Cartilage Repair Knee Specialist Surgeon Tim Spalding - websupport

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Hallmarks of a Good  Knee Doctor? Featured

Hallmarks of a Good Knee Doctor?

Published in Press

Technical expertise and skill, of course — but someone who understands you, someone you trust, is also vital.

Indeed, research shows that a good relationship with your doctor can improve the chances of a successful outcome. But how do you find a specialist who fits the bill?
We’ve identified the country’s top consultants — as judged by their peers. We’ve canvassed the views of more than 260 consultants across seven specialties from around the country, and asked them this very simple, but key, question: If your own nearest and dearest were to need treatment in your field, to whom would you refer them — and why?
The consultants who earned the most votes from their peers are the ones who made it into our guides — though patients should bear in mind that this is not a scientific study.

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Knee Reconstruction using Osteochondral Allografts

Allografting or, to give its full name, ‘fresh osteochondral allograft transplantation (OCA)’ is an operation in which a damaged or diseased area of a joint is reconstructed using a bone and articular cartilage transplant. The cartilage cells can survive the transplantation only if the tissue is ‘fresh’, which means it has not been exposed to radiation or prolonged freezing.

OCA was pioneered at the beginning of the 20th century, and has had a long and successful history. It is becoming increasingly popular as a treatment for large injuries caused by trauma, osteochondritis dissecans (growth abnormality of bone and joint), and bone death (osteonecrosis) resulting from lack of blood flow to the bone supporting the joint cartilage.

The scientific basis of OCA is the transplantation of fully developed or mature hyaline (joint) cartilage containing living cartilage cells (‘chondrocytes’) that survive the transplant and support the production of the cartilage matrix indefinitely. Theoretically, this maintains the tissue balance (‘homeostasis’) of the joint cartilage. Studies have shown chondrocytes living as long as 29 years after transplant. The graft often includes a portion of bone to help restore missing bone.

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  • Attachment -  Department of Trauma & Orthopaedics : Knee Reconstruction using Osteochondral Allografts download
  • Authors: Consultant Surgeons Mr Tim Spalding, Mr Pete Thompson, Mr Andy Metcalfe, UHCW NHS Trust
  • Contact email: via Desdimina Rai, Secretary to Mr Tim Spalding, Consultant Orthopaedic Surgeon.
  • Tel: 024 7696 5098, Email This email address is being protected from spambots. You need JavaScript enabled to view it.

The Trust has access to interpreting and translation services. If you need this information in another language or format please contact and we will do our best to meet your needs. The Trust operates a smoke free policy

    Document History
  • Author Mr Tim Spalding, Mr Pete Thompson, Mr Andy Metcalfe
  • Department Trauma & Orthopaedics
  • Contact Tel No 024 7696 5098
  • Published December 2017
  • Review December 2019
  • Version 1
  • Reference No HIC/LFT/2192/17

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  • Attachment - Osteochondral Grafting post operative rehabilitation download
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Tim is a Consultant Orthopaedic Surgeon based at the University Hospitals Coventry Warwickshire NHS Trust. He qualified from Charing Cross Hospital Medical School in London in 1982 and completed a fellowship in knee and sports surgery in Toronto, Canada in 1995. He has been specialising in knee surgery since that time.

Tim's interests cover the range of knee surgery including arthroscopic anterior and posterior cruciate ligament reconstruction for the unstable knee, meniscal surgery and reconstruction for the torn footballer’s cartilage, surgery for patello-femoral problems, articular cartilage repair and autologous chondrocyte transplantation for joint articular surface damage, through to osteotomy and joint replacement for the worn knee. More recent interests include meniscus transplantation and he has now done over 150 such cases which is the most in UK.

He is also actively involved with research and teaching both nationally and internationally. Most recently he is one of the lead developers of the National Ligament Registry dedicated to analysing and improving the outcome of Anterior Cruciate ligament reconstruction.

Download Tim's Abbreviated C.V : pdf download of Tims mini CV

 

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---------------June 2018------------------------

Tim spalding is featured in The Good Doctors Guide: Meet the best knee replacement surgeons and learn what exercises to do before your operation

---------------August 2015---------------------

Tim Spalding convenes the 7th Biannial international congress taking place at St Georges Park 2-3rd November 2015. For details see www.sportskneesurgery.org

 Sports Knee Surgery Conferences focus on the main current hot topics in knee surgery including Patello-femoral surgery, ACL surgery, The anterolateral ligament debate, PRP and biologics in the knee, Revision ACL surgery, Meniscal Transplant, Osteotomy and Articular Cartilage repair.

 

---------------May 2015---------------------

Presentation at International Cartilage Repair Society

Tim Spalding presented the latest results from his work on Meniscal Transplantation at the International Conference in Chicago.
Read the full article

 

 

---------------November 2013---------------------

 Sports Knee Surgery Conference Novemeber 2013: Tim meets up with his old knee fellows


tim spalding Knee fellows

From around the world Tims ex-knee fellows joined him at his International knee conference held at the new Football Association Sports Medicine centre St Georges Park.

A fellow is a senior trainee undergoing final training before becoming a specialist knee surgeon and the knee fellowship program at coventry has been running for 10 years, through the university of Warwick. Mark Dekkers was the first: in July - December 2003.

Back Row

Richard Carey-Smith (Perth, Australia) July - Dec 2007
Alan Getgood (London Ontario, Canada) July - Dec 2011
Rex Mayahi (current knee fellow August to December 2013)
Curtis Robb (currently Locum Consultant Coventry) July 2012 - June 2013
David Wright (Specialist Physiotherapist at University Hospital Coventry)
Pete Thompson (Specialist Knee Surgeon at Coventry and co-lead of the fellow post)

 

 

 

Front Row

Pete Kempshall (Cardiff) Jan - June 2012
Simon Spencer (Glasgow) Jan 2011 - June 2011
Tim Spalding
Mark Dekkers (Brisbane, Australia) July 2003 - Dec 2003
Price Gallie (Brisbane, Australia) Jan 2005 - Dec 2005
Jonathan Bird (Lewisham, London) Jan 2010 - Dec 2010
Asim Siddique (Harrogate, UK) Jan 2004 - Dec 2004
Michael Thomas (Research Physiotherapist for the knee team at Coventry)

Very Front
Debra Dunne (Nurse Specialist at University Hospital Coventry)

Fellows unable to attend :Glenn Clewer, Mike Carmont, John Radovanovic, Fraz Hussain, Greg Sterling, Andrew McGee, Phil Dalton

 

 

 

 

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Tim Spalding is one of the lead developers of the UK National Ligament Registry launched at BASK (British Knee Society Meeting) in March 2013.

For detailed information see the website www.uknlr.co.uk or the attached pdf file

All knee surgeons are encouraged to register through the website and to enter their patients into this nationally approved registry.

Medical Professionals Logins

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Arthroscopic Meniscal Allograft Transplantation With Soft-Tissue Fixation Through Bone Tunnels

Meniscal allograft transplantation improves clinical outcomes for patients with symptomatic meniscus-deficient knees. Read online how Tim and his co author We describe an established arthroscopic technique for meniscal allograft transplantation without the need for bone fixation of the meniscal horns.

After preparation of the meniscal bed, the meniscus is parachuted into the knee through a silicone cannula and the meniscal horns are fixed with sutures through bone tunnels. The body of the meniscus is then fixed with a combination of all-inside and inside-out sutures. This technique is reliable and reproducible and has clinical outcomes comparable with those of bone plug fixation techniques.

READ THE FULL TEXT AND SCIENTIFIC PAPERS
  • Tim Spalding F.R.C.S.(Orth)
  • Ben Parkinson F.R.A.C.S.Orth
  • Nick A. Smith, M.Sc., M.R.C.S.
  • Peter Verdonk, Ph.D.

Publication History
Published Online: October 12, 2015
Accepted: June 2, 2015
Received: February 16, 2015

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Recent Presentations to learned societies (Since 2007)


Spalding TJW Rathinam M, Hussain F. Thompson P. Biological resurfacing of the knee.
BASK Spring Meeting, Belfast March 2007 (Poster)

Spalding TJW, Rathinam M, Thompson P. The 5 to 9 year results of Autologous Chondrocyte Implantation cartilage repair of the knee in active Armed Forces personnel
EFORT congress Florence, Italy. 10 – 15 May 2007 (Poster Selected as special e-poster)

Spalding TJW. 6-9 year intermediate results of autologous chondrocyte implantation cartilage repair of the knee in active Armed Forces personnel.
ISAKOS Congress, Florence Italy. 27 – 31 May 2007 (e-Poster)

Spalding TJW
Early clinical experience with TruFit Plugs for Cartilage Repair.
ICRS Warsaw, Sept 29th 2007

A Saithna, J Arbuthnot, R Carey Smith, M Thomas, T Spalding : Bilateral simultaneous anterior cruciate ligament reconstruction: a safe option
BASK Spring Meeting, Bournemouth April 18 -19th 2008

A Saithna, R Carey Smith, M Thomas, P Thompson, T Spalding: Opening wedge distal femoral varus osteotomy. Is it good enough?
BASK Spring Meeting, Bournemouth April 18 -19th 2008

A Saithna, R Carey Smith, P Thompson, M Dhillon, T Spalding: Successful results following cartilage repair in the knee using a novel synthetic osteochondral scaffold.
BASK Spring Meeting, Bournemouth April 18 -19th 2008

Lisa Cooper, C Mauffrey, M Costa, P Thompson, T Spalding: The Accuracy of the Patient Assisted Pivot Shift Test for Anterior Cruciate Ligament Rupture
BASK Spring Meeting, Bournemouth April 18 -19th 2008 (Poster)

T Spalding, J Farr, B Cole, M Brittberg, S Nehrer, F Almqvist, A Imhoff, B Mandelbaum, T Hosea, J Richmond. A novel intra-operative, single stage procedure for cell-based cartilage repair and regeneration: CAIS
British Orthopaedic Association Annual Congress Sept 2008

Saithna A, Carey Smith R, Thompson P, Dhillon M, Spalding T: Bone marrow stimulation cartilage repair surgery in the knee without prolonged non-weight bearing: it’s now a lot easier.
British Orthopaedic Association Annual Congress Sept 2008

Almqvist F. Nehrer S, Farr J, Cole B, Brittberg M, Spalding T. Imhoff A, Lazaro M. Implantation of minced autologous cartilage on a synthetic scaffold. Development of a one-stage cartilage repair technique. IMUKA Netherlands Feb 2009

A Saithna, T Crane, K Dunn, T Kuchenbecker, P Thompson, M Dhillon, T Spalding: Qualitative MRI data related to clinical results following cartilage repair using TruFit™ plugs: A two year follow up study.
BASK Edinburgh 2-3 April 2009 (Poster)

A Saithna, J Arbuthnot, B Almazedi, P Thompson, T Spalding: Does ACL reconstruction with accelerated rehabilitation influence the outcome of concomitant meniscal repair?
BASK Edinburgh 2-3 April 2009 (Poster)

MR Carmont, P Makrides, T Crane, M Dhillon, P Thompson, T Spalding. Meniscal reconstruction using a collagen meniscal implant: new hope for the post menisectomy knee?
BASK Edinburgh 2-3 April 2009 (Poster)

T Spalding, R Carey-Smith, M Carmont, K Dunn. TruFit Plugs for Articular Cartilage Repair in the Knee: 2 Year Experience, Results and MRI Appearances
AANA San Diego 2nd May 2009
S.P. Arnoczky, T. Spalding, E. Wright. Cartilage repair using TruFit plugs in a sheep model: Long-term (18 mos) histological evaluation
ICRS Annual congress Miami US 23-26 May 2009

T. Spalding, R. Carey-Smith, M. Dhillon, K. Dunn, T. Crane, P. Thompson. TruFit Plugs in the knee - Do they fill the gap? Qualitative MRI and clinical results at 2 years
ICRS Annual congress Miami US 23-26 May 2009

MR Carmont, P Makrides, T Crane, M Dhillon, P Thompson, T Spalding. Meniscal reconstruction using a collagen meniscal implant: new hope for the post menisectomy knee?
British Orthopaedic Association Annual Congress 16-19 Sept 2009 (Poster)

T Spalding, J Farr, B Cole, M Brittberg, S Nehrer, F Almqvist, A Imhoff , B Mandelbaum, T Hosea, J Richmond. CAIS project: European multicentre randomised controlled pilot study of a one stage procedure for cell based cartilage repair.
British Orthopaedic Association Annual Congress 16-19 Sept 2009

T Spalding. Femoral Tunnel Positions – Are we anatomical? A Critical Analysis on 3D CT scans
ACL Study Group, Phuket, Thailand Feb 20th – 26th 2010.

T. Spalding, J. Bird, G Clewer, M. Dhillon, P. Thompson. Femoral Tunnel Positions – Are we anatomical? A Critical Analysis on 3D CT scans. BASK Annual Meeting March 25-26th 2010

F. Almqvist, T Spalding, J Farr, B Cole, M Brittberg, S Nehrer, A Imhoff , B Mandelbaum, T Hosea, J Richmond. CAIS project: European multicentre randomised controlled pilot study of a one stage procedure for cell based cartilage repair. BASK Annual Meeting March 25-26th 2010.

P Thompson, T Spalding. Unicompartmental Knee Replacement BASK Annual Meeting March 25-26th 2010. (Poster)

Spalding T, Thompson P, Clewer G, Carmont M, Bird J, Dalton H. Femoral tunnel position in ACL reconstruction—are we anatomical? A critical analysis using 3d CT scans. ESSKA Congress, Norway June 2010 (Poster)

M Odumenya, K McGuinness, T Spalding, PJM Thompson. Early Results of the Corin Uniglide
Unicompartmental Knee Replacement from an Independent Centre ESSKA Congress, Norway June 2010 (Poster)

Spalding T, Clewer G, Bird J, Thompson P, Carmont M, Collin G, Dhillon M. TruFit CB plugs for articular cartilage repair in the knee: clinical and radiological results at 3 years ESSKA Congress, Norway June 2010 (Poster)

Modified Mocart scoring system and three year MRI followup of Chondral repair using TruFit plugs. M. Dhillon, G. Collin, R. Wellings, P. Thompson, T. Crane, T.Spalding. 9th World Congress of the International Cartilage Repair Society. Barcelona, Spain. 26-29th Sept 2010

TruFit plugs for cartilage repair in the knee. 4 year results and refining the indications. T. Spalding, P. Thompson, M. Dhillon, J. Bird. 9th World Congress of the International Cartilage Repair Society. Barcelona, Spain. 26-29th Sept 2010

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Key Publications (in reverse order back to 2004)

  • MN Anomah, SJ Krikler, CE Ackroyd, TJW Spalding, AA Amis. The Principles of an Ideal Patellofemoral Arthroplasty. A review. Submitted to JBJS May 2013.
  • Brown C, Spalding T, Robb, C. International Orthopaedics: Medial portal technique for single-bundle anatomical Anterior Cruciate Ligament (ACL) reconstruction. Orthopaedics: Volume 37, Issue 2 (2013), Page 253-269.
  • Getgood A, Spalding T. The Evolution of Anatomic Anterior Cruciate Ligament Reconstruction The Open Orthopaedics Journal, 2012, 6, (Suppl 2: M5) 287-294 287.
  • Saithna A, Kundra R, Modi CS, Getgood A, Spalding T. Distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. A systematic review of the literature. Open Orthop J. 2012;6:313-9. Epub 2012 Jul 27.
  • Carmont MR, Scheffler S, Spalding T, Brown J, Sutton PM. Anatomical single bundle anterior cruciate ligament reconstruction. Curr Rev Musculoskelet Med. 2011 Jun;4(2):65-72.
  • Spencer SJ, Saithna A, Carmont MR, Dhillon MS, Thompson P, Spalding T. Meniscal scaffolds: Early experience and review of the literature. Knee. 2012 Mar 3.
  • Bird J, Carmont M.R, Dhillon M, Smith N, Brown C, Thompson P, Spalding T. Validation of a New Technique to Determine Midbundle Femoral Tunnel Position in Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Computed Tomography Analysis. Arthroscopy 2011. Arthroscopy. 2011 Sep;27(9):1259-67. Epub 2011 Jul 8.
  • M.R. Carmont, T. Crane, P. Thompson, T. Spalding. Medial patellofemoral ligament reconstruction for subluxating patellofemoral arthroplasty. The Knee, 2011;18(2):130-132.
  • Saithna A, Arbuthnot J, Carey-Smith R, Spalding T. Simultaneous bilateral anterior cruciate ligament reconstruction: a safe option. Knee Surg Sports Traumatol Arthrosc. 2010 Aug;18(8):1071-4.
  • Crane T and Spalding TJW. The Management of Patella Stress Fractures and the Symptomatic Bipartite Patella. Oper Tech Sports Med 2009 17(2):100-105.
  • Carmont MR, Carey-Smith R, Saithna A, Dhillon M, Thompson P, Spalding T. Delayed incorporation of a TruFit plug: perseverance is recommended. Arthroscopy. 2009 Jul;25(7):810-4.
  • Carey-Smith R, Spalding TJW, Masri B. TruFit polymer scaffolds for the management of cartilage defects of the knee. Techniques in Knee Surgery. 2009 June:8(2)136-141.
  • Schindler OS, Misra R, Spalding TJ. Osteonecrosis of the medial tibial plateau: a case report. J Orthop Surg (Hong Kong). 2006 Dec;14(3):325-9.
  • Tim Spalding, Timo Malinen, Mark Tomson, Meinolf Goertzen, Robert Sinclair, Anne Allen. Analysis of medical problems during the 2001-2002 Volvo Ocean Race. NZJSM. 2005;33(2):38-42
  • Chandratreya AP, Spalding TJ, Correa R. Development and efficiency of an acute knee trauma list. Injury. 2006 Jun;37(6):502-6. Epub 2005 Dec 20.
  • T Spalding, M Dekkers, A Siddiqui. Short Stay Mini-incision Total Knee Replacement – Hype or Reality? JBJS SuppI 2005;87-B:151.
  • Hand CJ, Spalding TJW. Association between anatomical features and anterior knee pain in a "fit" service population. J R Nav Med Serv. 2004;90(3):125-34.

Chapters

  • Spalding TJW and Gallie P. Osteotomy about the knee. In Sports Medicine by Johnson and Pedowicz 2007
  • Spalding T and Peterson L. Articular cartilage repair in the athlete. In Oxford Textbook of Orthopaedics 2009 (In Print)
  • Spalding T. History and Examination of the knee In Oxford Textbook of Orthopaedics 2009 (In Print)

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Specialist Knee Surgeon, University Hospitals Coventry and Warwickshire NHS Trust
Honorary Associate Professor, Warwick Medical School, University of Warwick
_____________________________________________________________________________

Qualifications

MB. BS. (LOND) 1st August 1982
FRCS(Ed) 8th July 1988
FRCS Orth 26th April 1994

Date of Birth
24th September 1959

Accredited 1st January 1996

Medical School Charing Cross Hospital Medical School, London

Current Appointment Consultant Orthopaedic Surgeon
University Hospitals Coventry and Warwickshire
Hospitals NHS Trust
Coventry, CV2 2DX

GMC Number 2596958

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braceThere is a lot that can be done for injured knees, from simple treatments to complicated long operations. It all depends on what is injured, how badly and what your aims and expectations are.
Options include:

  • Protection using splints and knee braces
  • Rehabilitation through physiotherapy and targeted exercises, combined with painkillers
  • Surgical repair or ‘keyhole’ surgery (arthroscopy)


ACL Injury or rupture
Usually it is difficult to cope getting back to pivoting impact type sports such as football and rugby without a good functioning ACL. The ligament does not heal very well on its own to allow fast pivoting. Therefore, typically the ligament is reconstructed using tissue from around your knee, rather like Michael Owen when he tore his ligament playing football.
This surgery is performed once the swelling from the acute fresh injury has settled and when the range of movement has returned to nearly normal. Physiotherapy is important to help regain that movement and sometimes the knee is rested in a knee brace. An MRI scan may or may not need to be arranged.
PCL Injury
Usually the PCL can heal and surgery is not necessary. Initially a knee brace is used to support the healing, followed by physiotherapy and strengthening exercises. However some knees will still feel unstable and then surgery can become an option – rebuilding the ligament using other tissue from around the knee. Once again it can take a long time to get back to sport.
Collateral ligament injury
MCL sprains (medial ligament injury) usually heal well and do not need surgery. There are different grades of injury and simple injuries just need physio and time – perhaps 6 weeks to fully recover. More significant injuries may need a supportive brace for 4 – 6 weeks and it can take up to 3 months to get back to sport after rehabilitation. It is uncommon to need surgery. However, if the ligament is completely torn in combination with tearing the anterior cruciate ligament then surgery is more often needed.
Meniscus tear
The menisci are the C-shaped cushions in your knee. They tear by being trapped between the thigh bone and the shin bone. Small tears can settle on their own over 6 weeks or so and may not need any surgery. Some tears don’t however and continue to cause intermittent pain on the side of the knee during activity. The small torn portion can then be removed at keyhole surgery (arthroscopy). Sometimes the fragment is large enough to block the knee going straight and this is called a ‘locked knee’. If this happens then more urgent arthroscopic surgery is needed and it may be possible to repair the torn cartilage back into place. Not all tears can be repaired and it is more usual to remove the small torn fragment.
The cartilage does not have a good blood supply which is why most tears do not heal. Removing the torn part does not usually cause long term problems but it depends on how much was removed.
Patellar dislocation
There are a variety of reasons why your kneecap is more likely to dislocate, or feel like it is going to dislocate or give way, and this dictates how it can be managed. Management includes the use of a knee brace to hold the kneecap in place and physiotherapy to strengthen the surrounding muscles and ligaments. Surgery can be used to change the way the kneecap moves compared to the other structures around it.
Articular cartilage injury
The articular cartilage is the smooth layer that covers the bones in your joints and stops your bones rubbing together when you move. Cartilage can be damaged in injuries or through wear and tear, and can cause pain, swelling and giving way.
To assess the damage to your cartilage you may need to have an arthroscopy. There are then several options for treating the area of damage. This may involve removing the damaged part and tidying the area up, or using other techniques such as microfracture or cartilage transplantation.

What can I do to help my knee in the future?
There are several general things that you can do to help the knee including:

  • Regular exercise including stretching to maintain a good level of fitness
  • Increase leg muscle bulk through exercise
  • Weight loss to limit loading of your knee
  • Look after your knee (if injured) with: rest, ice, compression and leg elevation
  • Wear support braces during contact sports.
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