Mr Bridle works very closely with consultant hip and knee surgical colleagues, Mr Sulaiman Alazzawi and Mr Philip Mitchell, as well as the wider Fortius Clinic Multidisciplinary group.

We operate on difficult cases together and the three of us share the inpatient care of our post-operative patients, to ensure that there is always someone available to review our patients in the days after the operation, while they are in hospital.  One of us is always available to deal with concerns and see patients after they have gone home if there are concerns.

The Fortius difference

Fortius Clinic are a well-established Sports and Orthopaedic clinic in Central London, with out patient facilities and imaging in the City and Marylebone and surgical sites at the Fortius Surgical Centre and the Cromwell Hospital.

Fortius have now expanded into South West London, with an outpatient facility in Wimbledon and surgical facilities at Spire St Anthony’s Hospital.

The state-of-the-art clinic Fortius Clinic Wimbledon is in the centre of Wimbledon, close to good transport links and parking available nearby.  The facility includes modern consulting rooms, X ray, ultrasound and MRI; very competitive self pay rates are available for MRI.

The Fortius Joint Replacement Centre at Spire St Anthony’s St Anthony’s is a modern hospital, including new operating theatres, with a MAKO robot for hip and knee replacement, and an Intensive Care Unit to support more complex patients and surgery.

COVID and our practice

The COVID pandemic finally seems to be reaching the end and private hospitals are back to working at full capacity.  The majority of the population are now fully vaccinated. It remains important that hospitals maintain a COVID safe environment, to protect our patients from the risk of infection, which can still be serious in people who had undergone surgery. We have pathways, which have proved very effective in avoiding COVID infections in our surgical patients.

Out patient consultations are normally face to face for new and post surgical patients. Remote consultations (ie video / telephone) are often more convenient for follow up visits for results and continue to be used.

London hip surgeon Mr Simon Bridle sees patients at the Fortius Clinics in Marylebone and Wimbledon and at St Anthony’s Hospital.  See below for contact numbers to make appointments or call my PA Adriana on 07765190703.

Hip Replacement

A new study has revealed that hip replacements improve quality of life, but not activity levels. Published within the Journal of Bone & Joint Surgery, the results raise concerns over physical behaviour following the procedure.

Here, we’ll look at what the study found, and why maintaining mobility is important for best results.

Understanding the latest study

The prospective study was carried out by the University of South Australia and the University of Adelaide. It included a total of 51 patients, with an average age of 66. Each had undergone a total hip arthroplasty using the same technique, as well as the same type of implant.

Before they underwent the procedure, they were assessed for the function of the joint, any hip-related symptoms, and for quality of life. They also participated in a gait analysis, alongside musculoskeletal modelling. This helped to give the researchers an in-depth knowledge of their biomechanics and walking performance.

A subgroup of patients had to undergo activity monitoring and gait analysis one year, and two years after the surgery. At each appointment, patients reported improvements in pain, hip function, and in their general quality of life. However, their activity levels according to the 24-hour activity tracker, showed very little or no change. On average, patients were asleep or sedentary for around 19.5 hours each day.

In some cases, patients were more sedentary after the hip replacement. This leads to concern over continued mobility.

The importance of keeping mobile after a hip replacement

The latest findings are concerning given how important it is for patients to keep active after undergoing a hip replacement. Just some of the benefits keeping active will provide include:

  • Increased muscle strength
  • Better cardiovascular fitness
  • Improved balance and flexibility
  • Psychological benefits

It is important to keep active after any surgery. When the body is sedentary for long periods of time, it can cause the joints to stiffen. This would greatly impact mobility, preventing you from leading a more active lifestyle.

Keeping moving after a hip replacement also helps to build up the muscles around the joint. This helps to keep it in position and prevents pain and discomfort. Staying active will also improve your mood and improve your overall fitness. Staying active in older life is essential for wellbeing.

What is stopping patients from being more mobile?

There are a couple of reasons why activity levels don’t increase after undergoing a hip replacement. Many patients have a concern about over-exercising on the new joint. They don’t want to derail their recovery or place too much pressure on the artificial joint.
Another potential reason could be that consultants often caution against doing too much too soon. This can lead to a misunderstanding over how much activity they should do.

If you are due to undergo a hip replacement, staying active is crucial. If you’re unsure how much activity you should be doing, talk to your surgeon. They will be able to advise you of the best ways to maintain mobility moving forward.

Joint Replacement Backlog

Researchers have revealed the stark impact that COVID has had on the NHS joint replacement waiting lists. According to new figures, tackling the backlog could take a staggering 10 years.

There are currently 160,000 hip and knee replacements delayed due to the pandemic. Here, we’ll look at the ongoing impact COVID is having on the sector and what patients can do if they are facing long delays.

Understanding the latest figures

The latest figures were concluded after researchers trawled through patient medical records. They wanted to see how many procedures had been carried out in NHS and private hospitals across the UK. Only Scottish procedures were unavailable due to being stored on an independent database.

Prior to the COVID outbreak in 2019, there were 219,143 joint replacement procedures carried out. However, in 2020 this figure dropped by a staggering 106,000. Rather than this being down to fewer patients needing a replacement, instead, it is an indication of the effects of the pandemic. Additionally, 50,000 procedures have needed to be delayed in 2021.

Although the findings have yet to be peer-reviewed, the researchers claim they are important due to being more accurate than waiting list data. It also suggests that waiting lists could be six months longer than usual.

This is terrible news for patients who have been left in constant pain and discomfort. However, there are things you can do if you have been affected.

Many patients are turning to the self-pay sector

Current backlogs are mostly affecting the NHS. However, private clinics are starting to feel the pressure as more people turn to the self-pay sector.

Waiting lists tend to be much shorter with self-pay treatment and the quality of treatment is excellent. Although some backlogs have occurred in the private sector, they are much shorter than those experienced on the NHS.

What can you do if you are facing a long wait?

If you are stuck waiting for a joint replacement, there are some things you can do to cope with pain and discomfort. While you might not feel like it, exercising is a great way to keep the joint mobile and pain-free. It’s a good idea to seek advice from a physiotherapist. They will be able to put together a tailored plan to help you get more comfortable.

You can also download apps such as Escape Pain. This will provide you with plenty of advice you can follow while you wait. Don’t forget about the mental impact too. Join online support groups and consider seeking therapy if you are finding it especially difficult.

The backlog of joint replacements is causing concern for both patients and surgeons. Hip and knee replacements provide instant relief, making it essential to carry them out quickly. If you are tired of waiting for your surgery to go ahead, book a consultation with joint replacement specialist Mr Simon Bridle today.

robotic joint replacement

Since its introduction in the 1960s, joint replacement surgery has helped millions of patients regain their mobility. Over the years, technology has enhanced the techniques used to carry out the procedure. Robotic joint replacements are the latest technique used by surgeons around the globe. The question is, how does robotic joint replacement compare to traditional techniques?

Here, you will learn more about traditional and robotic joint replacements, and which technique is better for patients.

What is a traditional joint replacement?

Traditional or conventional joint replacements involve open surgery, where the worn surfaces of the joint will be replaced with artificial structures. These are made from a combination of materials, including metals, plastic and ceramic.

The procedure has a good success rate, though there are some risks and complications to be aware of. Some of the main complications include wound infection, Prosthesis malfunction, and blood clotting. Your surgeon will discuss the risks with you during a consultation. There is no evidence that the robotic assisted approach increases the risk of any of the complications.

How is a robotic joint replacement different?

Robotic joint replacement follows the exact same procedure as a traditional replacement. However, it allows more accurate planning the surgeon gains the advantage of robotic arm assistance, to allow more accurate implantation. The surgeon oversees the procedure, so it isn’t controlled by the robot which some patients can be concerned about. Prior to the surgery, a CT scan will be carried out. This will be used to produce a 3D model of the joint.

The benefits of robotic joint replacement over traditional methods

While the surgeon is still in control during a robotic joint replacement, there are unique benefits the technology delivers. The main benefits include:

  • Increased accuracy
  • Reduces injury to healthy tissue
  • Customised to each patient
  • Better outcomes

The MAKO robotic assisted technique which Mr Bridle uses involves the patient’s joint being digitally modelled in 3D in the robot from the CT. This means surgery can be visualised and planned, based on each patient’s unique anatomy.

The robotic assistance allows orthopaedic surgeons to perform hip surgery with greater accuracy. Studies have shown that the robotic procedure matches leg length five times better than conventional surgery. The angle of the joint also plays a major role in the success of the procedure. Robotic surgery has been shown to be twice as accurate as manual surgery. We hope that improved accuracy will allow the joint to function more normally and prolong the lifespan of the replacement.

With knee replacements the surgeon is able to adjust the position of the components to get the best fit and balance during the surgery and the robotic assistance allows very accurate bone cuts. Throughout the surgery, the robotic arm uses data taken from the CT scan to create space for the surgeon to operate in preventing accidental damage to nearby tissues. A well aligned, well balanced knee is reliably achieved, there is good evidence that patients get over the surgery more quickly and that a better functioning knee is achieved.

Mr Bridle offers both robotic hip and knee replacements and has currently performed more than 100 robotic hip replacement surgeries. Renowned for its high success rate and improved recovery, robotic surgery is fast replacing traditional methods. If you do have an option to undergo robot assisted over traditional surgery, you should take it.

Call 020 8947 9524 to discover whether a robot assisted joint replacement surgery could be right for you.

Waiting for a joint replacement

The Versus Arthritis charity has called for more support for those awaiting joint replacements. Often left in constant pain, patients need more physical and emotional support while they wait, according to the charity.

The ‘Impossible to Ignore’ campaign from Versus Arthritis, includes a six-point support package for patients. This provides invaluable help and support for those currently facing a long wait for their surgery. Here, we will look at what the new support package includes and what patients can do to look after themselves while awaiting a joint replacement procedure.

Understanding the new support package

Due to the backlogs that have developed during the pandemic, waiting times for planned surgeries are at record levels. In a Versus Arthritis poll of 900 people awaiting surgery, more than three-quarters (79%) said they felt their physical health had deteriorated.

According to the study, roughly 89% (nine out of ten) reported their pain had increased, 90% reported reduced mobility, 79% reported a loss of independence, and 72% reported deteriorating mental health.

The new six-point support package recommended by Versus Arthritis covers the following:

  1. Patients must be adequately informed about the date of their surgery, as well as the services and care they can receive in the meantime.
  2. Patients with arthritis will receive personalised self-management support for managing their pain until surgery is available.
  3. A primary care network (or a group of GP practices working closely with other primary and community care workers), should actively promote physical activity programmes for people with arthritis, enabling them to stay active and prepare for surgery.
  4. All people with arthritis should have access to mental health support to help them manage their pain, depression, and anxiety.
  5. Providing patients with arthritis who are in work, or who are seeking work, with information about financial assistance and advice.
  6. A COVID-19 recovery plan that is tailored to the specific needs of individuals with arthritis.

The Royal College of Surgeons has also recommended specialist hubs to be set up to deal with the extensive backlogs.

Preparing for joint replacement surgery

If you are currently waiting for your joint replacement procedure, there are things you can do in the run-up, whether you are opting for a private, speedier solution or sitting on a NHS waiting list.

To manage your pain and ease mobility, it is imperative you keep moving. There are resources online you can use to exercise safely while you wait for the surgery. Many physiotherapists are also offering online support to patients.

You can also seek help with your mental health through charities such as MIND. They too have a lot of online resources you can take advantage of. Of course, you can also ask the advice of your surgeon.

Waiting for a joint replacement can be painful and frustrating. To prevent the issue from worsening, it is important to look after yourself and keep moving. Staying as healthy as possible will also help.

vitamin D and knee replacement pain

A new study published within the Menopause Journal, has revealed that a vitamin D deficiency in women could lead to increased pain after a knee replacement. It is not the first study to identify a link between a Vitamin D deficiency and musculoskeletal problems.

Vitamin D is known to be crucial for our health. However, many of us simply are not getting enough of it. Here, we will look at what this latest study revealed and other potential causes of pain after a knee replacement.

Studying the link between vitamin D and knee replacement pain

The latest study examined how vitamin D levels affect the functional outcome, as well as pain levels, after a knee replacement procedure. It included results from 226 postmenopausal women in 2017-2019, who had undergone a knee replacement due to symptoms of osteoarthritis.

The women were separated into two groups. One had a Vitamin D deficiency, while the other had adequate levels of the vitamin. It was revealed that those who had a Vitamin D deficiency, experienced negative early functional outcomes after the knee replacement. It was also shown to increase the amount of pain felt after the procedure.

Worryingly, the study also revealed that around 70% of postmenopausal women who were due to undergo the procedure, had a Vitamin D deficiency.

Why is Vitamin D so important?

There have been a lot of studies which have revealed the importance of Vitamin D levels for our health. In terms of our bones, past studies have shown that a deficiency in the vitamin can increase the risk of developing Osteoarthritis, fractures, lower bone mineral density, and cause more severe bone pain.

The job of Vitamin D is to regulate the amount of phosphate and calcium within the body. This in turn keeps the bones, muscles, and teeth healthy. The main source of the vitamin is the sun, making it important to get outdoors frequently.

Vitamin D deficiency can also cause conditions such as Rickets, and other bone deformities.

Other potential causes of knee replacement pain

While a Vitamin D deficiency has shown to increase pain after a knee replacement procedure, it isn’t the only risk factor. The study also revealed that smoking and a high body mass index can play a role in post-operative pain.

Occasionally, pain after a knee replacement could point to an underlying issue. For example, it could suggest a loosening of the implant, or a potential infection. For this reason, it is important to undergo a check-up with the surgeon if pain is an issue after the procedure.

Pain after a knee replacement operation is common. However, typically over-the-counter medications help to eliminate the pain. If your pain doesn’t subside after a few days, consult with your surgeon to determine whether there is an underlying issue.

This new research provides a useful guideline to both health providers and patients. Those who do have a Vitamin D deficiency may want to take supplements to build up their levels prior to undergoing a knee replacement procedure.

hip arthritis and FAI

Femoro-acetabular Impingement or FAI is a relatively recently recognised condition; it was initially described by orthopaedic surgeon Dr Reinhold Ganz who described the condition in 2003 and identified it as a likely cause for the development of hip arthritis in later life.

The condition affects the junction between the rim of the acetabulum (or hip joint socket) and the femoral head and neck; the socket has a fibrous rim called the labrum, which acts as a shock absorber during movement of the joint.

In an attempt to learn more about the condition, researchers from the Mayo Clinic and China carried out a recent study.

Here, we will look at what Femoro-acetabular Impingement is, how it is treated, the link between hip arthritis and FAI and what the new study revealed.

What is FAI?

Femoro-acetabular Impingement is associated with additional bone growing on the front of the neck, giving it an irregular shape, or on the socket.  This irregular shape causes the neck to pinch against the front of the socket, and this can eventually damage the labrum, causing a tear.  This pinching causes pain, particularly when people twist their hip.

There are different types of FAI you can develop. These include Pincer, Cam, and Combined. Pincer impingement affects the socket, as extra bone forms on the rim, while Cam impingement affects the femoral head. Combined impingement means you have signs of both Cam and Pincer impingement.

Symptoms of FAI include pain, limping, and stiffness. Little can be done to prevent the condition, and it isn’t known how many people suffer with the condition. However, it is known that it mostly affects younger patients.

How is FAI diagnosed and treated?

There are several tests which can diagnose FAI. Imaging tests such as an MRI tend to be the first types of tests carried out. They can help to identify any potential abnormalities or damage within the joint of the hip.

In terms of treatment, it will depend upon the severity of the condition and the symptoms experienced. Corticosteroids can be used to control inflammation, while physical therapy can help to improve mobility and strengthen the joint.  Strengthening the core and gluteal muscles is very important and often all that is needed to relieve patients’ symptoms.

If surgery is required, arthroscopic hip surgery is the most common option. This minimally invasive procedure involves removing damaged bone and cartilage. Open hip surgery can also be carried out, but this is rarely done nowadays.

What did the latest study reveal?

A total of 1,893 patients were involved in the latest study into FAI. It revealed that females have an increased risk of the condition. Interestingly, it also discovered that incidences of the condition increased from 2000-2016. This is largely thought to be down to an increase in awareness of FAI.

Older patients who present with the condition

While there is a link between hip arthritis and FAI, it is uncommon in older patients. Those who present with the same symptoms of FAI, are more likely to be showing signs of arthritis. Furthermore, if arthritis is present, arthroscopic surgery wouldn’t be suitable, as the hip is ‘too far gone’ for this to help.

If you suspect you may have Femoro-acetabular Impingement, book a consultation with Mr Simon Bridle today. While he does not treat FAI, he often carries out MRI testing for patients referred by physiotherapists. Older patients will also be able to determine whether the cause of their symptoms is actually regenerative arthritis, where the only surgical treatment is hip replacement.

Living with chronic joint pain

When you are living with chronic pain, life can often seem unbearable. There have been a number of studies carried out recently, looking at the impact the recent lockdowns have had on chronic pain patients. One study, carried out by the University of Liverpool, revealed those living with chronic pain during lockdown have experience increased pain, anxiety, and loneliness.

Currently, pain medications are one of the few treatment’s patients turn to for relief from joint pain. However, new guidelines have been released from NICE, advising against the use of pain medications for chronic pain patients. This includes common pain medications such as painkillers and ibuprofen. Instead, increasing exercise and undergoing CBT are being recommended.

Here, you’ll discover what treatment options are available to patients experiencing debilitating symptoms from chronic joint pain.

Why should pain medications be avoided?

The main reason doctors are being advised not to prescribe pain medication to patients with chronic pain, is due to the side effects they can cause. Opioids in particular are known to lead to severe side effects, including a high risk of addiction.

While pain medications are frequently used to treat chronic pain, there is actually very little evidence to suggest that they work. No studies have shown that pain relief medication helps to improve quality of life or pain in chronic pain conditions.

Exercise and antidepressants could be ideal alternative

According to NICE, exercise and antidepressants could be much more effective treatments for chronic pain patients. While exercising is probably the last thing you feel like doing, it is known to have a positive effect on pain reduction.

When you exercise regularly, it helps to keep the joints moving and the muscles strong. Daily exercise is also known to be extremely important to our mental health. It can aid in weight management, which will also reduce the pressure on the joints.

In terms of what type of exercise you should do, your doctor will be able to advise you of the best exercises to focus on. You could also see a physiotherapist who will be able to create a fitness plan based upon your chronic illness symptoms.

What treatment options are available?

The treatments available for chronic pain, largely depend upon the type you are suffering with. If you have chronic pain caused by Osteoarthritis in the knee or hip, a replacement surgery could help. Hip and knee replacements are a common procedure that are shown to provide significant improvements in quality of life and pain relief.

Booking a consultation with a hip or knee replacement specialist will help you determine whether surgery would be an ideal option for you. It is important to consider the risks and complications, alongside the benefits, before deciding if it is right for you. Call 020 8947 9524 to book a consultation with Mr Simon Bridle.

London hip replacement success

If you are due to undergo a hip replacement, there are numerous things that can impact its success. A recent study has looked into whether your level of fitness could play a role in how successful a hip replacement will be.

Here, we’ll look at what the study found and whether your fitness level could determine how successful your hip replacement is.

What did the latest study find?

The latest study, published within The Journal of Arthroplasty, aimed to determine the impact of a patient’s level of physical activity on the outcome of a total hip arthroplasty.

It is already known that the procedure provides excellent results in terms of functional improvement and pain relief in all patients. However, would being fitter improve the surgery’s success?

The researchers of the study used data from the institutional registry of patients who were having a total hip arthroplasty from 2007 to 2012. Patients who underwent a thorough assessment after the surgery were identified. Satisfaction scores, rates of complication and revision surgical procedure rates were all compared between patients with a higher and lower fitness level.

Interestingly, more active patients believed they would achieve more favourable outcomes than non-active patients before the surgery. After a 2-year assessment, it was revealed that active and inactive patients had similar levels of satisfaction. They also had comparable outcomes.

The non-active patients also experienced an increase in activity two years after the procedure. This could be down to the fact that their bad hip was preventing them from exercising.

Is it important to keep fit before a hip replacement?

Although the recent study doesn’t show a link between lower fitness levels and a poorer outcome, it is still important to keep fit prior to surgery. The fitter you are, the fewer the risks.

Overweight patients are particularly vulnerable to complications from surgery. As a hip replacement is a major surgery, the body needs to be as fit as possible if you want a speedy recovery.

Of course, keeping fit before a hip replacement isn’t always easy. If you are struggling to stay active due to pain or reduced mobility, gentle exercises such as Pilates are a great option. You could also visit a physiotherapist for help getting in shape for the surgery.

Other factors that could impact hip replacement results

Alongside your fitness levels, there are a few other factors that could impact the results of a total hip arthroplasty. The surgical technique used, and the prosthesis material can both affect the success of the procedure. Non-surgical factors also include age, sex, and BMI.

Hip surgeon Mr Simon Bridle will be able to identify and discuss any risk factors you need to be aware of during your consultation. He can also give you a better idea of how successful the surgery is likely to be. Most patients who undergo a hip replacement experience significant improvements in both pain relief and function.

revision hip replacement

A new UK study has discovered that an osteoporosis drug could help to halve the number of revision hip replacements required.

While the majority of hip replacements run smoothly and last for up to 20 years, revisions are sometimes needed. The trouble is this is a major operation that carries significant risks. Therefore, anything that can reduce the chances of patients requiring a revision hip replacement is highly beneficial.

Here, we will look at what the recent study revealed and whether it could be suitable for all patients.

Understanding the latest study

The new study was carried out by the University of Sheffield and the Sheffield Teaching Hospitals NHS Foundations Trust. It included 22 patients in its Phase 2 clinical trial. Bone imaging and bone biopsies were used to determine whether the osteoporosis drug was working.

It was discovered that when the drug was injected, it prevented microscopic wear particles from the replacement joint being absorbed by the bone cells. It is well established that this can lead to the bone around the joint being damaged and loosening the implant.  If the drug prevents this process, this could prevent the bone from being eaten away and reduce the need for a revision surgery.

The researchers believe this breakthrough could help to prevent half of the revision surgeries currently carried out.

What is a revision hip replacement?

The revision hip replacement procedure is much more complex and longer than an initial replacement surgery. Specialised tools and implants are used during the procedure and it requires extensive planning by the surgeon.

There are different types of revision surgeries that can be carried out. It will depend upon the type of replacement needed and the extent of the problem. For example, it could be that just some of the components of the artificial joint need replacing. Or it could be that the entire joint needs to be replaced.

A revision procedure can be more difficult to perform due to damage caused to the soft tissue and bone. It is also associated with more risks than the initial surgery. These include dislocation, infection, damage to the nerves, blood clots and failure of the implant. Your surgeon will discuss the risks with you in detail before you decide whether or not to undergo the procedure.

What does this latest research mean for patients?

Due to how risky and complex revision replacement surgeries are, the new study is good news for both surgeons and patients. However, it is important to note that it was only a small study. The researchers are now going to be carrying out a larger third clinical trial to get a better idea of how effective the drug is

Mr Simon Bridle also urges a further note of caution: “Patients also need to realise that all drugs carry the risk of side effects. This is something that will need to be addressed before the osteoporosis drug can be used to treat patients in the mainstream.”

If you are concerned about your previous hip replacement, call 020 8947 9524 to book a consultation with Mr Simon Bridle today. A revision surgery may not be required but seeking treatment quickly can help ease the pain and discomfort you are currently experiencing.

Get in Touch


Fortius Enquiries Line:
020 3195 2442

PA to Mr Bridle: Adriana Espinel-Prada
T: 07765 190703

Fortius Joint Replacement Centre
Spire St Anthony’s
801 London Road, North Cheam, Sutton, SM3 9DW

Fortius Clinic Central
17 Fitzhardinge Street

Fortius Clinic Wimbledon
22 Worple Road
SW19 4DD