News & Blog

Information on all things hips and knees

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Knee injuries in rugby are very common due to nature of the sport which can be gradual wear and tear or damage from impact and trauma.

Here we discuss two common knee injuries rugby player may experience:

Anterior Cruciate Ligament (ACL) injury

The ACL connects the thighbone to the shinbone, stabilising the knee joint, and is a common injury in rugby players due to quick twists and turns of the body.

Symptoms include:

  • Difficulty bearing weight on the knee
  • Swelling of the knee
  • Pain and ‘popping’ in the knee

Treatment consists of ACL reconstruction surgery which can be carried out via a minimally invasive approach, and consists of taking tissue from somewhere else in your body, or from a donor, to replace the damaged ligament.

Meniscus tear

The meniscus is cartilage between the shinbone and thighbone that absorbs shock. It can be injured through sudden changes in direction.

Symptoms include:

  • Sudden knee pain
  • Swelling of the knee
  • Difficulty bending or extending the knee

Treatment can involve surgery to repair the damaged tissue, or surgery to replace the whole meniscus.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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We all have fluid filled sacs known as bursa that cushion our joints. Bursitis occurs when they become inflamed.

Symptoms of knee bursitis are:

  • A painful knee
  • A swollen knee
  • The skin around the knee may be sore and tender

Treatments for knee bursitis:

You can try taking a break and resting your knee as well as using ice and anti inflammatories to reduce inflammation and pain.

It is also possible to have a steroid injection to reduce the swelling.

If your knee bursitis is particularly bad and not responding to the above, then an orthopaedic surgeon can drain it for you

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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Joint pain is commonly caused by degeneration as we age, overuse and injury. However, it is possible that stress and anxiety can cause or worsen existing painful joints.

The ways stress can affect your joints:

  1. Long term stress may cause a build up of inflammation in the body that may lead to painful hip and knee joints.
  2. Anxiety can cause you to tense your muscles which in turn can make them stiff, inflamed and painful.
  3. Stress can weaken your immune system which may lead to joint infections and pain.

However, it is difficult to conclude that anxiety and stress directly leads to joint pain and it is advise to get any hip and knee pain looked at by a professional to rule out any other underlying condition.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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Due to the sudden twists and turns when playing football, as well as the repetitive nature of running it is common for footballers to experience hip and knee pain.

4 common injuries to the hip and knee are:

Anterior Cruciate Ligament (ACL) injury

The ACL connects the thighbone to the shinbone, stabilising the knee joint, and is a common injury in footballers due to quick twists and turns of the body.

Symptoms include difficulty bearing weight on the knee, swelling of the knee and pain and ‘popping’ in the knee.

ACL reconstruction surgery can be carried out via a minimally invasive approach, and consists of taking tissue from somewhere else in your body, or from a donor, to replace the damaged ligament.

Meniscus tear

The meniscus is cartilage between the shinbone and thighbone that absorbs shock. It can be injured through sudden twisting and turning of the knee.

Symptoms include sudden knee pain, swelling and difficulty bending or extending the knee.

Treatment can involve surgery to repair the damaged tissue, or surgery to replace the whole meniscus.

Hip labral tear

Hip labral tear is a tear to the cartilage holding the ball and socket of the hip together. This can be caused by repetitive fast changes in direction when running.

Symptoms involve pain and instability in the hip.

Surgery is usually performed via a hip arthroscopy and consists of stitching the torn tissue back together or reconfiguring the damaged tissue with tissue from elsewhere in your body, or from a donor.

Hip osteoarthritis

Osteoarthritis is when the cartilage that protects the hip joint wears over time as you age or if you are particularly active. It is not unusual for football players to develop hip osteoarthritis due to repetitive vigorous hip movement.

Symptoms include joint pain, difficulty walking and stiffness in the hip.

Hip replacement surgery can repair or replace the damaged hip joint with a prosthetic joint.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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Hip osteoarthritis occurs when the protective cartilage breaks down usually due to wear and tear as we age, leaving the bones to rub against each other.

However, it is also possible to be more susceptible to osteoarthritis if you have had previous injury or trauma to the joint, if you are overweight, female and have had past conditions that may damage the joint, such as gout or rheumatoid arthritis.

Typically, symptoms of arthritis of the hip present as pain, swelling and tenderness of the joint. It is possible to experience knee pain, as well as groin pain if your hip is arthritic because the nerve that supplies the knee runs past the hip, which may be inflamed and sore.

Treating hip arthritis consists of taking painkillers and anti-inflammatory medication to help with pain and inflammation. Physiotherapy and exercise to help strengthen the muscles around the joint and loosing weight if you are overweight to reduce pressure on the joint.

If the above have not been successful or if your arthritic hip is advanced, then hip surgery to repair or replace the damaged hip joint can be considered.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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The two main types of knee surgery are:

An arthroscope (a tube with a small camera on the end), is inserted into a small incision made in the knee. The images from the camera are displayed on a monitor for your surgeon to see, and the procedure is carried out via another small incision in the knee.

Total or partial knee replacements are commonly performed on knee joints. During a knee replacement the worn out joint is removed and is totally or partially replaced with an artificial joint.

Mako robotic assisted surgery allows your knee surgeon to create a 3D model of your knee and to create a personalised surgical plan. Pre-defined plans with real-time tracking feedback allows your surgeon to operate to extreme accuracy. Robotic knee surgery is more accurate than manual techniques and helps to preserve healthy bone and tissue, which results in a faster recovery and less post-operative pain.

The most frequently performed knee operations are:

  • Meniscus surgery

The meniscus is cartilage that acts as a shock absorber between the shinbone and thighbone. If you are experiencing knee pain, swelling, and difficulty extending or bending the knee then you may have damaged or torn your meniscus.

Arthroscopic knee surgery is used to repair the damaged meniscus. This can be performed as a partial meniscectomy or meniscal repair to remove or repair the damaged tissue. Meniscus transplant surgery can be performed to replaced the whole meniscus and replace with donor tissue.

  • Anterior cruciate ligament reconstruction (ACL)

The anterior cruciate ligament (ACL) connects the thighbone to the shinbone and stabilises the knee joint and is one of the most common sporting injuries. If you are struggling to bare weight, have swelling, severe pain and ‘popping’ in the knee, then you may have a ruptured ACL.

ACL reconstruction is carried our via a knee arthroscopy. It consists of taking tissue from elsewhere in your body to replace the ligament. It is also possible to use donor tissue or an artificial graft.

  • Patellar tendon repair

The patella tendon connects the bottom of the knee cap to the shinbone. If you have pain and tenderness in your kneecap, swelling and difficulty bending and straightening the leg then you may have damaged your patella tendon.

The damaged parts of the tendon are removed and then stitched back together. If your patellar tendon is badly ruptured you may have the tendon replaced with tissue from elsewhere in the body or with donor tissue.

  • Investigation of the knee joint

Knee arthroscopies are often performed to take a look inside the knee joint to investigate any abnormalities inside the joint.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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The Anterior cruciate ligament (ACL) joins the thigh bone to the shin bone at the knee joint, and provides stability to the joint.

Causes of an ACL tear

An ACL tear and other knee ligament injuries are often caused by playing sports such as football, netball and rugby due to the nature of sudden twists, turns and overextending the leg.

Symptoms

If you have a ACL tear you will probably be experiencing pain and your knee giving way, as well as have limited mobility to your leg.

ACL reconstructive surgery

Surgery can consist of repairing the torn ligament by stitching it back together, or using a graft of tissue from elsewhere in your body or a donor. The joint surface or cartilage may also be repaired if it is damaged. You will then have physiotherapy rehabilitation to help build your strength back up again and get back you on your feet and active again.

Surgery can be performed using a minimally invasive approach (key hole surgery) to reduce your stay in hospital and speed up your recovery time.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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Sports enthusiast Neil experienced sudden knee pain which was so severe it inhibited his mobility and left him unable to climb the stairs and enjoy his daily life.

After consultation with Mr Makrides from Midland Hip and Knee Clinic, he had a partial knee replacement and was back at the gym squatting just 3 months after his operation, and has recently, 4 months after his knee surgery, posted the fastest rowing times recorded by Concept 2’s contributors (ages 60-69) around the world so far this season at 1000 and 2000 metres.

Neil, experienced popping and clicking in his right knee for a few years until he suffered a severe sharp pain which left him in excruciating pain and unable to bear weight on his joint, making his job as a Gym Manager untenable, and no longer able to pursue his love of exercise and physical challenges.

After visiting his GP and being given a course of anti-inflammatories for arthritic wear and tear of the knee joint, he had a short period of improved mobility but decided to pursue surgery to enable him to get back to his active lifestyle.

Neil was treated by Consultant Orthopaedic Surgeon, Mr Panos Makrides at Spire Parkway Hospital in Solihull. His main desire from the outcome of surgery was to get into the top ten UK times for 2000 metres in his age group on Concept 2’s indoor rowing ranking, after not being able to progress rowing over the past 2 years due to his knee pain.

Neil says, ‘Mr Makrides, while managing my expectations, reassured me that normal function and my rowing were achievable.’

Following surgery, Neil was able to work through the post operative rehabilitation exercises well enough to be discharged within 24 hours, and continue follow up physiotherapy appointments to aid his recovery further. 

Just a few months after his partial knee replacement surgery, he was back on the rowing machine and posted the fastest time recorded by Concept 2’s contributors (ages 60-69) around the world so far this season at 1000 and 2000 metres.

Neil says, ‘I’ve been shocked how quickly I have been able to perform at an excellent level. I am delighted to think that within 10 months of a partial knee replacement I have every chance of setting a new GBR 1000m record, aiming to challenge for the 2000m record and maybe have a chance of qualifying to compete at C2’s World Championships in Toronto in Feb 2023’.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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Hip dysplasia, or developmental dysplasia of the hip (DDH) is when the ball and socket part of the hip joint does not form properly in babies. It is most common in the left hip of girls, although both hips can be affected.

This can happen when the socket is slightly too shallow which results in the ball (the femur) not being held in place as tight as it should be. This can result in the femur dislocating.

How is hip dysplasia diagnosed?

Every newborn baby has a physical screening examination, during which the baby’s hips will be checked. If the midwife or doctor thinks there may be an issue, an ultrasound will be scheduled.

How is hip dysplasia treated?

Often a baby’s hip can correct itself within the first few weeks but if it hasn’t then there are treatments available. If hip dysplasia is left untreated it may lead to limping when walking, osteoarthritis of the hip and frequent pain.

If a baby is diagnosed with hip dysplasia in their first few weeks of life, they will likely be fitted with a splint called a Pavlik harness, which holds the baby’s hip in a stable position and is worn for a few weeks.

If the harness has not helped or if the baby is diagnosed later on in life (after 6 months) then surgery may be required. Surgery for hip dysplasia is called reduction surgery. It is carried our under general anaesthetic and surgically places the femur head into the hip socket.

Sometimes mild to moderate cases of DDH are not picked up in infancy which can leave you more prone to getting arthritis in the hip at a younger age. Mr Makrides is a specialist who manages the consequences of hip dysplasia if it was not picked up and corrected in infancy.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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Joint pain can come with age through wear and tear, as a lifetime of overuse can take its toll on our hips and knees.

The tissue and cartilage that surrounds and protects the joints gradually thins over time which can cause the bones to move less freely. The most common degenerative condition of the hip, knee and sometimes hands is Osteoarthritis.

What can I do to reduce joint pain?

Lifestyle plays a huge part in reducing joint pain. Maintaining a healthy diet as well as regular exercise can have a positive impact, by not only reducing the weight load on the joint but also by building and strengthening the muscle support. Exercise also produces hormones which make you feel good which in turn may alleviate your discomfort level.

Swimming is a great low impact workout and also works your body harder due to the resistance of the water. Regular walking is also beneficial and can not only prevent the onset of pain but also slow down the degeneration of the joint. However, never continue exercising if it is causing you pain.

If your pain is particularly bad to the point where your mobility and movement is limited and the pain is regular on the majority of days then it may be worth seeking professional help.

Why is joint pain worse at certain times of the day?

Joint pain can be worse in the morning due to stiffness from lying still for a long period of time over night. Usually, any discomfort should pass fairly quickly and is a sign of wear and tear on the joints. If it lasts for longer periods of time then you may have a more severe condition of the joint.

Is joint pain more common in women?

Yes, Osteoarthritis most often affects women, mainly after going though the menopause due to the decrease in oestrogen.

What treatments are available for joint pain?

The underlying cause of joint pan will need to be found in order to be treated, however painkillers and anti-inflammatory medication may help initially to reduce swelling and therefore pain. It is also important to maintain a healthy weight and active lifestyle to strengthen the muscle and ease pressure on the joint.

Depending on the condition causing hip and knee pain, treatments available may be a hip arthroscopy, knee arthroscopy, hip replacement or knee replacement.

How do I book a consultation?

You can book either a face to face or virtual consultation with Mr Makrides by contacting his secretary. You can find her details here.

Appointments are available via private medical insurance or paying for yourself. Click here for the most up to date self funding fees, and here for private medical insurance information.


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Welcome to the Midland Hip and Knee Clinic based at Spire Parkway in Solihull, Spire Little Aston in Sutton Coldfield and Spire South Bank in Worcester. We offer Self-funding and Private Insurance payment options.

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