nikhil pradhan's
 Cheshire Hip and Knee Clinic

Specialist: Knee Surgery, Hip Surgery, Sports injury & general orthopaedics
Patient Experiences Knee

Revolutionary new technology in Total Knee Replacement – iASSIST

Mr Nikhil Pradhan, consultant orthopaedic surgeon at Spire Cheshire Hospital, has performed the first iASSIST Total Knee Replacement in the UK. Currently Mr Nikhil Pradhan is the only surgeon using this technology in the UK (statement correct March 2014).

Mr Nikhil Pradhan first met John Kowalczyk when he came for a consultation at Spire Cheshire Hospital. John was a young gentleman with pain in his knee who had received many differing opinions about his treatment options. He had osteoarthritis of his knee and the pain and stiffness from his knee were affecting his daily activities and his sleeping pattern had been altered.

Mr. John Kowalczyk, March 2014

He works as an IT Manager for a global pharmaceutical publishers and his previous employment 15 years ago was working in the building trade as a commercial glazier.

Considering his young age and increased demands on his knee he was keen to get a solution that would allow him to continue with his job and give him a pain free knee. He was a good candidate for the iASSIST Total knee replacement.

Traditional knee replacement may use instruments placed inside the thigh or shin bone to assist with alignment and positioning. The iASSIST alignment pods are placed outside of the bone, potentially allowing a less invasive procedure. The iASSIST also allows the surgeon to check if the alignment is correct whilst in surgery using the validation pods. Patients may therefore benefit from reduced blood loss and complications such as fat embolism minimising their stay in hospital and increasing rate of recovery.

“I first became aware that something was quite wrong with my knee probably ten years ago, every time I knelt down for any reason I got the feeling I was kneeling on a drawing pin," says John.

“I thought I better do something about it about, so two years ago had a procedure called a keyhole flush at a local hospital. In my opinion this procedure made me more aware of the pain as I had very little, if any, cartilage left in the joint afterwards.

“I spent the next two years asking questions, having tests and being told that I was too young to have a knee replacement as I could be left crippled due to a family inherited disease called Charcot-Marie-Tooth. The pain was really bothering me so I wanted to proceed anyway, however  at every stage I was being put off and eventually told by a surgeon at another hospital that he would not carry out the procedure.

“I asked my insurance company if I could have a second opinion and I chose to visit Spire Cheshire Hospital after my partner was told that Mr Nikhil Pradhan, consultant orthopaedic surgeon, was a specialist in knee procedures.

“On contacting Spire Cheshire Hospital I was given an appointment with Mr Nikhil Pradhan. Following his initial examination he immediately sent me for an X-ray and 20 minutes later he was showing me my knee joint on his computer. He asked me several questions about my medical history, working history and current employment and told me it was clear I needed surgery.

“Mr Pradhan told me that I could have a new procedure called an iASSIST knee replacement which was less intrusive and explained all the details of the procedure to me. Mr Pradhan was fantastic, he arranged a surgery date for me and I felt relieved that finally I would have some relief from the pain I was experiencing.

“One week prior to my surgery I had a meeting with a member of the hospital physiotherapy team. They were very professional and explained about the work I need to do after the procedure to enhance my recovery and also what to expect after surgery.

“Within four days of physiotherapy, good food and rest, which had always been the planned stay in the hospital, I was walking out to my partner’s car to go home. I was armed with a full set of physiotherapy exercises to do at home and telephone numbers in case I needed any help from the nurses or physiotherapists.

“Within two weeks I didn’t need the crutches although I did have to take it easy!

“After seven weeks I had completely stopped all pain killers and my leg is feeling pretty good. The physiotherapists have been monitoring my progress at my post-surgery appointments and I have gained movement in my left knee that I haven’t experienced for years!

“I am writing this account nine weeks after my operation. I have now been back at work two weeks, after a progressive phased return. I would like to thank Mr Pradhan and all the staff at Spire Cheshire Hospital for making the whole experience much more pleasant. The quality of food was fantastic and cleanliness of my room and the hospital was second to none.

“I would definitely recommend Mr Pradhan and Spire Cheshire Hospital to anyone in a similar situation to myself. My advice would be don’t wait until the pain gets worse, make an appointment to see a specialist consultant like Mr Pradhan who can advise you on your treatment options and relieve your pain.”

I would definitely recommend
Mr Pradhan and
Spire Cheshire Hospital
to anyone in a
similar situation to myself

-Mr Kowalczyk

Personalised Minimally invasive Total Knee Replacement

Prior to my admission to the Spire Cheshire Hospital, in October 2010, I had already had arthroscopic surgery on my right knee. This took place in June 2010 at another private hospital and it failed to alleviate the agony in my joint.

Mr. W, October 2010

As an ex-pro rugby league player and sportsman I could not play golf or train at the gym as every step was painful, so my lifestyle had been put on hold.

I consulted my doctor and he arranged for me to see Mr Nikhil Pradhan at Spire Cheshire Hospital. At the consultation Mr Pradhan looked at my x-rays and informed me I needed a total knee replacement. He was very caring and professional and he made sure I understood what the procedure involved.

On the day of my admission I was greeted by a pleasant receptionist and taken up to my room. The operation went really well and the following day I was walking ‘pain free’, with crutches, under the supervision of the physiotherapist. The nursing staff were faultless in their compassion and care during my five day stay, nothing was too much trouble. Also the catering department need to be recommended for their food and their willingness to please. Ten days later I returned to have my stitches removed and my first physiotherapy assessment. The physiotherapist could not believe I had full movement in my knee and no pain what so ever – I could even kneel down!

With the permission of the physiotherapist I was in the gym after twelve days and seven days later, at my final assessment, I was discharged by my physiotherapist as I had could fully bend my knees and had made an excellent recovery. I cannot praise the hospital staff, my anaesthetist and Mr Pradhan highly enough for all my care and well being – Thank you!

"I cannot praise the hospital staff, my anaesthetist and Mr Pradhan highly enough for all my care and well being"

-Mr W

Signature™ Knee Replacement surgery

In September 2010 I returned to the UK after working on an overseas project for four years. During this time my ability to walk had deteriorated considerably, thus creating severe pain in my knees.

Mr. H, February 2011

Realising that something had to be done as soon as possible, I had a consultation with Mr Nikhil Pradhan Consultant Orthopaedic Surgeon at Spire Cheshire Hospital. He was of the opinion that I required total knee replacement, and recommended that I undergo bilateral Signature™ Knee replacement. X-rays were taken of both knees during the consultation and these confirmed that there was nothing left of the cartilage to the inner face of each knee, which was the cause of the discomfort & pain, plus my awkward posture. Once it had been decided that I would proceed with the operation, I was requested to have an MRI scan to both legs between the ankles and the waist, which was carried out at the hospital. The results were then sent away to create the personalised positioning guides for the total knee replacement.

During the first two weeks of November I had to go through the pre-admission procedure at the Nurses Clinic at the hospital. This was followed by an introduction to the Physiotherapy Department who were to play a major part in my post operative recovery, and finally I was introduced to the Anaesthetist who would be in attendance during the forthcoming operation.

On the day of the operation I arrived at the hospital early morning, and the operation to both legs was carried out within a few hours. During the time that I was in the operating theatre & the recovery room, my family were allowed to sit in my room where the hospital staff looked after them with coffee, newspapers and television, in order that they could see me as soon as possible after the operation.

On day 3 I took my first steps, with the help of a zimmer frame and plenty of encouragement from both the nursing staff and the physiotherapists. I am the first to admit that this day was the most difficult of the whole procedure, however within a few days I had progressed to crutches and by day 8, I was able to go up and down the hospital staircase using the handrail and one crutch for support. This was the final goal which had to be achieved prior to being discharged, to go home.

I would like to thank Mr. Pradhan, plus everybody employed at Spire Cheshire Hospital, who contributed to the fact that my operation was a totally successful , and that my stay in hospital was as comfortable as possible. The nursing staff were caring and attentive, the physiotherapists were very professional, and the food and beverage staff prepared and delivered enjoyable meals.

After I came out of hospital I attended the physiotherapy department as an outpatient for about 8 weeks, to learn what exercises needed to be carried out to ensure full recovery of the leg muscles etc. I would also like to thank my wife and family who have encouraged me to continue with the exercises at home post operation. I would certainly recommend Signature™ Total Knee Replacement. Mr Pradhan and the team at Spire Cheshire Hospital have given me a new lease of life, and I hope that it will not be too long before I can travel overseas again to continue with my career.

"Mr Pradhan and the team at Spire Cheshire Hospital have given me a new lease of life"

-Mr H

Minimally Invasive Knee replacement surgery

John Ashby is a 63-year-old active man, working full-time in a solicitor’s firm in Stockton Heath during the week, while enjoying walks in the Cheshire countryside at the weekend and entertaining his grandchildren in the holidays.

Mr.John Ashby

However, after suffering sharp pain in his left knee during several of his walks last September, the enjoyment of his social activities was quickly replaced by severe discomfort that worsened to the point that he couldn’t walk without pain. Suffering in silence for a month, John finally ventured to see his GP following a health assessment at Spire Cheshire Hospital.

X-rays at the local NHS hospital revealed severe arthritis in his left knee. He was recommended knee replacement surgery, but wasn’t keen to wait for four months for surgery and he wanted to guarantee that he had the best surgeon and minimise the need for future surgery.

John was referred to see Mr Nikhil Pradhan, who practices at Spire Cheshire Hospital. During the consultation, Mr Pradhan confirmed that knee replacement surgery was necessary and informed him of a new treatment that was available that could potentially help him regain his mobility and improve the positioning of his knee implant compared to traditional surgery.

The Signature™ Knee procedure involves an MRI scan of the hip, knee and ankle which provides the surgeon with detailed images of the patient’s knee anatomy. An exact 3D model of the knee can then be created to help decide the size of implant needed and the positioning of the implant. A customised jig is then made to support implant positioning during the operation.

Mr Pradhan comments: “The operation takes about an hour to perform and is less invasive than traditional surgery as it doesn’t require alignment rods being inserted in the bone canals of the thigh and leg. The patient specific customised jig enables me to make minimal cuts and position the knee implant accurately in relation to the three dimensional anatomy and to the mechanical axis of leg. In comparison to computer navigated surgery, there is less risk of bone fracture, as there is no need for marker pins and surgical time is reduced. All these advantages have the potential to reduce the need for further surgery in the future.”

“In John’s case, he is still quite young and is keen to return to work quickly and minimise the need for further surgery. As the procedure can be performed under local anaesthetic, the recovery tends to be quicker and I encourage patients to be on their feet walking within hours of surgery. I like to ensure that my patients are completely independent when discharging them, which involves extensive physiotherapy and rehabilitation, with the patient walking unaided within a month.”

After the operation John plans to work from home for four weeks post-surgery so that he can do physiotherapy exercises in the comfort of his own home.

John comments: “While I was slightly apprehensive at first about the treatment, I have complete confidence with Mr Pradhan and the staff at Spire Cheshire Hospital. They have given me hope that I will be able to enjoy my walks and my grandchildren’s company, without pain and fear of further incapacity.”
"I have complete confidence with Mr Pradhan and the staff at Spire Cheshire Hospital"

-Mr. John Ashby
Spire Cheshire Hospital
Fir Tree Close,Stretton Warrington,
Cheshire WA4 4LU
Tel: 01925710401
Fax: 01925710401
Consultant in Trauma and
Orthopaedic Surgery

Warrington Hospital NHS Trust
Lovely Lane Warrington
Cheshire WA5 1QG
Tel. 01925662758
Fax. 01925 662211