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Clinical Experience

Spinal Surgery

MS (All India Institute of Medical Sciences, New Delhi- Prof Dave)

My interest in low back pain dates back to my thesis on the subject, while I was a trainee at the All India Institute of Medical Sciences in New Delhi. The AIIMS is the Premier Medical Institute of India, with a Spinal Unit, which has an International reputation. Professor P.K. Dave and Professor Jayaswal ran a weekly Scoliosis clinic and a Low Back Pain clinic. I learned both anterior and posterior exposures of the Lumbar spine. I continued as a Senior Registrar at the AIIMS after my MS examination.

Higher Surgical Training

I worked with Mr R. Rushman at the Royal Free Hospital and was exposed to some aspects of lumbar spine surgery. Working with Mr Noordeen at Great Ormond Street, gave me valuable experience in deformity correction and instrumentation of the spine especially pedicle screws and posterior instrumentation.

Current post

My current practice involves General Orthopaedics with about 50% of my time involving back pain and its management.

Joint replacement

During my training, I had the opportunity to observe and use a wide range of different hip and knee implants. As a consultant, I continue to improve my techniques. Over the last couple of years, I have visited centres of repute in Belfast, Exeter, Amsterdam, the Lubinus clinic in Kiel and the Endo Clinic in Hamburg. Working with Professor Bentley and Mr. Bradnock gave me the opportunity to observe complex hip and knee revision surgery at the RNOH.

Hip resurfacing

Over a period of time I had noticed that more and more young patients were being referred for hip arthroplasty. It was also clear that the expectations and demands in these patients were more than those in the older age group. They were also well informed especially due to the easy availability of information on the internet. In addition to the now more accepted uncemented ceramic on ceramic hip replacements, I have had considerable experience with metal on metal resurfacing (Birmingham arthroplasty) in this group of patients. The early results have been promising.

Trauma and Management of the acutely injured

Trauma management has been an area of my special interest since training in India. At Bassetlaw hospital, helped set up the trauma meeting in a multidisciplinary setting. The meeting has resulted in several useful protocols and guidelines being set out, helping to improve communication amongst different members of the team involved in delivery of acute trauma care.

As an ATLS trainer I have organised “in house” acute trauma management courses, based on the ATLS principles. By attending trauma symposia every year, I keep abreast of the recent advances. I have also done the AO basic and advanced courses.

Having trained in busy hospitals in Britain and India means I am able to deal with patients of polytrauma, severe open injuries and most other complex trauma. Except for definitive management of pelvic trauma, which we refer to regional centres, I have been happy to deal with all other cases in my current practice. I have some experience in the application of ring fixators/ hybrid frames for periarticular fractures in the lower limb.

Within the department, I have a special interest in Paediatric trauma, internal fixation of os calcis fractures and intercondylar fractures of the humerus.

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