I treat hip and knee problems in general. I deal with hip and knee arthritis, soft tissue problems in and around the hip and knee such as trochanteric bursitis, piriformis syndrome, meniscus cartilage tears and muscle and ligament sprains and tears. I deal with unexplained hip and knee pain where a firm diagnosis has not been made. Examples of conditions such as these are sacroiliitis and plica syndrome.
I do both primary and revision (redo) hip and knee replacement, keyhole surgery of the knee and soft tissue operations around the hip and knee.
For NHS patients, you can usually be seen within 10 working days. Please ask your GP to send in a referral to The Oaklands Hospital for Mr Gaurav Batra and your appointment will be made in my clinic. If you can call my secretary or drop us an email at the same time, we will look out for your referral and expedite your appointment.
For private patients, please bring in your insurance details and any authorisation code. The Oaklands Hospital needs these so you can be seen. Please bring your referral letter. For new patients, you will be given a registration form which you can complete in the waiting room. A list of your current medications and any allergies you suffer from is very useful.
I will need to examine your legs and feet, so please wear clothes and shoes which are convenient for you. Loose trousers or shorts allow for easy examination for knee patients. For ladies, tights can be troublesome if your hips or knees need to be examined.
Let me start by saying that most patients get through their treatment with no problems or only minor irritations, such as swelling or discomfort. However, all treatments carry a degree of risk. Even an injection carries a tiny risk of infection.
For knee keyhole surgery, there is a small risk of infection, deep vein thrombosis (clot in the leg or pelvic veins) or pulmonary embolus (clot in the lung) and in very rare occasions, this can be fatal. Depending on what is damaged within your knee, I can give you some guidance regarding chance of success of surgery, but unfortunately, no one can guarantee absolutely that all symptoms will vanish.
For hip and knee replacement surgery, there is a small risk of infection, clots (deep vein thrombosis) or pulmonary embolus (clot in the lung) and in about 1 in 1000 cases, this can be fatal. Hip replacements can occasionally dislocate (1-2%) and you may note that your leg is slightly longer or shorter than the other side (usually not a problem). For both hip and knee replacements, important nerves and blood vessels lie near the joint and very occasionally can be damaged which can unfortunately affect future function. Knee replacement patients can sometimes develop excessive stiffness (arthrofibrosis), though this can be reduced by physiotherapy and non-operative means.
- Stopping smoking can help. Smoking worsens wound healing and increases the risks of chest infections, heart attacks and blood clots.
- Maintain your mobility prior to the operation. This will help post-operative mobility.
- Losing weight before the operation is very helpful. You may even delay the need for surgery. If surgery is already arranged and you manage to lose weight before surgery day, this is still helpful. It can make access to the joint easier and reduce the size of the incision. Post-operative mobility may be better and reduce the risk of clots. If you manage to keep the weight down after the operation, it may even help your joint replacement last longer.
- In the week before surgery, please wear comfortable loose clothing and avoid injuring your legs or getting scratches on them. If small cuts or scratches appear inflamed or infected on day of surgery, I may not be able to proceed safely so your operation will be delayed.
Minimally invasive surgery is when the size of incision is made smaller for cosmetic reasons. The operation itself does not change. Whilst I keep incision sizes reasonable, I feel that the quality of the operation and correct placement of implants is paramount and making the incision too small can be counterproductive.
I’d be lying if I told you it won’t hurt at all. However, you will receive pain relief to minimise your discomfort. For joint replacements we use our Enhanced Recovery Programme that will reduce your pain, using drugs given before, during and after surgery
Your new joint is a synthetic man made one and does not remodel or repair itself like your own bones or cartilage. Excessive activity can wear it out quicker than expected. However, you can do most things but high impact activities are best avoided. If there is any specific activity you are worried about after joint replacement please tell me about it prior to surgery as it may alter your treatment options or timing of surgery, for example you may prefer to wait until after retirement.
For uncomplicated keyhole surgery of the knee, most people are comfortable to drive 2-3 weeks after surgery. Evidence has shown that for all joint replacements driving is affected up to 6 weeks and so should not be attempted until after this time point. For hip replacements, there is an additional risk of dislocation and I prefer it if you can avoid driving for 12 weeks following surgery.
Only about 1 in 5 people manage to knee comfortably following knee replacement. Most people find it uncomfortable.
Whilst this is impossible to predict with absolute accuracy, the National Joint Registry shows that the hip replacement system (Exeter) is the best surviving implant with more than 98% still working well 10 years after initial surgery. Studies on the PFC knee replacement that I use show that more than 97% are still working well after 10 years.
Most people get over straightforward knee arthroscopic surgery within 2 weeks. Some people unfortunately take longer. Occasionally, symptoms can temporarily worsen after keyhole surgery, especially if the joint has significant arthritis. With physiotherapy and planned rest periods, most people will have improvement in their symptoms again.
I will do my utmost to make sure your treatment is tailored to your needs. If there is any aspect you want to discuss further, please do not hesitate to bring it up. I will do my best to help.