Orthopaedic revision surgery centre

Orthopaedic surgeons and scientists at UHS have launched the first ‘centre of excellence’ to combine revision surgery for hip and knee replacements with the development of new and safer implants.

The centre for arthroplasty and revision surgery, based at Southampton General Hospital, brings together clinicians, scientists and academics from the Trust and the University of Southampton.

In addition to resolving patients’ problems, the centre gives surgeons the opportunity to investigate why some devices fail and why some perform better than others and work with industry to create better alternatives.

The development comes after widespread concern over the effectiveness of metal-on-metal hip replacements, with research published in The Lancet suggesting 6.2% fail within five years.

This was followed by a call from the Medicines and Healthcare Regulatory Authority for more than 50,000 people with all metal replacements to have annual blood tests because of concerns about the release of chrome and cobalt into the bloodstream.

The centre, led by consultant hip surgeon Jeremy Latham, is made up of two academic leads, seven surgeons, two physicians, six scientists, four radiologists, a pathologist, a microbiologist and an expert in trace elements.

“Joint replacement surgery has transformed the lives of millions of people over the last 50 years and most replacements last for many years, but sometimes they fail and need revision surgery,” said Mr Latham.

“And recent problems encountered with various metal-on-metal hip implants have made it clear that there is a need for a centre of excellence to tailor care very specifically to the individual – one size definitely doesn’t fit all.”

The team will look at all aspects of revision joint surgery, including implant and patient factors that affect the success of replacements, and will focus on the effect of early intervention with drugs and vitamin D to assess whether or not surgery can be delayed or avoided in some cases.

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Page comments

Thank you for your comment. In an ideal world, current British Hip Society recommendations are a review at eight years, and then every five years indefinitely. Metal on metal needs much more rigorous follow-up, although this is not always consistent.
Doug Dunlop (18/10/2018 14:56:20)
Lack of follow up after a primary thr is a major reason for the problems that lead to a revision. I was 45yrs old when I had both hips replaced. I have not had any scans or treatment for twenty years. This has left me with bone thinning and a loose thr. Medication ie vit d @ calcium may have helped. Scans every 3 yrs should have been done. Now surgery is more complicated @ risky
Linda Chesworth (16/09/2018 22:07:22)
In general terms, it is difficult to comment on just a history without examination. The GP is usually best placed for both, but if you are not happy you can always ask for a second opinion. If they are indeed swollen, then onward referral to a specialist would seem appropriate.
Doug Dunlop (09/01/2018 16:29:04)
Dear Mr Latham I have problems with both knees with one badly swollen and painful.It makes walking hard and I have fallen once I fell and broke my nose cutting it to the bone.My Dr seems reluctant to offer anything but steroid.What can I do?
Anonymous (22/12/2017 15:44:57)
Great for the future which will reveal many more victims. Too late for the people already damaged with a bleak outlook. Too many professionals still refuse to recognise cobaltism. I have a long story but not tonight!
derek (15/01/2016 18:11:35)
Thank you for your email. I am sorry to hear about your knee problem. We would be very happy to try and help you. I recommend that you speak to your GP and ask for a referral to the Knee Team at Southampton General Hospital. One of our specialists will see you and advise treatment as necessary. Kind regards.
Jeremy Latham (09/04/2015 10:41:03)
I recently heard about your service from a co-governor at RBCH and XCH NHS Trust. I had on knee replacement in 2005 and the other became very inflamed. I was anticipating need for a second TKR but having booked an appointment privately during the next 10 days with a combination of glucosamine HCL, MSM and omega 3 was again able to walk without pain. I now have regular physio on a vibrator machine butlnee will not fully cope with body weight yet and maybe revision surgery could be complicated as it may be possible to remove some bone without a TKR?? It may be worth obtaining a referral from my GP
Brian Young (31/03/2015 00:35:24)
I'm sorry to hear about your hip problem. It sounds as though you need to seek advice as soon as possible. I recommend that you contact your local hospital's orthopaedic department for advice. Alternatively, you might wish to contact DePuy via their website for advice on surgeons who have expertise in revision surgery in Bulgaria. Kind regards.
Jeremy Latham (06/01/2014 10:31:57)
I now live in Bulgaria making it difficult to find a consultant to investigate my hip problems. Knowing my body I am certain I will need at least one hip revision as it clunks. I am in constant & acute pain. I know my implants are part of the DePuy recall. What I cannot find is the manufacturer of my shoulder implants.
derek (21/12/2013 08:23:22)
Thanks very much for your questions about the Cormet 2000 made by Corin. I suggest that you contact their customer services department on 01285 659866 for more information on their products. Kind regards.
Jeremy Latham (30/07/2013 16:06:25)
Do you know why the Corin Cormet 2000 is no longer being used? I understand there are issues with this implant, do you know why? Is it the design, is it difficult to implant precisely or are there other reasons?
Anonymous (29/07/2013 12:58:05)
I am sorry to hear about your troublesome hip. My advice to you is first of all to discuss the matter with the orthopaedic surgeon who did the operation. If you feel that this wouldn't be helpful, then of course we would be very happy to see you in Southampton to assess the problems that you have, and how best to investigate and manage them. Kind regards.
Jeremy Latham (25/06/2013 14:34:17)
I had a MoM DePuy ASR hip fitted in Jan 2009 at London Bridge Hospital, as time passed there were serious complications and I elected for revisionary surgery in July 2011. There were high levels of Cobalt and Chromium in my blood and necrotic tissue was found during the revisionary surgery.

My life has been turned upside down since this happened, I am unable to work anymore as a project manager and am devastated by the loss of my professional and every day life.

I still suffer from many side affects which are unexplained and to which as yet there are no answers ie. pains in my chest,breathing difficulties, severe pain around the hip joint, very stiff joint, severe headaches, poor memory, lack of concentration, extreme headaches, tiredness, bipolar disorder, skin rashes and reduced eyesight

I have seen a cardiologist, neurologist,toxicologist,colorectal specialist, urologist, opthalmologist and a audiologist.

I only get out of the house about once a week now as the pain is too much and I end up having to stay in bed for 3 or 4 days to recover. I am also under the care of a Psychiatrist as I've had suicidal tendencies since this happened.

I have Bupa cover and would appreciate if I could attend your clinic for a review and to maybe discuss further options.


Sandy Doherty
Sandy Doherty (23/06/2013 13:42:51)
Thanks for your comment. I am sorry to hear about your father's predicament. Complications following fractures of the hip bones can sometimes happen, and these sometimes need to be sorted out with another operation. We would be delighted to see your father in clinic to assess his problem and advise him on appropriate treatment. Please ask him to contact his general practitioner and request that he is referred urgently to one of our hip clinics in Southampton. If there are any problems, please let my secretary know as soon as possible. I hope that this is helpful. Kind regards.
Jeremy Latham (16/08/2012 11:41:09)
Hi, my father in law had an emergency hip repair about 5 years ago, this has caused him lots of trouble ever since, the pins through the bone have come loose. He has seen a consultant in Bournemouth (even though he lives in Southampton) who basically didn't want to know. He's in a lot of pain and is effectively immobile. What is the right process to get him seen by someone with specialist skill who can genuinely consider his options? His quality fo life is really suffering and even at 84 I can't believe modern medicine can't do anything to help him...
Roy Thompson (14/08/2012 19:42:44)
I had revision surgery on my left hip in 2009 by Jeremy Latham with an excellent result!. I now lead a normal life,I swim and attend an excellent hip and knee rehabilitation exercise class once a week in my local area of Fawley. Many thanks.
Annette Drodge (27/05/2012 19:20:45)
My husband had a total knee replacement in August,2011 under Mr Tyce. Unlike these other commenters, he recovered very well, very quickly and has achieved maximum bend with no pain. Obviously, it is possible but he was exercising almost straight away, did intensive physio, bought a small exercise bike (£15 Tesco) and hasn't looked back. We are very pleased both with the SGH treatment and the Hampshire suppport services. His operation was under the 'fast recovery' programme which also seemed to help.
Pauline Wood (27/05/2012 18:31:54)
Thanks for your comments.
Mr Saunders, I'm sorry to hear about your knee. I advise you to see your GP and request that you are sent back to the Knee clinic for further advice.

Ms Meldrum, I suggest that you contact Mr Gent's secretary at SGH for further advice.

Mr Middleton, sorry to hear about your knee. It sounds as though you need to be referred back to the Knee Clinic for further investigations of your problems. Please contact your GP for a referral.
Jeremy Latham (25/05/2012 18:04:08)
I had my knee replacement on the 5th May 2010, I havenot yet managed to bend my knee without suffering constant pain . I only manage approxamately 2-3hrs continuose sleep.waiting to see my G.P
Roy PP Saunders (24/05/2012 19:25:49)
Given that I had a hip replacement in 2005 and am not due a review for another 4 years after previous annual check ups should I be asking for clarification as to what type of replacement I had and whether I should be seen for a review? I was operated on by Mr Ed Gent-and was sent from SGH to the Nuffield for my surgery. Thanks
Denise Meldrum (24/05/2012 13:56:09)
I had a right knee total replacement on 9th May 2004. I was sent from Southampton General to Royal Hospital Haslar for the surgery.

Now the dratted thing is getting very painful again, I really do not want to go thro' the proceedure again! Is there any alternative?
Angus Hugh Middleton (24/05/2012 11:17:25)