Information for clinicians

Foot and ankle

Our highly specialist team offer the full spectrum of care for all foot and ankle disorders, including treating some of the most challenging conditions. Our aim is to offer individualised, patient-centered care, working collaboratively to improve the quality of lives of our patients.

Our fully comprehensive service treats conditions, including bunions and lesser toe deformities, sports injuries, deformity around the foot and ankle, and arthritis. As one of Europe’s busiest trauma centres, we also see and treat high volumes of foot and ankle trauma andspecialise in high energy injuries and complex fractures.

Using the latest imaging techniques, such as standing CT scanning, we can offer detailed diagnosis of problems and thorough planning of treatment, including specialist surgery. All our consultants have undertaken advanced fellowship training in foot and ankle surgery, both nationally and internationally, becoming highly skilled in the latest surgical techniques, including minimally-invasive and arthroscopic surgery and joint preservation techniques, such as total ankle replacement.

The unit receives surgical trainees from around the region and runs a highly competitive, nationally-recognised fellowship training programme. Our consultants represent a number of specialist societies, including the European Foot and Ankle Society (EFAS), the British Orthopaedic Association (BOA) and the American Orthopaedic Foot and Ankle Society (AOFAS), contributing to education, international collaboration and innovation in orthopaedics. Our team is passionate about research and education; publishing widely on all aspects of foot and ankle surgery and acting as faculty on numerous courses and lectures worldwide.

Upper limb

Our team of experienced surgeons treat the entire spectrum of upper limb disorders and traumatic injuries. Our aim is to enable patients to return to an active, pain-free lifestyle as quickly as possible. We aim to provide our patients with the best possible experience throughout their treatment journey. Our surgical team is led by fellowship trained and internationally recognised consultant surgeons.

We provide world class care for the full range of musculoskeletal disorders, from the shoulder to finger-tip, and are a regional hub and tertiary referral centre for complex elective disorders and trauma in the upper limb. 

We work very closely with specialist colleagues in Plastic Surgery as well as the Trust’s specialised Therapy services.

We have two international fellowships in advanced upper limb surgery.

Seeing patients making a full recovery is the most rewarding aspect of our practice. Teaching how we achieve this and sharing our experience with our trainees is an important aspect of our unit work. Our team maintains cutting edge orthopaedic knowledge and is regularly invited to share our knowledge and experiences at international meetings. We host two2 of London prestigious orthopaedic training programs (Percivall Pott and Royal London) and work closely with Queen Mary University of London, where several of our team hold honorary senior lecturer positions and are MSc faculty members.

We are proud to be at the forefront of orthopaedic research. We are involved in several National Institute of Health and Care Research (NIHR) trials and other internationally funded studies. We strive to promote innovation and advances in bone and joint health.

Lower Limb

The lower limb service within Barts Bone and Joint Health offers the full range of care for patients with lower limb conditions. We have a long, rich heritage of innovation, training and research in orthopaedics.

Our service is located at the Barts Health Orthopaedic Centre (BHOC), our dedicated elective orthopaedic centre,the Royal London Hospital, providing complex orthopaedic care alone, and Whipps Cross University Hospital, our centre of excellence for hip fractures.

Our consultants work together within a multidisciplinary team to deliver optimal care, offering expert opinions from a group of experienced and caring surgeons. We treat the full spectrum of orthopaedic complaints, including degenerative joint disease, sporting and traumatic injuries, developmental conditions, inflammatory joint problems, bone and joint infections, and metastatic bone cancer. Surgical procedures include arthroscopic (keyhole) surgery of the hip and knee; partial, total and revision hip and knee replacements, including custom made joint replacements, pelvic reconstruction operations, and osteotomies for deformity correction.

We offer complete care to children and adults from our local area, as well as patients from across the UK and internationally. Each consultant has fellowship-level expertise to ensure we provide patients with the highest possible level of care.

Our service is integrated with the academic orthopaedic department, a dedicated fellowship programme and the Percivall Pott and Royal London Hospital training programmes. We deliver world-class training to doctors from the UK and abroad from the start of their careers to the most senior surgeons developing specialist skills.

Limb reconstruction

Limb reconstruction is a subspecialty of orthopaedic surgery, treating complex orthopaedic conditions such as complex lower limb trauma, bone infection, malunion, non-union (where the bone does not heal or does not heal correctly), large bone defect treatment, and skeletal deformities including short limbs.

All limb reconstruction procedures in our unit, based at the Royal London Hospital, are tailored individually to our patients. We follow established surgical principles and use a variety of internal implants or external frames to reach the best possible outcome for our patients.

Our orthopaedic consultant team is led by Mr Alexandros Vris and Mr Alexios Dimitrios Iliadis and is complemented by our clinical nurse specialist, Ms Jade Brien and our limb reconstruction physiotherapist, Mr Daniel Church. Our multi-disciplinary team works closely with plastic and vascular surgeons, microbiologists, endocrinologists, musculoskeletal radiologists, podiatrists, clinical pharmacists, clinical nurse specialists, and physiotherapists.

We have established and published our own breakthrough technique for all-internal bone transport in the femur. We collaborate closely with the limb reconstruction unit inat the Royal National Orthopaedic Hospital in Stanmore, running a joint international fellowship, a monthly meeting for challenging case discussion, and sharing research best practice.

We believe that training and education are key and run regular limb reconstruction training courses for junior surgeons, as well as our other broader team members. We support charity work abroad by donating all our reusable hardware to areas affected by conflict and developing countries.

Multiple injured patients

For over 25 years, The Royal London Hospital has been the UK’s premier level one trauma centre, dealing with the most severely injured patients in London. The Royal London remains by far the busiest centre in the UK and hosts London Helicopter Emergency Medical Service (HEMS) service on the helipad. 

Patients who have been involved in hugely traumatic (so-called ‘high-energy’) injuries come to us with many different problems; from the immediate life threatening (for example, massive blood loss or severe head trauma) to the long-term disabling (such as fractures, dislocations and loss of limbs).  The collection of trauma specialists within the hospital are leading experts within each of their respective fields at managing these conditions, working together with a fluidity that has been developed and fine-tuned over decades.  Care of the severely injured patient is absolutely within our expertise, and much of our time is spent training those future trauma specialists who will go on to do important work elsewhere in the future, passing on the knowledge.

On the orthopaedic side, our primary goal is to get patients back to as close to their pre-injury level of function as possible.  When almost every major region in the body is broken, it takes a huge amount of collaboration, expertise and familiarity to make sure surgery is done to the very highest standard, so the rehab process can start, and patients can begin returning to their lives.

Spine

The spine team at Barts Bone and Joint Health provides the complete range of adult and paediatric spinal services. The team are leaders in treating degenerative spine disorders, spinal deformity, scoliosis, back pain and disc disease. We are a specialist regional centre for spinal trauma and are leading the way in the treatment of spinal injuries. One of the few combined orthopaedic and neurosurgical departments in the UK, our team treats patients from around the world and can offer cutting edge technology, including navigated surgery, computer aided implants and robot operations to ensure the best outcome for every patient.

The department acts as the hub for the North East London and Essex Spinal Network, taking the leading role in education and research in the region. Benefitting from one of the only academic spinal groups in the UK, the service consistently works towards discovering new ways to manage patients with spinal disorders using the wealth of experience and the large, diverse population in London and Essex. Regular publication of peer reviewed papers, international presentations and pioneering undergraduate and postgraduate education, Barts Bone and Joint Health spine team is setting the standard for 21st century spinal care.

Young adult Hip

The Young Adult Hip service is a subspecialty of orthopaedic surgery, treating young patients (usually less than 40 years-old) with painful hip conditions, such as femoro-acetabular impingement, hip instability, deformity, sports injury, avascular necrosis, and degenerative conditions.

We aim to preserve native hip joints by treating the area of injury, for example labral tear by arthroscopic or key-hole surgery, and addressing underlying bony deformity and compromised biomechanics with bony procedures. When degenerative changes are too severe for hip preservation, we offer hip resurfacing or replacement, by minimally invasive techniques or using tailor-made implants where indicated.

Our unit is based at the Royal London Hospital and Barts Health Orthopaedic Centre.

Our consultant surgeons, including Paul Lee, Josh Lee, Pramod Achan, Sebastian Dawson-Bowling, Gareth Scott, and Professor Manoj Ramachandran, are skilled in various hip preservation, resurfacing and replacement techniques and work closely with specialist musculoskeletal radiologists and physiotherapists.

The unit engages and contributes to research and innovation with publications in areas of joint preservation and arthroplasty surgery. We run formal and informal teaching sessions for specialist training surgeons, for GP surgeries and for allied healthcare provider colleagues. Our referral pathway for primary, secondary and tertiary care is illustrated below. Our point of contact for enquiries is: najura.ahmed@nhs.net

Paediatrics

The paediatric orthopaedic department at Barts Bone and Joint Health delivers all aspects of children’s orthopaedics and trauma. At the Royal London Hospital, we have dedicated clubfoot, paediatric and adolescent hip, multidisciplinary sports, and comprehensive neuromuscular services. We also run routine multi-disciplinary one-stop baby hip clinics for babies with hip dysplasia and manage complex paediatric deformity clinics.

All paediatric orthopaedic and trauma procedures in our unit are tailored individually to our patients. For complex cases, there is a weekly Multi Disciplinary Team (MDT)If you where collaborative decisions are taken as to the best intervention. Our orthopaedic consultant team consists of five surgeons: Manoj Ramachandran, Claudia Maizen, Paulien Bijlsma, Gregory Firth, and Dimitrios Manoukian, providing a comprehensive paediatric orthopaedic and trauma service. Along with our two dedicated clinical fellows, our multidisciplinary team works closely with senior physiotherapy practitioners, plaster technicians, occupational therapists, anaesthetists, theatre nurses, endocrinologists, and musculoskeletal radiologists.

We are constantly innovating in terms of our clinical workflow algorithms, operative techniques and novel projects in digital and devices. Our research output is extensive and we have a large global network of top tier teaching hospitals with which we collaborate. We have a strong background in charity work abroad, having set up a charitable foundation, with frequent treatment and training trips to countries such as Ghana.