For those running the London Marathon on 21 April, you’ll now be entering the tapering stage, reducing your weekly mileage and allowing your joints to recover, muscles to repair, and body to recharge for that final test of your endurance.

Could running actually be good for knees?

For years, it has been perceived that running is incredibly damaging to your knees, yet several studies published recently have debunked that myth.

In a study published last year, researchers at Northwestern University in the US explored the relationship between long-distance running and knee arthritis. They established that a running history was not significantly associated with an osteoarthritis diagnosis.

The researchers surveyed almost 4,000 participants in the 2019 and 2021 Chicago Marathon for a detailed history of their running activity alongside a record of their knee pain and other arthritis symptoms.

The critical factors in developing knee arthritis were age, BMI, family history, and a previous knee injury or surgery.

This research follows a 2019 study published in the British Medical Journal for Sports & Exercise Medicine. This studied beginner, middle-aged runners and found that distance running did not result in the progression of meniscal tears and rebuilt some damaged cartilage. However, it did find damage to the cartilage and other tissues around the kneecap or patellofemoral compartment.

Common running knee injury conditions

Whether running long distances, doing couch to 5K or regularly attending your local Parkrun, it is essential to be aware of the effect running has on your joints. For each pound of body weight, your knee absorbs one and a half pounds of stress when you walk, which jumps to nearly four pounds when running.

Patellofemoral pain syndrome (PFPS)

This is the most common type of running knee injury. Pain is usually felt above, under, or just below the kneecap, and it typically worsens when you run or walk up the stairs. Often, the cause is biomechanical, which means the kneecap’s position is causing excessive friction or there is a muscle imbalance. It is treated with non-invasive measures such as rest and exercises aimed at improving strength and flexibility.

Iliotibial band syndrome (ITBS)

This thick band of tissue that runs all along the outside of your knee and thigh is the leading cause of pain on the outer part of the knee as it can rub against the lower part of your femur or thigh bone, which forms part of the knee joint. Treatment typically involves rest, anti-inflammatory medication and knee strengthening and stretching exercises.

Bursitis

The bursae are fluid-filled sacs that act as cushions in your joint. When inflamed, they can cause pain and tenderness and often occur due to overuse from running. Treatment includes rest, leg elevation, cold therapy and over-the-counter painkillers and anti-inflammatories. Surgery is not usually required, but a steroid injection might be recommended.

Prevention rather than cure

Many factors can affect your knees as you run, and steps you can take to prevent knee injury include:

  • Work on your core strength and mobility, as it can affect your running posture
  • Incorporate strength training into your routine, as the surrounding muscles play an essential role in protecting your knee
  • Be aware of any hip injuries or weaknesses, as these make you more susceptible to a knee injury
  • Try to maintain a healthy body weight, as a high BMI places more strain on your knee joints
  • Invest in a pair of running shoes that provide proper support
  • Stretch the muscles around your knees before a run, focusing on the quadriceps, hamstrings and calves
  • If your knees are sore after your run, use cold therapy
  • Ensure you have regular rest days to allow your muscles and joints to repair and recover
  • If you are developing pain with running, vary your exercise routine with lower-impact exercise, for example, cycling which puts less stress on the joints and can help to strengthen the muscles around the knee
  • Softer running surfaces such as a running track or a flat, smooth dirt trail can lessen the impact on the joints
  • Seek medical advice if your pain is persistent and not improved by conservative methods such as rest, ice and stretching

If you’re concerned about a running knee injury, you can arrange a consultation with Mr Neil Hunt for further investigations or treatment by making an appointment at one of his clinics or by calling Charissa Sullivan on 07724 909 414.

Following on from our previous article about what to do if an injury occurs on the slopes, here we recommend some pre-skiing exercises for preparing your knees for skiing.

To ensure a safe and enjoyable skiing experience, it’s crucial to prepare your body physically, especially when you’ve experienced an injury before and may have lost confidence.

By starting a pre-skiing exercise plan a few weeks ahead of your holiday, incorporating the right elements, you can reduce the risk of a knee injury on the slopes. So, what are the right elements of a pre-skiing exercise plan?

Why skiing preparation is so important

Skiing demands a unique set of physical attributes, including strength, flexibility, balance, and endurance. Neglecting to undertake an exercise programme that incorporates these can increase the risk of injuries and impact your overall skiing performance. To optimise your readiness for the slopes, it is advisable to embark on a well-structured pre-skiing exercise plan.

A recent study emphasised the significance of targeted exercises to reduce the likelihood of severe knee injuries requiring surgery highlighting the importance of strengthening the upper leg muscles with exercises such as squats and lunges. Strengthening these muscles not only improves skiing performance but also helps to prevent common knee injuries associated with skiing, such as ACL tears that can be very painful and may need surgical reconstruction.

Another study of young alpine skiers looked at the specific benefits of targeted balance exercises for skiing. It found a correlation between enhanced balance and reduced injury risk on the slopes. By incorporating balance exercises into your pre-skiing routine, you can improve your ability to navigate varied terrains and respond effectively to unexpected challenges.

The demands placed on muscles during skiing require a combination of strength and endurance. Engaging in a well-rounded strength training programme can not only enhance your skiing performance but also contribute to overall joint stability and resilience.

Creating a balanced pre-skiing exercise plan

To make the most of your skiing adventure, it is recommended to initiate an exercise plan 8 to 12 weeks before your ski holiday. This time frame allows for gradual conditioning, helping your body to adapt to the specific demands of skiing. However, if you have less than 8 weeks, an exercise programme can still make a big difference. A physiotherapist or a qualified personal trainer can assess your current fitness level, identify areas of improvement and tailor a plan that aligns with your skiing goals, taking into account any pre-existing conditions. When you cannot see an exercise specialist, there are plenty of free online guides and exercise videos available that are easy to follow. Set aside 30 minutes to do these, two to three times a week – little and often is the best way for building up your fitness to be ready for the slopes.

The pre-skiing exercise plan should encompass a mix of cardiovascular conditioning, strength training, flexibility and balance exercises. Cardiovascular workouts, such as indoor or outdoor cycling and jogging, enhance overall endurance while strength exercises target key muscle groups involved in skiing. Exercises such as squats, side lunges, Russian twists and planks are all great ways to build up strength.

Balance drills, such as single-leg exercises and stability ball exercises, enhance proprioception and prepare your body for the uneven and challenging surfaces encountered on the slopes. Flexibility exercises, including dynamic stretches and yoga, also contribute to improved joint mobility and range of motion. These are particularly important for the fluid and dynamic movements required in skiing.

Help with preparing your knees for skiing

Collaborating with a qualified physiotherapist or personal trainer will help to ensure that your pre-skiing exercise plan is tailored to your unique needs and goals. These professionals possess a deep understanding of biomechanics, injury prevention, and rehabilitation, making them invaluable partners in your skiing preparation journey.

An exercise specialist can guide you through proper warm-up and cool-down routines, ensuring that your muscles are primed for skiing and aiding in post-activity recovery. Additionally, they can provide advice on injury prevention strategies and offer specific exercises to address any pre-existing conditions or vulnerabilities. However, building up your fitness and following a pre-skiing exercise plan on your own, or with family or friends, will also be beneficial.

Overall, investing time in a well-structured exercise plan can significantly enhance your skiing experience, improve confidence, and reduce the risk of injuries. The key is to start early, stay consistent, and prioritise your physical readiness for a memorable and injury-free skiing season.

Mr Neil Hunt is delighted to be seeing patients and performing surgery at the new, state-of-the-art Fortius Clinic on Wigmore Street. This newly established seven-storey, 79,000 sq ft, private orthopaedic hospital in the heart of London has 39 en-suite inpatient rooms, consultation and treatment rooms, three operating theatres fully equipped with the latest technology, two anaesthetic rooms and a recovery bay to support patients with their initial recovery comfortably and safely. With an imaging suite fully equipped with the latest MRI and CT scanners and X-ray technology, patients benefit from fast access to diagnostic scanning as well as the comprehensive physiotherapy suite.

Neil is delighted to be able to perform robotic knee replacement surgery with Mako Smart Robotics technology at both the Fortius Clinic, London and at the Nuffield Health Leeds Hospital. This cutting-edge technology represents a significant advancement in the field of orthopaedics, setting the standard for orthopaedic care by offering patients precision and personalised treatment. The Mako system enables Neil to plan and perform knee surgeries with unparalleled accuracy, ensuring optimal outcomes for his patients.

To book an appointment, please call the clinic telephone numbers below 07724 909 414 or email clinic@neilhunt.co.uk.

 

📍 Fortius Clinic London
66 Wigmore Street
London
W1U 2SB
https://portal.fortiusclinic.com/#/welcome

 

📍 Nuffield Health Leeds Hospital
2 Leighton St
Leeds LS1 3EB
Tel: 0113 3227251 (option 1; option 1 for outpatients)
https://www.nuffieldhealth.com/consultants/mr-neil-hunt#book

As temperatures begin to drop, many people will be considering booking a ski holiday. Although ski injuries can be prevented with adequate preparation, accidents still happen. And knee injuries make up one-third of total recreational skiing injuries.

In recent years, the most common knee injury on the slopes involves a rupture of the anterior cruciate ligament (ACL). Before the introduction of carving skis, damage to the medial collateral ligament (MCL) was a more common knee injury, but it often accompanies an ACL injury.

Here, we look at ways to minimise the risk of a ski-related knee injury. Also, knee surgeon and ski enthusiast, Neil Hunt, gives his advice on what to do when a ski knee injury occurs.

Minimising a ski knee injury

Many injuries occur at the end of a long day on the slopes, when the muscles are tired. That’s why it’s important to prepare the muscles with strength and conditioning exercises, ideally practised several weeks in advance of a ski trip. Recent research found that exercises such as squats and lunges, which can help develop the thigh muscles ahead of a ski trip, can also lower the risk of needing a knee replacement later in life.

When you’ve not skied for a while, consider taking refresher classes with a qualified ski instructor. Understanding safe skiing techniques, as well as correct ways of falling and warming up, can keep you safe and injury-free. It is best not to take risks, and to know your limits when it comes to tackling different grades of runs. Also, it is important to allow the body to recover from a hard day on the slopes with adequate rest.

Choosing the correct ski equipment is another fundamental to staying safe. Boots need to be adapted specifically for you and your ability, but also for the ski conditions. For example, bindings that don’t release properly can put additional force through the knee, causing an injury.

What to do when a knee injury occurs on the slopes

Many ski injuries affecting the knee will be low grade, affecting the soft tissue and can be immediately treated with the RICE method (Rest, Ice, Compression and Elevation). If you’re still experiencing a lot of pain, then get a confirmed diagnosis, but don’t rush into surgery.

“The important consideration when a knee ski injury occurs, is to always get an early diagnosis and a consultation with a knee expert to discuss your options,” says knee surgeon Neil Hunt, advising that patients get advice sooner rather than later. “Ideally, get an MRI scan for an accurate diagnosis.”

With ACL injuries, an ACL repair may be the recommended treatment in many cases, rather than reconstruction surgery. But, this can only be decided with an early diagnosis and scan.

“A confirmed diagnosis will help with immediate treatment and rehabilitation, as well as indicating how urgently surgery may be required” he says.

And, in most cases, it’s prudent to wait until you’ve returned to the UK before seeking treatment.

Don’t be rushed into surgery

After experiencing a fall or injury when skiing abroad, you may be evacuated from the slope and taken straight to a surgeon, who may want to operate sooner than is necessary. Not knowing a surgeon’s credentials, alongside language or cultural medical barriers can put you at risk of long-term issues, such as knee stiffness. Also, understanding aftercare advice, including any recommended physio can be an issue.

“For the majority of cases, there are absolutely no negative implications in delaying treatment for a couple of weeks. It needs planning. But that doesn’t mean urgent surgery in the resort. And most of the time, it’s better not to.”

Medical technology is constantly evolving, leading to improvements in results. Robotic Arm Assisted Knee Surgery has been a significant breakthrough over the past decade, helping to reshape the way we view knee surgery.

What are the benefits of Robotic Arm Assisted Knee Surgery?

Compared with conventional knee surgery, robotic arm assisted surgery offers a range of potential benefits, principally increased accuracy in the planning and execution of the knee replacement.

One of the standout benefits of Robotic Arm Assisted Knee Surgery is its remarkable accuracy. The technology allows surgeons to plan to position implants in the best way for each individual patient. It then assists the surgeon in performing the surgery more accurately due to greater precision in the trimming of bone ends to fit the knee replacement with the removal of minimal bone. It also helps to reduce trauma to the soft tissues around the knee.

Before surgery, a CT scan generates an accurate 3D model of the patient’s joint anatomy. This enables the surgeon to plan the best position for the implants to give the best alignment and balance to the knee whilst removing the minimal amount of bone. The robotic arm then helps the surgeon trim the bone more accurately whilst preventing damage to the soft tissues.

When it comes to knee replacement surgery, accuracy is a prime factor in determining patient outcomes and robotic assisted knee surgery sets a new standard to help to achieve optimal outcomes for patients.

Neil Hunt is an experienced robotic knee surgeon and offers Mako Assisted Robotic Knee Replacement Surgery in London and Leeds.

Leeds knee surgery conference logoNeil was delighted to host the 2023 Knee Discussion Club meeting in York in September. The meeting was attended by 40 of the country’s top consultant specialist knee surgeons to discuss a range of issues related to knee surgery.

They spent an informative and enjoyable two days discussing topics ranging from advances in robotic surgery and the introduction of new integrated imaging and virtual reality assistance to the use of registries to optimise the outcomes of the patients they treat.

In addition, several guest speakers who were experts in specialised technology areas, attended to give their perspective on how the rapidly evolving technology and artificial intelligence fields could bring benefits to knee surgery with a focus on achieving the best possible outcomes for all patients.

Robotic technology has been making significant strides in the world of medicine, and knee surgery is no exception. A recent study published in Arthroplasty Today highlights the numerous benefits of using robotic assistance in knee replacement surgeries. These benefits ultimately lead to lower complication rates and improved patient outcomes.

Study into robotic-assisted surgeries

Researchers analysed data from over 45,000 total knee arthroplasty (TKA) procedures, comparing patients who underwent robotic-assisted surgeries and those who had conventional surgeries. The study focused on the first 90 days post-surgery, examining complications such as infections, blood clots, and dislocations.

According to the study, patients who underwent knee replacement surgery with robotic assistance experienced a complication rate of just 1.5%. In contrast, the complication rate for those who had traditional surgery was notably higher at 2.6%. This reduction in complications can be attributed to the superior accuracy and minimally invasive nature of the robotic procedure, which can lead to faster recovery times and fewer postoperative issues.

The study also found that patients who received robotic-assisted surgery had a shorter length of hospital stay and a lower rate of readmission to the hospital within 90 days after surgery compared to those who had traditional surgery.

Why less complications after robotic knee surgery?

One of the primary advantages of robotic-assisted knee surgery is precision. The advanced technology allows surgeons to make more accurate cuts and alignments, which can greatly improve the longevity and functionality of the implant. This increased precision ultimately leads to a more natural-feeling knee for patients, enabling them to regain their mobility and independence.

Moreover, robotic-assisted surgery often results in less blood loss and reduced need for pain management. This is due to the fact that the technology allows for smaller incisions and reduced tissue damage. As a result, patients can experience a quicker recovery and return to their normal activities sooner than with traditional surgical methods.

Robotic technology also aids in the customisation of knee replacement procedures. Surgeons can utilise the advanced imaging capabilities to create a personalised surgical plan for each patient, taking into account their unique anatomy and specific needs. This level of customisation can lead to improved patient satisfaction and long-term success of the implant.

Find out more – book a consultation

In conclusion, the use of robotic technology in knee surgery offers multiple benefits, including increased precision, reduced complication rates, and a more personalised approach to treatment. As this technology continues to advance and become more widely adopted, patients undergoing knee replacement surgery can look forward to a more promising future in terms of recovery and long-term results.

Neil has performed more than 4000 knee replacements, including total and partial replacements, and specialises in all aspects of knee surgery. For those patients that are suitable, he offers Mako robotic arm assisted knee replacement surgery, providing a tailored surgical plan for improved accuracy and better results.

To find out whether you would benefit from robotic knee surgery, book a consultation by calling 07724 909 414.

Considering knee replacement surgery but unsure about the right time to do it? You’re not alone. Choosing the right time for knee replacement surgery is crucial for its success and your overall satisfaction.

Here, we look at factors such as age, overall health, and the severity of your knee condition, that all play a significant role in determining the optimal timing for this life-changing procedure.

Additionally, we’ll explore the longevity of knee implants and discuss a study published in the Lancet to help you make an informed decision.

Knee replacement surgery – factors to consider

When it comes to considering a knee replacement operation, several factors come into play. These are:

Severity of pain and mobility limitations

One of the most significant factors in deciding to undergo knee replacement surgery is the severity of pain and mobility limitations you are experiencing. For those with osteoarthritis, it can cause debilitating pain and significantly impact the quality of life. If conservative treatments like medications, physical therapy, and lifestyle changes have not alleviated your pain or improved your movement, it may be time to consider surgery.

Age and longevity of knee implants

While there is no specific age to undergo knee replacement surgery, age plays a crucial role in determining the longevity of knee implants. According to a study published in The Lancet, about 82% of total knee replacements and 70% of partial knee replacements last for 25 years. This information is of greater importance for younger patients, as they may require a revision surgery later in life if their implant wears out.

Overall health and surgical risks

Before opting for a knee replacement, it’s vital to assess your overall health and potential surgical risks.

As with any surgery, there are potential risks and complications. Common complications include infection, blood clots, and stiffness in the knee joint. However, advancements in surgical techniques and post-operative care have significantly reduced the likelihood of these complications.

Your surgeon will evaluate factors such as your weight, existing medical conditions, and history of prior surgeries to determine your suitability for knee replacement. Ensuring that you are in the best possible health before surgery can lead to a more successful outcome and faster recovery.

Benefits of knee replacement surgery

The most significant benefit of knee replacement surgery is the relief from pain allowing improved exercise tolerance and quality of life. Patients often experience increased mobility, allowing them to return to their daily activities and even participate in sports and recreational activities. Additionally, timely surgery can prevent further deterioration of the joint and surrounding tissues, leading to a better outcome and sometimes reducing the need for more extensive procedures in the future.

Call 07724 909 414 to book a consultation with Neil to make an informed decision on when to opt for knee replacement surgery.

Mr Neil Hunt is hosting a Sports Injuries of the Knee session on Thursday 25th May 2023 at 18:30 on behalf of Nuffield Leeds Hospital. Open to physiotherapists & associated professionals, he will be covering some common sports injuries that may present in primary care.

Topics to be covered will include the assessment and management of:

Ligament damage
Tendon injuries
Joint problems
Conservative management

This will be an in-person session at the Mercure Leeds Parkway Hotel with a buffet dinner from 18:30, with the talk to start at 19:00.

We hope you’re able to join us! Click here to book your free ticket for the event.

Last Monday, Neil was delighted to attend a patient info evening at Nuffield Health Leeds to introduce Mako robotic knee replacement to patients who have been experiencing the pain and lack of function associated with knee arthritis and who are contemplating a knee replacement. It’s estimated that almost 100,000 knee replacements are performed each year in the UK and Mako robotic arm assisted surgery represents an exciting technological innovation.

Robotic knee replacement event

Neil Hunt introduces robotic knee replacement LeedsAt the patient info evening, it was great to discuss the advantages of robotic arm assisted knee replacement over conventional surgery. It was also an opportunity to chat to the audience about the problems that they’ve been experiencing and how surgery could help. We were also able to carry out some mini-consultations with patients who are interested in proceeding with surgery.

The next free patient information event will be held this evening at the Nuffield Health Harrogate Fitness & Wellbeing Centre. Book a ticket to find out more about robotic-arm assisted hip and knee replacement surgery.

Or call 07724 909 414 to book a consultation with Neil to discuss your options.