PATIENT EXPERIENCE

Alain Perret-nSTRIDE® Treatment

February 17, 2022

Having nSTRIDE has given me my life back says father-of-three Alain

Pain-free movement is something we take for granted when we have it. But knee osteoarthritis can make everyday tasks like getting up and down stairs and walking the dog a real pain.

For keen sportsman Alain Perret his wear and tear osteoarthritis has gradually worsened over the last 10 years. The French-born father-of-three was forced to give up football and running and then, during lockdown, even walking became a real struggle.

Alain, 55, thought his only option was knee replacement surgery – something he was not keen on at all. But, after consulting his orthopaedic surgeon Mr Nikhil Pradhan, he was offered the latest autologous (‘from your own body’) treatment nSTRIDE®.

And, the single injection has made a huge difference to Alain’s mobility and quality of life.

He said: “I’d previously accepted that I would have to give up football and running. I was swimming and walking rather than doing any impact sport, and for me, I was happy being able to do that if it meant I could avoid major knee replacement surgery.

“Since the pandemic began I did quite a bit of walking which was fine at the beginning but then I needed to put a strap on my knee and then it got to a point last Winter when even going to the local shop was painful.”

Alain, who works in finance, added: “Within five minutes of going for a walk I would be limping.

“When you can’t walk without pain, when your day-to-day life is affected so much you then have to take action. So, last March when I saw Mr Pradhan there did not seem to be any alternative to a knee replacement.

“But when it came to the day, I just couldn’t go ahead with it. It’s such a major operation. I had family and friends who have had successful knee replacements which changed their life, but that was when they had almost no more cartilage left and were in pain 24/7. That was just not my case.”

Alain was offered nSTRIDE® and had the injection at Mr Nikhil Pradhan’s Cheshire Hip and Knee Clinic in Warrington.

The treatment, developed by Zimmer Biomet, uses healthy extracts from patients’ own blood to uniquely target the causes of osteoarthritis as well as treating the pain itself. Aimed at patients with mild to moderate disease, a single treatment can provide effective pain relief and improved knee function for up to five years.

Alain said: “I was told nSTRIDE® is really aimed at people with low to medium levels of knee osteoarthritis, rather than me, but I completely trust Mr Pradhan. He does not push you towards doing anything but we talk about what I want to achieve and then decide together on what’s the best way to manage my knee pain and my expectations.

“I’m just so glad I had the injection. Within a week I went for a bike ride and was able to walk pain free to the local shops.

“A month later and I was doing hour long walks three times a week, something I had not been able to do in over a year. I drove all the way to France and was able to do family walks – just amazing!

“I know that I still have holes in my cartilage and this is not a long-term fix, but with nSTRIDE® the pain and stiffness is not stopping me living my day-to-day life. I don’t feel as if my world is continually shrinking.

“There are just days when I completely forget about my knee and I am really pleased with the decision and would definitely do it again.”

Knee pain is the reason for around 60,000 GP appointments every day in the UK and 23 per cent of all people over the age of 50 report severe knee pain.

The novel nSTRIDE® therapy is designed to provide long-lasting pain relief and, uniquely, to target the inflammation which drives cartilage degradation and destruction in osteoarthritis. Anti-inflammatory proteins and anabolic growth factors are taken from the patient’s blood and, after being concentrated in a centrifuge, injected back into the knee.

Mr Pradhan said: “Alain has been a patient of mine for several years and I am delighted that nSTRIDE® is working so well for him.

“The management of pain is a ladder with painkillers and physiotherapy at the bottom and surgical options finishing with a knee replacement at the top. But for a lot of people there is an unbearable gap in between which has widened further because of the pandemic.

“nSTRIDE® provides me with a potential solution to offer these patients. For the first time we are looking at being able to treat the cause of pain – not just masking the pain – which is potentially game-changing.”

John Brazel – Total hip replacement

March 17, 2021

Spire Cheshire Hospital | Patient story – March 2021

John Brazel – Total hip replacement

John Brazel is a very active 66 year old, who has played county league squash since his early 20’s and continuesto play four days a week. For the last 10 years he’s also been an avid skier and snowboarder, as well as taking part in regular hikes in the Lake District.

But in 2019, hebegan suffering frompain and mobility problems. His groin started to ache after walking a few miles and he began experiencing spasms in his hip whilst on the squash court.

“I had initially put the symptoms down to just muscle strain and age, but hearing good reviews of Spire Cheshire and Mr Pradhan in particular, I decided to get it checked out towards the end of 2019. I expected it to be a minor ailment and for him to tell me it was nothing to worry about.” John explained.

Mr Pradhan, Consultant Orthopaedic Surgeon practising at Spire Cheshire hospital, diagnosed John with osteoarthritis of the hip joint, which is a common condition in men and women over the age of 40.

“Mr Pradhan was very professional and crystal clear in the consultation, but I was totally shocked when he advised that the only solution was to have a hip replacement. As a sportsman my whole life revolves around athletic activity, so Iinstantly thought this was the worst thing possible and that it would put anend to all the sporting activities that I loved.”

Mr Pradhan explained to John that he could see no reason why he wouldn’t be able to get back to normal, if he followed a thorough rehabilitation path.

John continued: “He said the decision to have surgery was ultimately up to me, but he was reassuring that he thought it would be the best course of action. I came back from a snowboarding trip in February 2020 and booked the surgery for later on that month.”

Mr Pradhan then performed a minimally invasive (SPAIRE) technique total hip replacement on John.

SPAIRE is a tendon saving surgical technique for hip replacements which can offer a faster recovery and enhanced stability to patients.

The technique allows fewer tendons to be damaged and there are no post-operative restrictions. Patients are immediately encouraged to exercise the hip through a full range of movement – resulting in restoration of hip function and enhanced stability.

John was back home two days after the surgery, and had stopped using his crutches within a week. Within a month he was undertaking a 4k walk and was back on the squash court; and by his second month of recovery he was walking up to 15k, as well as practising yoga.

“Due to the pandemic, the gyms and squash courts were closed, but when they opened again in August I was back on the court and playing squash three or four times a week, as well as tennis. The guys I play with would definitely agree that I’m back playing as competitively and at the same level as I was pre-surgery – but only now, I’m pain free!

“The absence of pain, increased mobility, and the recovery time has all been amazing, and was even better than Mr Pradhan predicted. I would definitely say as an active individual to go for a hip replacement procedure takes a massive leap of faith – but one that I am so glad I took when I did.”

Mr Pradhan commented, “Thetotal hip replacement was the best course of action, and thankfully it enabled John to continue all of his sports and athletic activity. He was totally committed to his rehabilitation and physiotherapy and I am glad that he is now back to enjoying his life to the fullest.”

Golf fan Marc back in the swing thanks to hip operation by Mr Nikhil Pradhan-Marc Thompson

March 11, 2018

“My advice to people now would be to get the operation done as soon as possible”

Marc Thompson

Golf enthusiast Marc Thompson is delighted to tell you about a very special shot he took – the one that won the match!

The fact that only eight weeks earlier 39-year-old Marc had undergone a complete hip replacement made his ‘rare triumph’ even sweeter.

Dad-of-two Marc, from Orford near Warrington, said: “I thought I was too young to have a new hip and I fought against it for a long time but, in the end, I had little option – it was either have the operation or basically stop doing any physical activities at all.

“After years of being sports mad I was in a situation where I couldn’t even play golf – in fact even walking was painful.”

Marc, a planning manager with Webhelp UK, damaged his hip as a teenager while playing rugby but continued to play football into his 30s. When the hip pain put an end to that he turned to cycling and golf to keep active

But as he moved into his 30s he found he was in constant pain, unable to sleep properly and forced to give up all sports. “It even got to the point where I struggled to put on my shoes and socks,” he said.

It was when he met Orthopaedic Consultant Surgeon Mr Nikhil Pradhan at Spire Cheshire Hospital in Warrington, that Marc became convinced that an hip operation was something that couldn’t wait any longer.

“I was worried I was too young but Mr Pradhan told me ‘if your joint is stopping you from doing the things you want to do then that is the right age for a replacement’ and I realised he was right.”

Mr Pradhan explained: “Marc was young to have a hip replacement but he has a young family and was determined to lead an active life. However, his symptoms were steadily getting worse and were preventing him from doing many of the things he loved.

“When I saw him towards the end of last year he had a painful, stiff left hip and his x-rays confirmed significant arthritis, which confirmed to me he needed a total hip replacement.

“I operated using a minimally invasive technique and the latest in hip implants which tend to support someone with a high activity level like Marc.

“He has made an excellent recovery and I am delighted to have helped him I am pleased to have helped Marc get back to his ‘normal’ life style.”

As for Marc – who plays his golf at different courses across Cheshire and North Wales of a 16 handicap – he is delighted at the speed of his recovery as well as his new golf swing.

“I feel much better swinging a golf club now as I’m less restricted and have no pain. I’m in a golf society with about 20 other guys and, amazingly, I won the first competition I played after my operation – everyone was just a surprised as I was!”

Away from the golf course Marc is also feeling the benefits as he can once again be ‘Action Dad’ as far as his two sons are concerned.

“My boys are 11 and 15 and for years it’s been ‘I can’t do this, I can’t do that’ because of my hip. Now I can do the ‘dad’ things again like playing football – although they still run rings around me.

“My advice to people now would be to get the operation done as soon as possible. I now get eight hours unbroken sleep every night and I’m a happier person because of it. It was one of the best decisions I ever made and I just wish I’d done it several years ago.”

Knee cartilage tear – Yvonne Thompson

March 11, 2018

I am still on a high weeks later and have entered the London Marathon Ballot and I would just love to get a place to run in that…fingers crossed!! I have also entered a few other races , some trail half marathons and I am even considering an Ultra for 2017 … there is no stopping me now!!

Knee cartilage tear – Yvonne Thompson

In February 2015 my knee pain got increasingly worse and I was struggling to walk or run even a short distance without severe discomfort. I had booked to do the Manchester Marathon in April 2015, but soon realised my dream of running this was impossible.

I decided to see Mr Nikhil Pradhan, Consultant Orthopaedic Surgeon at Spire Cheshire Hospital, I had seen Mr Pradhan about 5 years earlier with knee pain and at that time wanted to do an arthroscopy but I had chosen to rest up rather than go for surgery.

When I saw Mr Pradhan again in March 2015, the MRI scan showed a cartilage tear (grade 3) in my right knee and so my surgery was booked in for April. Mr Pradhan was really helpful in accommodating my work commitments with his surgery times, he booked my operation for late on a Tuesday before a Bank Holiday weekend so that I could get six days rest at home but only actually take three days off work.

All the staff at Spire Cheshire Hospital were friendly and helpful and I was in and out of the hospital that same evening.

Matthew Gouldthorpe was my physiotherapist and he was fantastic. He knew that I wanted to get back to my running and he gave me lots of good advice and strengthening exercises to do.

As I was using my left knee more I realised that there was increasing pain there too, so I mentioned this to Mr Pradhan at my right knee follow up appointment. An MRI scan was then booked for my left knee which showed I had another tear only grade 2 this time! So surgery was then booked for my left knee.

Mr Pradhan suggested that I take up Yoga – it has been the best thing I have done – it has undoubtedly helped with my core strength and improved my running form!!

More Physiotherapy with Matt followed the second operation and my left knee recovered very quickly. I was back doing my Bootcamp classes after only 3 weeks; however I was still nervous about running. In a moment of madness I booked my place for the Marathon in April 2016…it seemed quite an unrealistic goal and even Matt felt it was a long shot, but I wanted something to aim for to keep me motivated!

With Physiotherapy approval I started a couch to 5km in September 2105 and slowly built up to running a 10km in December – I was thrilled, but knew I had a very long way to go!

In January I seriously started to train increasing my miles each week and when I reached 14 miles in February Matt signed me off from my physiotherapy programme and wished me luck for my Marathon. That evening I went running –pleased to have the Physiotherapists ‘approval’, but unfortunately took a really bad fall smashing my face and scraping my knee. I then had a severe head injury and concussion and was taking painkillers for headaches for over three weeks.

My marathon training plan was yet again disastrously halted again in February and once again I was utterly devastated!

After 3 weeks of no fitness training or running I decided to just go for a little run, I was pretty shaky but I was just hoping my knees were okay and that my confidence had not completely gone. The sun was shining and I ran for nearly 3 hours – pain free and I loved it!!

So I decided to try again, it was even more of a long shot now with only 6 weeks left until the Marathon and I did not know if it was even possible!! I decided that if I could stay in one piece and reach 20 miles then I would try to run it on the day.

On the 10th April (only 10 months after my second operation) – I found myself on the start line of the Great Manchester Marathon, very nervous but excited too! I think I just was so thrilled to finally make it to the start line!! My training was about doing the miles, I knew that I would not be fast, but sub five hours was my goal…I smashed my goal and have to say it was one of the best four hours and 44mins of my life – what an achievement!! Friends and family were there to support me and share in my special day – I loved every single mile. I never ‘hit the wall’, my knees were pain free…unbelievable to achieve that in such a short space of time!!

I am still on a high weeks later and have entered the London Marathon Ballot and I would just love to get a place to run in that…fingers crossed!! I have also entered a few other races , some trail half marathons and I am even considering an Ultra for 2017 … there is no stopping me now!!

Mr Nikhil Pradhan, Consultant Orthopaedic Surgeon at Spire Cheshire Hospital said

“Yvonne is a young enthusiastic patient who enjoys sporting activities and exercise regularly. She had a knee problem which was limiting her sporting activities and this can have a negative impact on all aspects of life. Arthroscopy (key-hole) surgery can offer a good solution in such patients and helps improve their symptoms and get them back to full sporting activity. I am pleased that Yvonne has had an excellent recovery and that she has managed to achieve her goal of running the marathon. We have a good team at Spire Cheshire who help in preoperative and postoperative physiotherapy and rehabilitation which is crucial to patients achieving a full recovery”

Signature™ Knee Replacement surgery-Mr. H

March 11, 2018

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.

Personalised Minimally invasive Total Knee Replacement

March 11, 2018

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

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.”

Revolutionary new technology in Total Knee Replacement – iASSIST

March 7, 2018

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