skiing! He is also a keen pianist, playing anything from Blues to Classical. He is married to a local GP at Bristol University Students’ Health Service and together they have three children.
Jonathan treats patients with conditions of the knee, specialising in knee arthroscopy (keyhole surgery), joint replacement and trauma surgery. He performs unicompartmental, total and revision knee replacements.
Jonathan was appointed as a Consultant Orthopaedic Surgeon in Exeter in January 2015 after completing his specialist training in the East Midlands. He undertook Fellowships training in knee surgery in Exeter and Nottingham, and he undertook a Travelling Fellowship to Chicago. He became a Fellow of the Royal College of Surgeons in 2013. He now works as one of the knee specialists at the renowned Exeter Knee Reconstruction Unit at the Royal Devon and Exeter Hospital.
To complement his training, he also completed a Master’s Degree in Sports Medicine at the University of Bath (receiving a merit award and was a Medical Team Leader on the athletics track at the London 2012 Olympics treating injured athletes.
Jonathan also maintains an active commitment to training, research and governance. He is on the advisory board of both Beyond Compliance and ODEP, national committees that evaluate new knee implants to ensure patient safety. He is on the editorial board of the popular BJ360 orthopaedic journal, and he is also a member of the prestigious AO trauma faculty that trains surgeons in trauma surgery.
Mr Andrew Porteous is a consultant orthopaedic surgeon, specialising exclusively in knee surgery. His practice treats a high proportion of complex ligament, joint replacement and revision cases from the South West, South Wales and from abroad. Andrew graduated in Medicine from the University of Cape Town (MBChB 1990) before undertaking his surgical and orthopaedic training in Bristol, England. He completed his sub-specialisation in Knee Surgery with a Fellowship under John Bartlett in Melbourne, Australia.
He holds a Masters degree in Orthopaedic Engineering and has been awarded the BASK President’s Medal. He is an editorial board member of The Knee journal and is a reviewer for the British Journal of Bone and Joint Surgery, as well as the European journal of Knee Surgery, Sports Traumatology and Arthroscopy. He lives in Bristol with his wife and three children. He formerly played representative level rugby and rowed for the University of Cape Town but now enjoys travel, swimming, cycling, tennis and golf – when he has the time
Professor Andrew Price studied medicine at the University of Cambridge (Gonville and Caius College) before completing his clinical studies at St.Thomas' Hospital in London. For his Orthopaedic training he joined the Oxford training programme in 1997, becoming a Clinical Lecturer in NDORMS in 2001. He was awarded a DPhil in 2003 through the University of Oxford (Worcester College), studying the Oxford partial knee replacement. He then completed a year of specialist Knee Fellowship training in Melbourne, returning to NDORMs and the Nuffield Orthopaedic Centre in 2004, where he was subsequently appointed Reader and Honorary Consultant in Knee Surgery.
In 2011, through the University of Oxford Recognition of Distinction exercise, he was made a Professor of Orthopaedic Surgery at NDORMS. His clinical work as a Consultant Knee Surgeon is based at the Nuffield Orthopaedic Centre, where he was Lead Clinician for Hip and Knee Team between 2009 and 2012. His research is based in NDORMS at the Botnar Centre, where he Leads the Knee Research Group. He is a Fellow of Worcester College (Tutor for Graduate Entry Medical Studies), Executive Committee Member for the British Association for Surgery of the Knee, acting Chair of the BASK Research Committee and a Member of the UK National Joint Registry Steering Committee.
David is a Surgical Care Practitioner in the Princess Elizabeth Orthopaedic Centre in Exeter, where he has worked for almost 17 years. Having started out originally as a scrub nurse, David has progressed to his current specialist role working within the Exeter Knee Reconstruction Unit. His scope of clinical practice includes the delivery of care within operating theatres as a surgical assistant, as well as working with post-operative patients in the wards and outpatient clinics. David also plays a part in the co-ordination of novel ways of working within the department. This includes the development and co-ordination of our Virtual Knee Clinics, and the co-ordination of regional team review meetings for the management of problem knee replacements and knee joint infections. Within the very active knee research department at Exeter, one of David’s key roles is to develop and maintain systems to help us with data collection and data analysis for a range of projects
As a Chartered Physiotherapist Rowenna has specialised in Musculoskeletal / Orthopaedic Physiotherapy. For the last 10 years, she has worked in the Exeter Knee Reconstruction Unit, where they have set up a Multi-Disciplinary Clinic for management of painful Knee replacements/ problematical native knee. One of the most successful parts of this is being able to have a team (Orthopaedic Surgeons, Anaesthetist specialising in Pain Management, Physiotherapist) that are using similar explanation of medical terminology to patients. The team try to ensure patients have realistic expectations regarding any potential surgery, or aim to get the knee in best possible condition prior to any further surgery.
Having seen many problematical primary Knee replacements and Revisions, Rowenna realises this can cause untold upset / misery to all involved from Clinicians, patients, relatives, let alone the cost of interventions. She feels passionate to ensure we give patients knees the best possible outcomes, that they are well informed regarding any potential surgery and have realistic expectations to engage with rehabilitation. She has a clinical interest in the management of the native osteoarthritic knee.
Andrew Toms studied Medicine at Birmingham University where he was awarded the Sir John Lewis prize for medicine. He started his Orthopaedic and Trauma training immediately at the Birmingham Accident Hospital and followed this through with a year's basic surgical training rotation under the Professor of Orthopaedics, Auckland, New Zealand. He completed higher surgical training on the Stoke/Oswestry Orthopaedic training rotation and during this period completed a research degree in Engineering from Cardiff University focusing on revision knee replacement.
He was subsequently awarded a Smith & Nephew research award in 2003, British Association of Surgery of the Knee Educational Travel award in 2004, Cutner award from the Royal College of Surgeons of Edinburgh in 2004, British Orthopaedic Association award in 2004 and the Charnley Trust Foundation Award in 2004. He completed the Adult Reconstruction Fellowship in Vancouver at the University of British Columbia, where he spent a year operating, skiing, sailing and chasing his 3 young children. Andrew now specialises in surgery of the knee, particularly complex primary total knee replacement, revision knee surgery and knee trauma. He is currently on the European Knee Society research board, NIHR Orthopaedic lead for the SW and is research chair for BASK. Major research interests include pain post TKR, periprosthetic joint infection and alignment in TKR. The unit collaborates as part of NIHR trials and European multicenter studies in these key areas.
Ben graduated from Edinburgh Medical School in 2005, and undertook his postgraduate training in orthopaedic surgery in Edinburgh. He became a Fellow of the Royal College of Surgeons (Edinburgh) in 2016. Ben’s Medical Doctorate degree researched the impact of alignment on Total Knee Replacement surgery. He spent 2017 working in the arthroplasty unit at the Vancouver General Hospital in Canada and will start work as a Clinical Lecturer / Consultant at the Exeter Knee Reconstruction Unit in September 2018.
Dr Vikki Wylde is a Senior Lecturer in in Musculoskeletal Health Services Research at the University of Bristol. Her research is focused on improving patients’ outcomes and experiences of joint replacement, with a specialist interest in the assessment and management of chronic post-surgical pain after knee replacement. Vikki has experience in a number of different research methods, including systematic reviews, complex intervention development, feasibility studies and randomised controlled trials.