Why did you decide to become a Consultant Orthopaedic Foot & Ankle Surgeon ?

I chose Foot and Ankle surgery because it was a thinking person‘s specialty. It’s a much more complex area in my eyes compared to other orthopaedic specialties and the impact of one pathology and deformity can have huge implications for another area of the Foot and Ankle. In this sense, it’s important to get it right first time and given that most people stand on their feet, the ability to make patients stand and walk and therefore function better can be hugely rewarding.

I chose to work in private practice to compliment my NHS practice. I think there are areas of private practice which are better which include the speed at which patients are seen, the personalisation of services (in that you get to see the same clinician all the time) and access to faster scans and reduced waiting time for procedures. Private practice helps my NHS practice simply through being busy meaning that I see more patients, recognise more pathology and gain more understanding and experience at managing problems.

What are the common symptoms that your patients tend to present with?

Pain, difficulty walking or standing and potentially deformity are the main symptoms which a patient will present to me with. The exact location and severity of these will vary dependent upon the underlying problem which they have. In that sense there’s a diagnostic conundrum which frequently presents itself because Foot and Ankle is not made up of one or two bones or joints but close to 30 bones, multiple joints and many tendons and ligaments with each one having the potential to go wrong and impact the function of another part of the foot or ankle.

What are the treatments that you're able to offer your patients?

To aid diagnosis, I’m a strong advocate for using a very novel imaging modality known as a standard CT scan. I’ve been using this since 2016 and unlike many imaging modalities, it’s performed with a patient in the standing position. This means it is taken in a functional position and therefore offers much greater information, and importantly, more relevant information than many other types of investigation.

Concerning treatments, I offer everything that is evidence based to work. This includes specialist injections for plantar fibromas and Achilles tendinopathy, all the way up to using patient specific custom-made instrumentation in the use ankle replacement surgery.

What are your areas of sub-specialist interest?

I see a lot of patients with sporting injuries which include ankle sprays, ligament tears and tendon ruptures. I offer a individualised approach for each patient which means deciding on whether conservative treatment (such as bracing, a boot or physiotherapy) or surgery is best. Conversely, I will see patients at the opposite end of the spectrum with long-term problems rather than fresh injuries, and in some cases this will include neuromuscular problems. I have patients who come and see me from all over the world (often for a second or third opinion) with the goal of making them stand and walk better. Many of those patients will have had surgery before which may have failed and they are looking for rescue options.