Speakers
Ajay Malviya
Tony Andrade
Raghbir Khakha
Adrian Hughes
Specialist Society
Session Title: Rotational Alignment of the Lower Limb: A Multi-speciality Approach to Optimising Outcomes
Session Description: We are excited to present a collaborative session jointly hosted by the British Hip Society (BHS), the British Orthopaedic Foot and Ankle Society (BOFAS), and the British Association for Surgery of the Knee (BASK). Discussion will centre around the critical but often complex issue of “rotational alignment of the lower limb”, a topic that has wide-reaching implications for clinical practice across multiple subspecialities.
The lower limb is a highly interconnected system, where alterations in the alignment of one joint can influence the function and biomechanics of others. As orthopaedic surgeons, we frequently encounter patients with conditions that affect the hip, knee, and ankle joints, yet the interrelationship between these regions is often not fully appreciated when it comes to achieving optimal alignment. This is especially true for patients undergoing joint replacement surgeries, realignment procedures, or trauma management. Correcting and maintaining ideal rotational alignment is crucial not just for improving immediate surgical outcomes but for ensuring long-term function and quality of life.
In this session, we aim to provide a comprehensive look at the current understanding of rotational alignment, addressing the nuances and challenges that arise across the hip, knee, and foot & ankle. The multi-speciality nature of this session reflects the need for collaboration between, as each region of the lower limb plays a role in overall alignment and function. By combining expertise from BHS, BASK, and BOFAS, we hope to bridge the gap between these specialties and provide a more holistic approach to managing rotational malalignment.
Our expert speakers will tackle the subject from multiple angles, starting with the hip, and then considering the knee and foot and ankle. We will complete the session with a panel discussion addressing how the sub specialities can collaborate in management of these deformities to achieve optimal outcomes.
This session is designed not only to deepen our understanding of rotational alignment but also to spark new ideas for cross-speciality collaboration, allowing us to improve patient outcomes across the entire lower limb. We hope the discussions will allow a good understanding of the issues to all lower limb surgeons, enhance surgical techniques, and promote a more integrated approach to the management of rotational alignment.
On behalf of the British Hip Society, BASK, and BOFAS, we thank you for joining us, and we look forward to an engaging and productive session.
Co-Chairs: Tony Andrade and Ajay Malviya
Agenda:
14:30 - 14:35 Introduction Tony Andrade
14:35 – 14:45 Rotational malalignment from the hip perspective Ajay Malviya
14:45 – 14:55 Assessment and management of torsional malalignment around the knee Raghbir Khakha
14:55 – 15:05 Twisty bones – the foot and ankle perspective Adrian Hughes
15:05 – 15:30: Panel case-based discussion
Chairs: Tony Andrade, Ajay Malviya
Panel: Femi Ayeni, Leela Biant, Raghbir Khakha, Adrian Hughes
Ajay Malviya is a Consultant Orthopaedic Surgeon at Northumbria Healthcare NHS Foundation Trust in the North-East of England and at Nuffield Health Cambridge Hospital. He trained in the Northern Deanery and has done specialist fellowships in hip preservation and joint replacement surgery in Cambridge, London and Switzerland.
He specialises in periacetabular osteotomy for hip dysplasia using a minimally invasive approach and hip arthroscopy for femoroacetabular impingement. In his routine practice, he deals with sports injuries of the hip and has published and presented widely on the results of hip arthroscopy and pelvic osteotomy in athletes and the general population.
He has completed a PhD on the role of hip arthroscopy in femoroacetabular impingement. Preservation of the hip joint is his principal philosophy but he has a wide experience of joint replacement surgery catering to the young population, if necessary.
In his routine practice, he does more than 150 hip and knee replacements annually for all age groups. He also performs around 150 hip arthroscopies and more than 75 pelvic osteotomies for hip dysplasia annually; making him the highest volume hip preservation surgeon in the North East and amongst the top in the country.
Mr Tony Andrade is a fellowship trained consultant Orthopaedic, Hip and Knee surgeon with a special interest in Hip preservation surgery and arthroscopic hip surgery.
He set up the hip preservation service at the Royal Berkshire Hospital in 2002 and it rapidly evolved into a tertiary referral centre. He has been at the forefront of the evolving surgical techniques in arthroscopic and other hip preservation procedures. This led to establishing a visiting surgeon program where surgeons from the UK and across the world were able to join him to learn these surgical techniques. He also then later established a hip arthroscopy fellowship program in 2016. He has also been fellowship director for a lower limb arthroplasty fellowship at the Royal Berkshire Hospital since 2004.
He is current chair of the Non-Arthroplasty Hip Registry (NAHR) user group for the British Hip Society. This registry captures outcomes from hip preservation surgery nationally.
He has been a member of the International Society for Hip Arthroscopy (ISHA) since it was founded in 2008, and was the 2020-21 president, of what is now known as ISHA – The Hip Preservation Society.
Dr Raghbir Khakha is a trauma and orthopaedic surgeon with a specialist interest in joint preservation, ligament reconstructions and arthroplasty. He is based at Guys and St Thomas Hospitals in central London where he has a fellowship programme. His training involved a fellowship in Massachusetts General Hospital in Boston and Basingstoke in Hampshire focusing on complex osteotomy and paediatric knee surgery. He did his basic science degree in trauma and Orthopaedics at the Royal National Orthopaedic Hospital, followed by a Masters in the same subject.
Raghbir has taken an active role in multiple international scientific initiatives. These include co-chairing the osteotomy certification programme, co-authored the osteotomy consensus, host ESSKA travelling fellows, co-chair the osteotomy committee as well as a reviewer of several ESSKA consensus initiatives. He has published over 50 peer reviewed articles with a focus in joint preservation and is actively involved with teaching around the world.
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Mr Hughes graduated from Cambridge University in 1998, completing his medical training at Guy’s and St. Thomas’ Medical School, London in 2001. After completing his orthopaedic training in Bristol and becoming a Fellow of the Royal College of Surgeons of England in 2011, he then completed the internationally prestigious Ilizarov Fellowship at the Bristol Royal Infirmary. |
Leela Biant is the President of the British Association for Surgery of the Knee and the King James IV Professor, The Royal College of Surgeons of Edinburgh. She is Academic Head of Dept Trauma & Orthopaedic Surgery at University of Manchester, Honorary Consultant Trauma and Orthopaedic Surgeon, Manchester University Hospitals an is Co-Director of the regional North West Joint Preservation Service, serving a a poulation of over 7 million patients for Cartilage Repair and Regeneration. Leela trained in London and completed specialist fellowships in Sydney and London.
She was Consultant Trauma and Orthopaedic Surgeon in Edinburgh for 8 years before moving to Manchester. Her thesis was entitled ‘Articular Cartilage Injury and Repair in the Young Adult Knee’ and her research focus includes biological regenerative surgery and advanced joint replacement. She has won multiple awards for research, and now leads a strong research team that includes academic clinicians, biomedical engineers, materials scientists and cell biologists. Leela is an elected ICRS Senior Fellow, and founded the ICRS Global patient registry. She is a Lifetime Honorary Fellow of the UK Biological Knee Society in recognition of her work in this field. She has won awards for teaching, and is a clinician advisor to NICE. She was an ABC Travelling Fellow in 2010 and BASK Travelling Fellow in 2014.