This section provides a wealth of information about the knee; conditions that can affect it, treatment options and detail on the operations along with rehabilitation afterwards.
These pages are provided for general information only — you should not undertake any part of a programme unless instructed by your consultant or physiotherapist.
If you have had or are about to undertake knee surgery in my care, I hope that you will find these information sheets useful. The area is forever expanding as new innovations and information becomes available.
There is also a section of patient stories where patients have written helpful information about their journey to recovery. If you have anything to add to the site about your own experiences, please contact Mr Spalding at his office.
  • Knee Conditions and Topics
  • How Does Weight Affect My Knees
  • Knee Osteoarthritis and Obesity
  • The Torn Meniscus (Cartilage)
  • Coping with the Worn Knee
  • The Female Athlete - ACL injuries
  • Acute Knee Injury
  • SONK - Patient Info
  • General information about the knee

Knee Conditions and Topics

This section provides a wealth of information about the knee; conditions that can affect it, treatment options and detail on the operations along with rehabilitation afterwards.

These pages are provided for general information only — you should not undertake any part of a programme unless instructed by your consultant or physiotherapist.

If you have had or are about to undertake knee surgery in my care, I hope that you will find these information sheets useful. The area is forever expanding as new innovations and information becomes available.

There is also a section of patient stories where patients have written helpful information about their journey to recovery. If you have anything to add to the site about your own experiences, please contact Mr Spalding at his office.

How Does Weight Affect My Knees

We are a growing population, not just in number but also in size! In 2011 almost 25% of the English population was obese and these numbers continue to rise.

Most of us understand that being significantly overweight can cause all sorts of problems with health such as high blood pressure, heart disease and diabetes, but what is it doing to our joints?

As rates of obesity have gone up in the UK, so have rates of osteoarthritis of the knee.

What is osteoarthritis of the knee?

Osteoarthritis, sometimes called OA, degeneration or ‘wear and tear’ is the progressive loss of a joint’s articular cartilage, this causes the joint to become stiff and painful. Articular cartilage creates a smooth protective covering over the ends of our bones so that we can move our joints freely without friction. Articular cartilage is only a few millimeters thick, over the years it can become worn away and the joint can become painful, this is osteoarthritis.

How do I know if am overweight?

Body mass index (BMI) and waist circumference can be used to estimate if you are a healthy weight. You can work out your BMI by dividing your weight in Kg by your height in meters2. A waist circumference over 102cm for men or 88cm for women is considered obese.

Find a BMI calculator tool here:
What is a healthy BMI for an adult?
less than 18.5 Underweight
18.5 – 24.9 Ideal
25 – 29.9 Overweight
30 – 39.9 Obese
40 +  Very Obese
How does being overweight affect my knees? Research shows that if you are overweight or obese you are at three times greater risk of getting knee osteoarthritis than the rest of the population. Your risk of knee OA also goes up the heavier you are, by 35% for each 5 BMI units you gain. Simply put; gaining weight increases the chances that you will suffer with osteoarthritis of the knees leading to pain and stiffness of the joints. The good news.  Losing weight reduces your chances of developing knee OA

Knee Osteoarthritis and Obesity

But what if I already have knee OA? If you already have problems with your knees there is clear evidence that losing weight reduces the symptoms of pain and immobility and can delay or prevent surgical intervention. These findings are regardless of the level of structural damage caused by OA, improvement in symptoms is found in patients who lose weight no matter what their x-rays say. There are benefits to losing weight if you need a knee replacement too. Performing a total knee replacement operation on an obese patient is technically more challenging for the surgeon, the surgery takes longer to perform and there is a higher risk of complications like infection. Over time implants used in total knee replacement fail more quickly in obese patients. What is the best way to lose weight? Studies show the most effective means of losing weight is following a lifestyle that gives you a ‘continuous energy deficit’. This essentially means that the amount of energy you put into your body as food and drink should be less than the amount of energy you use in your daily activities. Effective, long-lasting weight loss is achieved through adjusting your lifestyle, rather than crash dieting. Finding the best strategy that works for YOU is important and getting support from your family and friends can make a big difference. There are many weight loss plans and methods out there to chose from; here are some suggestions for effective weight loss programs. Weight Loss Guide    |    How to Lose Weight Exercise is an obvious way to lose weight but knee pain can make weight-bearing activities difficult. Running, football or squash may not be possible due to pain. With all types of exercise, be guided by what you can do comfortably and stop if it hurts too much. Cycling and swimming are excellent exercise alternatives that put minimal strain on the knees, but still get your heart rate up and burn calories. If you can move about comfortably there is evidence that combining weight loss through diet and regular long-term exercise is effective at improving arthritis pain and mobility, in addition to the normal care you receive from your GP. Either weight loss or exercise is better than standard care alone, but combining both gets even better results. If you are overweight or obese aim for losing 5% of your total current weight over 20 weeks to give symptom relief. Losing 10% within 12 weeks has been shown to have even more significant clinical effects. What if I wait until after my surgery to lose weight? The evidence says this is not the general rule! One study showed that after knee replacement 21% of patients gained further weight whilst only 14% lost weight. Don’t put off until tomorrow, what you can do today! Weight loss reduces symptoms, delays surgery and, if surgery does become necessary, improves the outcomes you will experience. Written by Rachel Milner (Medical Student) for the knee team UHCW NHS Trust 
BibliographyBlagojevic, M. et al., 2010. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society, 18(1), pp.24–33. Christensen, R. et al., 2007. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Annals of the Rheumatic Diseases, 66(4), pp.433–439. Gudbergsen, H. et al., 2012. Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society, 20(6), pp.495–502. Jiang, L. et al., 2012. Body mass index and susceptibility to knee osteoarthritis: a systematic review and meta-analysis. Joint, bone, spine: revue du rhumatisme, 79(3), pp.291–297. Messier, S.P. et al., 2004. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis and rheumatism, 50(5), pp.1501–1510. Salih, S. & Sutton, P., 2013. Obesity, knee osteoarthritis and knee arthroplasty: a review. BMC Sports Science, Medicine and Rehabilitation, 5, p.25.

Make a Booking

To make an appointment please contact Mr Spaldings’s secretary Nicki on 01926 772731 or by email office@timspalding.com

REFERRAL LETTERS: Whilst it is not necessary to have contacted your GP or insurance company before booking an appointment to see Mr Spalding, it is important that do you have a referral letter from your GP, as this summarises the relevant problems and important past history. You can bring this referral letter with you or it can be sent by your GP to the address below.

Address for referral letters:
Nuffield Health Warwickshire Hospital
Old Milverton Lane
Leamington Spa, Warwickshire
CV32 6RW

Payment Terms

Dealing with your Insurance Company
During every step of the process, you need to keep your insurance company informed in order to obtain approval for further appointments, physiotherapy or MRI or surgery etc.
Each insurance company is different with a different level of requirement but they are usually very helpful. If you have any difficulties or need any specific procedure codes and information for the insurance company then please contact Nicki on the office phone number or by email.

Please enquire about Outpatient consultation prices for uninsured or self pay patients

Inside The Clinic

You will be offered an appointment time and Mr Spalding makes every effort to try and keep to that time. However as you may appreciate sometimes appointments may take longer and there may be a wait. It is a balance between keeping to time and offering everyone a high quality of service.

It is helpful if you could please bring with you:

  • Referral letter from the GP if it has not already been sent by the GP.
  • Any previous letters or correspondence relating to your knee problem.
  • Any relevant xrays or MRI scans
  • Shorts or appropriate clothing as it is important to be able to examine the whole knee and leg during the consultation.

In clinic Mr Spalding will spend time discussing your symptoms and then examine your knee(s) prior to discussing various options for treatment.

It may be necessary to take xrays which can either be performed on the same day or at a later time. MRI scans are usually performed on another day if required.

Physiotherapy Arrangements

You may well have had physiotherapy prior to the operation and it is expected that you would go back to the same physiotherapist afterwards for the post operative rehabilitation.
Sometimes it is appropriate to undergo different physiotherapy and this should be discussed with Mr Spalding. He has a network of linked physiotherapists who have similar interest and dedication to helping knee problems.

We currently recommend therapists within our physiotherapy network, though this is ever expanding.

Lorem ipsum dolor sit amet, consectetur adipisicing elit. Optio, neque qui velit. Magni dolorum quidem ipsam eligendi, totam, facilis laudantium cum accusamus ullam voluptatibus commodi numquam, error, est. Ea, consequatur.
Lorem ipsum dolor sit amet, consectetur adipisicing elit. Optio, neque qui velit. Magni dolorum quidem ipsam eligendi, totam, facilis laudantium cum accusamus ullam voluptatibus commodi numquam, error, est. Ea, consequatur.