What we do

Joint replacement is one of the most common and effective techniques in surgery. There are now over 200,000 hip and knee replacements performed each year in England and Wales, and they are incredibly successful, with high levels of implant survival in the long term and excellent clinical outcomes. However, joint replacement is not perfect. Outcomes after total knee replacement are variable, and up to 20% of patients are dissatisfied with their final result. While complications occur in a small percentage of patients who undergo joint replacement, this still equates to large numbers of patients: around 1,000 patients a month have to undergo revision of their hip or knee replacement in the UK. Our research aims to address these problems from a number of standpoints, working with clinicians and academics in different disciplines both within and outside the Imperial College.

Why it is important

We are lucky as surgeons to have such successful interventions, but in the rare cases where joint replacements are unsuccessful, the outcomes can be devastating. One serious complication, infection, can lead to significant functional loss, morbidity, mortality, repeated major surgical interventions, and substantial resource use for healthcare systems. Small improvements in the management of complications, as well as a better understanding of when we can use less invasive surgical techniques, have the potential to generate significant benefits for large numbers of patients.

How it can benefit patients

The aim of our surgery is to develop less invasive, more effective, and safer options for patients undergoing joint replacement surgery.

Summary of current research:

1. Examining routinely collected national and international data to determine the predictors of revision and poor functional outcomes from surgeon, patient, and implant factors, particularly focusing on less invasive interventions such as partial knee replacement, which have a lower rate of serious complications.
2. Working with bioengineering to produce new instruments, implants, and techniques to improve outcomes following joint replacement.
3. Developing investigations and interventions to address the most serious complication of joint replacement, prosthetic joint infection.