News & Blog

Information on all things hips and knees

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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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Mr Makrides has proudly celebrated being part of the team at Spire Little Aston Hospital, who have achieved 500 Mako Robotic Assisted Joint Replacements!

Mako allows your surgeon to create a 3D virtual model of your hip or knee’s unique anatomy so he can follow your unique personalised plan during surgery.During surgery, the robotic arm guides the surgeon within a pre-defined area using real-time tracking feedback which can adjust for very small movements. This makes it extremely precise and accurate when putting the implant in.

Advantages of the Mako robotic arm are:

  • Can be used for partial or total hip and knee replacements
  • Helps create a personalised surgical plan
  • 2-3 times more accurate joint replacement than manual replacement
  • Produces minimal blood loss and a smaller scar
  • Helps preserve healthy bone and soft tissue
  • Results in less post-operative pain than manual techniques
  • Provides a quicker recovery and shorter hospital stay

What is recovery like?

Recovery is much quicker than traditional hip and knee replacements. You will have a personalised physiotherapy plan and may be able to walk just hours after your surgery, and return to your everyday activities in 1-4 weeks.

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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A hip fracture is a break in the femur (top of the thigh bone). Fractures are often caused by falls and are more common in the elderly. Some conditions such as Osteoporosis can weaken the bones and cause hip fractures.

Symptoms of a hip fracture

  • Hip pain
  • Difficulty bearing weight on your leg
  • Trouble moving and lifting your leg

Treating a hip fracture

Usually surgery is required for a hip fracture. Sometimes the hip can be supported with plates and screws, however most cases may need a hip replacement. The type of surgery you will be offered will depend on your age, your health, how bad the fracture is and the condition of your bones.

Can I prevent a hip fracture?

As most hip fractures occur in the elderly or those with osteoporosis, you could use a walking aid for support and perform exercises to help strengthen the muscles around your joints.

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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Both hip resurfacing and hip replacements are operations to help relieve hip pain. Hip pain is often caused by the cartilage that cushions the bones wearing down over time and causing pain and inflammation.

Hip resurfacing?

Hip resurfacing is where the damaged surface of the femur (ball of the thighbone), and the socket are removed and reshaped. This retains most of the bone and is usually offered to younger, more active patients. Hip resurfacing is more commonly performed on men as women won’t benefit from the procedure for as long due to levels of oestrogen changing after the menopause.

During hip resurfacing surgery, your consultant orthopaedic surgeon will:

  1. Make a small incision in the thigh to access the hip joint
  2. Shave the damaged bone and cartilage from the femur (ball of the thighbone)
  3. Attach a smooth metal cap to the ball
  4. Remove the damaged bone and cartilage from the hip socket
  5. Attach a metal shell into the hip socket
  6. Move the femur (ball of the thighbone) into the hip socket
  7. Close the incision with stitches

Hip resurfacing can be quicker to recover from than a traditional hip replacement and can be effective long term relief from hip pain for younger more active patients.

Hip replacement?

A hip replacement is where the whole joint is removed and replaced with an artificial one. It is a common procedure and offered to older patients with significant joint damage and severe symptoms.

During hip replacement surgery, your hip surgeon will:

  1. Make a small incision in the thigh to access the hip joint
  2. Remove the damaged femur (ball of the thighbone) and socket
  3. Implant the replacement socket
  4. Insert a short metal stem with a ball on it into the ball of the thighbone
  5. Close the incision with stitches.

A hip replacement can hugely reduce pain, with almost all patients getting complete, or near complete relief from arthritic hip pain, and thus increased mobility.

Minimally invasive hip surgery

Mr Makrides offers minimally invasive hip surgery using the Direct Superior Approach. This avoids damage to surrounding muscles and tissue which results in a shorter hospital stay and a faster recovery time.

Robotic assisted hip surgery

Mr Makrides can also perform hip replacement surgery using the Mako robotic arm assisted surgery. This is carried out at Spire Little Aston Hospital and allows your surgeon to use the robotic arm to guide him along pre-defined areas using real time tracking which adjusts to the smallest of movements. This results in extremely precise surgery with minimal blood loss, scarring and post operative pain.

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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Keeping your bones and joints healthy can help to prevent serious damage if you are injured or especially from wear and tear as we age due to our bodies loosing bone density over time. Women are more at risk of bone and joint conditions such as osteoarthritis once they have gone through the menopause.

Foods for bone and joint health

It is beneficial to consume calcium rich foods as the only way our bodies get it, is by our diet. Calcium rich foods include:

  • Dairy such as milk, cheese and yoghurt
  • Green leafy vegetables such as broccoli and kale
  • Fortified foods such as bread and soy
  • Nuts

Alcohol and carbonated drinks can prevent your body from absorbing calcium.

Supplements for bone and joint health

Vitamin D is important for your bone health as it helps the body absorb calcium. Most people in the UK do not get enough vitamin D, especially in the winter months so it might be worth taking a supplement.

Exercises for bone and joint health

Exercise can help reduce the load on your joints by helping you loose any excess weight, as well as build the muscles around the joint.

Low impact activities such as swimming are good as they don’t put stress son the joints as running does.

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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Perthes’ disease is a rare childhood condition affecting the hip. The femoral head (the ball of the joint) loses blood supply and without oxygen from the blood supply, the femoral head becomes malformed.

Symptoms of Perthes’ diesease

  • Hip pain
  • Groin pain
  • Joint stiffness
  • Walking with a limp

Is Perthes’ disease curable?

Most children with Perthes’ disease respond well and recover from treatment. Treatment can involve surgery to re-shape the bone. This is done via an Osteotomy procedure where the bone is cut and repositioned and surgically held in place, until the bone has healed.

Can Perthes’ disease cause a problem later in life?

If left untreated Perthes’ disease can lead to arthritis of the hip joint which may result in needed a hip 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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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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If you are experiencing groin pain, you may actually have a hip condition and the pain is radiating downwards. If you are older it may be due to arthritis or fracture. If you are younger you may have hip pain as a result of an underlying condition such as hip dysplasia or hip impingement.

Arthritis of the hip

Osteoarthritis is when the protective cartilage on the ends of your bones wears down over time which causes pain as the bones will rub against each other.

The main symptoms of osteoarthritis of the hip is pain, tenderness and stiffness.

Most commonly osteoarthritis is caused from wear and tear as we age, being overweight, having other conditions such as rheumatoid arthritis or gout. It is also more common in women than men.

If your symptoms are milk you can try to treat your symptoms with lifestyle changes such as loosing weight, taking anti-inflammatories or steroid injections. However, if your symptoms are interfering with the enjoyment of your daily life and the joint is badly damaged then surgery can be explored.

Hip replacement surgery, also known as an arthroplasty, is a common procedure where the damaged joint is removed and replaced with an artificial one.

Depending on the condition of your knee you may be offered a total hip replacement, or a partial hip replacement.

Mr Makrides specialised in minimally invasive hip surgery to reduce your hospital stay and increase your recovery time, as well as Mako robotic assisted hip replacement.

Hip fracture

A hip fracture is a break in the top of the thigh bone, usually caused by falling or a direct injury.

You may experience hip pain, difficulty moving your leg or bearing weight.

You may need hip surgery to secure the joint with plates while it heals, or you may need a hip replacement if the break is particularly bad.

Developmental dysplasia of the hip (DDH)

DDH is checked for at birth, however mild to moderate cases can be missed and only diagnosed in adulthood after an investigation into what is causing your hip pain.

DDH causes the hip socket to be shallow and not sit flush with the ball. If diagnosed later in life you may have arthritis at a younger age. A hip arthroscopy is usually performed to stabilise the hip joint.

Hip impingement

Hip impingement or femoroacetabular impingement (FAI), is when something causes the bones in the hip joint to rub against each other, such as a difference in the size compatibility of the ball and socket, which can cause pain.
 
It is often mistaken for other conditions such as sprains and many people may suffer with hip pain before a full diagnosis. It can cause arthritis at a younger age. You may have a hip arthroscopy to shave off excess bone to align the ball and socket.

Labral tear

A labral tear is an injury to the cartilage that holds the ball and socket of the hip together. It is often the result of conditions such as hip dysplasia or hip impingement. It can cause pain and instability in the hip joint and increase the risk of developing arthritis at a younger age.

Surgery is usually performed via a hip arthroscopy to repair the damage. If you have an underlying conditions such as hip dysplasia or hip impingement then you may also have treatment for them at the same 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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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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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.

Copyright 2022. Panos Makrides - Specialist Hip and Knee Surgeon