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Case Gallery
A small selection of imaging illustrating the kind of work described elsewhere on this site. Every image is anonymised, and nothing here identifies a patient.
Upper limb
The problem on the left, the result on the right. Radiographs from shoulder and elbow reconstruction, replacement and fracture surgery.
Rotator cuff arthropathy. The cuff has failed and the humeral head has risen against the acromion. A reverse replacement lets the deltoid do the work the cuff no longer can.
Severe glenohumeral arthritis with the joint space worn away. A stemless anatomic replacement recreates the normal ball and socket, and depends on an intact rotator cuff.
A shoulder locked out of joint for months in an elderly patient. Putting it back would not have held, so the joint was reconstructed.
A humerus broken around an existing replacement stem. Fixed with two plates and cables, keeping the original implant rather than revising the whole reconstruction.
A radial head fracture too comminuted to repair reliably, treated with an uncemented replacement.
A shear fracture of the capitellum fixed with two headless compression screws, buried beneath the cartilage so nothing sits proud of the joint surface.
The point of the elbow, fixed with a locking plate.
For recurrent instability where bone has been lost from the socket. The coracoid is transferred to rebuild the glenoid and acts as a sling across the front of the joint.
A fractured greater tuberosity held with suture anchors and endobuttons, restoring the cuff attachment without bulky metalwork.
The biceps tendon reattached to the radial tuberosity with an endobutton, through a small incision at the front of the elbow.
A proximal humerus fracture too comminuted to reconstruct reliably, treated with a reverse replacement.
An MRI taken in the ABER position, showing the labrum torn from the front of the socket after dislocation.
Lower limb
Before and after. Joint replacement is judged on alignment, on restoration of leg length and offset, and on how reliably the plan was carried out. Occasionally it is judged on how a failure is put right.
Arthritis confined to the inner half of the knee. Only that compartment is resurfaced; the ligaments and the rest of the joint are left alone.
Arthritis across the whole joint. Planned in three dimensions and carried out with robotic assistance.
Osteoarthritis with avascular necrosis of the femoral head, replaced with robotic assistance and close attention to leg length and offset.
A hemiarthroplasty that kept dislocating, revised to a total hip replacement with a constrained liner holding the head captive.
A cemented Exeter stem broken in the bone. An uncommon but demanding reason to revise a hip replacement.
The same kind of fractured stem after extraction at revision surgery.
How the work actually looks
This is a shoulder arthroscopy set up in the beach chair position, with the patient semi-upright, the arm free to be moved through a full range, and the joint visualised on a screen through small portals.
Images on this page are deliberately restrained. Graphic operative photography has its place in surgical education, but it rarely helps a patient trying to decide whether to have an operation.
A note on these images. All radiographs have been cropped to remove any identifying information, and no patient is identifiable from anything shown here. Images are provided for general education only and do not represent a guaranteed outcome. Results vary between individuals.
Bring your own scans to a consultation
If you already have X-rays, an MRI or a CT, bring them. A specialist reading of imaging you already own is often the fastest route to a clear answer.