News & Innovation

Young Adult Hip Problems By Mr Tahir Khan Consultant Orthopaedic Surgeon at the RNOH PPU

By Mr Tahir Khan
Consultant Orthopaedic

Hip joint is pivotal to normal bipedal ambulation. Any deformity in the articulation leads to significant disability in young, active individuals. Patients with hip problems, typically complain of the following:

  • Groin pain after physical activity
  • Dull ache or Discomfort after walking, running, dancing or prolonged sitting
  • Stiffness affecting hip movements
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Chronic Pain – A global concern  By Dr Tacson Fernandez

By Mr Panos Gikas
Consultant Orthopaedic and Sarcoma Surgeon
Honorary Lecturer, Department of Physics, UCL

Recently there has been an increase in interest in performing hip replacement surgery by less invasive means, and by smaller incisions. Some of these so called minimally invasive techniques however are only reduced skin incision techniques and are associated with the same muscle and/or tendon injury as “conventional” approaches.

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Chronic Pain – A global concern  By Dr Tacson Fernandez

People who through no fault of their own have their lives demolished by pain deserve our help. Professor Henry McQuay from Oxford clearly highlights the plight of chronic pain sufferers in his article in the BMJ 2008, “Help and hope at the bottom of the pile1

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Mr Goldberg - A Novel Stem Cell Treatment for Cartilage Defects in the Ankle

Articular cartilage is the thin shock absorber of the ankle. Like all joint surfaces the ankle is lined by cartilage which allows smooth gliding motion and transmits forces from the floor to the body. When the articular cartilage becomes damaged, as a result of trauma (ankle sprains or fractures) or as a result of loss of blood supply (osteochondritis dissecans) then the body has a limited repair potential.

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Mr Robert Lee - Minimally Invasive Anterior Column Reconstruction in Spinal Adult Degenerative Deformity

Spinal adult degenerative deformity encompasses a wide range of pathologies including spondylolisthesis (slip of one vertebra on another), scoliosis (sideways curvature of the spine) and positive sagittal balance (unable to stand upright due to flattening of the curves in the spine). Often all three of these conditions can present in one patient. Patients present with severe back and in particular leg pain due to degeneration of the intervertebral discs leading to compression of the nerves and ‘sciatica’.

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Birth Brachial Plexus Palsy  (BBPP - Erb’s Palsy) Mr. Tom Quick  MB MA(Cantab)FRCS

A 19th-century Bavarian doctor, Wilhelm Heinrich Erb, gave his name to a nerve injury which happens to babies during birth. Erb’s Palsy is a weakness of shoulder and elbow muscles.

Arm nerves come from the spine in the lower neck at C5, C6, C7, C8 and T1. These nerves come together at a major junction called the brachial plexus. During birth, as the child squeezes out of the mother’s pelvis, the neck can be over-stretched damaging the nerves. Injury can be mild, recovering rapidly and completely, nerves can be partially or totally snapped, or pulled clean from the spinal cord.

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Ankle Replacement Mr Andrew Goldberg OBE

Arthritis in the ankle is extremely painful and can affect someone’s quality of life as much as end stage heart failure. Even getting up to make a cup of coffee can be difficult.

The commonest cause of ankle arthritis is a break of the ankle or leg or recurrent severe sprains, but it can take anything up to 20 years to develop because the cartilage wears away gradually and with it does the shock absorbing capacity of the joint lining. Eventually bones rub against bones which cause a limp, stiffness and pain.

Physiotherapy and losing weight can help in some cases - otherwise, surgery may have to be considered.

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stem cell harvest and transplant for cartilage defects in the knee

Articular cartilage is a thin layer of highly specialised tissue that provides a smooth, lubricated surface for joint movement and transmits forces to the underlying bone. Articular cartilage, however, has a limited capacity for healing and repair, which means that once the joint surface is damaged, the subsequent repair is limited. The resultant repair is often with a different type of cartilage – fibrocartilage, which lacks the same biochemical structure as normal articular cartilage and has been shown to break down more rapidly. The injured joint is therefore unlikely to return to its original structure and function, predisposing the patient to premature osteoarthritis.

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