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Consultant Knee Surgeon - Mr Simon Ellis MA (Cantab) MBBS FRCS (Orth)

With the proposed change in the way in which elective orthopaedic services are provided in the NHS setting, this will allow patients more choice in access to specialist services. In preparation for this change currently practicing surgeons will need to look at providing services for NHS patients in both the NHS hospital in which they work as well as forging links with private hospitals in order to promote high quality easily accessible services promoting the highest standards of patient care.

Mr Ellis was appointed an orthopaedic surgeon to the Maidstone and Tunbridge Wells NHS Trust, in Kent in 1996. His practice is now specialised to soft tissue knee surgery as well as knee replacement surgery. Mr Ellis qualified from St John’s Cambridge followed by Charing Cross Hospital London before finishing his orthopaedic training in Wessex. Since his appointment as a consultant Mr Ellis has invested considerable time in the study and development of soft tissue knee surgery. In 2006 he toured America to explore the frontiers of arthroscopic knee surgery – a type of keyhole surgery – and anterior cruciate ligament (ACL) reconstruction. Following his American tour, Mr Ellis brought accelerated rehabilitation in anterior cruciate ligament reconstruction to his clinics in Kent allowing patients to return to sport between 3 and 4 months following surgery.

In 2008 he hosted an international meeting for orthopaedic surgeons at Leeds Castle in Kent, where he and Professor Howell presented live anterior cruciate ligament reconstruction surgery. Mr Ellis continues to lecture regularly on ACL reconstruction both nationally and internationally. He was guest surgeon to the Polish Knee Society meeting in 2009 and is due to lecture there again in October 2011. Mr Ellis regularly attends knee meetings as a delegate to maintain his own level of expertise, and recently attended ISAKOS in Rio de Janeiro.

Mr Ellis currently practises at Maidstone and Tunbridge Wells NHS Trust but offers his knee services thoughout Kent and East Sussex with busy practices at The BMI Somerfield Hospital in Maidstone, Fawkham Manor Hospital near Dartford and The McIndoe Surgical Centre in East Grinstead. Mr Ellis is looking to forge links with local general practices in these areas to offer competitively priced high quality soft tissue knee surgery to NHS patients in conjunction with the BMI group of hospitals.

Mr Ellis’s range of services include all aspects of arthroscopic knee surgery which is used to treat the majority of knee conditions as well as arthroscopic anterior cruciate ligament reconstruction which is also carried out as a day case. In arthritis surgery Mr Ellis is able to offer Oxford medial hemiarthroplasty and total knee replacement.

Back to sport in three to four months following ACL reconstruction

Mr Ellis specialises in anterior cruciate ligament (ACL) reconstruction, an area in which he has extensive expertise. He is one of a few surgeons who offers this procedure allowing patients back playing sport in three to four months.

Anterior cruciate ligament injury usually occurs when a twist is applied to the knee whilst the foot is firmly on the ground or twisting on landing. Footballers, netballers and skiers are particularly vulnerable to this type of injury and generally without appropriate treatment are unable return to the sport.

In the past reconstruction of the ruptured ligament was reserved for the elite athlete, for example Michael Owen and Joe Cole who both suffered anterior cruciate ligament rupture. Advances in surgical techniques and minimally invasive surgery mean reconstruction is now within the reach of the recreational sportsperson. Surgery no longer requires an overnight stay in hospital, post operative bracing or a prolonged period of time away from sport.

Mr Ellis uses the surgical technique developed by Professor Stephen Howell to treat anterior cruciate ligament injuries. Surgery is carried out as a day case using hamstring graft. There is a small cut over the upper shin, which is used to harvest the graft as well as pass the graft through the knee. The remainder of the technique requires two small cuts over the knee to perform the reconstruction inside the knee. Patients are mobilised straight after the procedure by a physiotherapist and are able to put their full weight through the operated leg and often don’t require crutches. Patients are discharged home on the day of surgery to start a pre planned rapid rehabilitation programme, which encourages an early return to normal activity. By two weeks after surgery the majority of patients are able to drive and most are able to return to work soon afterwards. At eight weeks patients are able to start direction changing exercises, supervised by a physiotherapist, and can start sport specific exercises with a view to returning to their particular sport by three to four months after surgery. This is in contrast to the usual six to twelve month period suggested by many surgeons. This technique is only possible because of the rigid, strong fixation devices used by Mr Ellis during the surgical procedure. These encourage early healing of the soft tissue graft to the patient’s bone. Mr Ellis now has considerable experience in this technique and is currently carrying out at least two or three reconstructions each week, and has numerous satisfied patients as a result.

Oxford medial hemiarthroplasty

The Oxford medial hemiarthroplasty has an excellent track record with a high level of patient satisfaction and reproducible long term outcome both from the Oxford Knee Unit as well as other units. When used in the correct situation in patients with almost exclusively medial compartment osteoarthritis of the knee it can be a definitive replacement with excellent long term outcome stretching beyond 20 years. Surgery is carried out usually requiring just 1 night in hospital with some patients mobilised on the day of surgery. Post operative pain is controlled using a spinal anaesthetic in conjunction with local anaesthetic and anti inflammatory injection at the time of surgery. Patients usually recover sufficiently to allow them to return to driving and sedentary work by six weeks but long term recovery continues up to a year following surgery. The advantage of partial knee replacement where this is indicated is greater function including flexibility of the replaced joint.

Knee arthroscopy

In addition to anterior cruciate ligament reconstruction Mr Ellis carries out about 10 arthroscopies (keyhole surgery) a week to deal with most knee problems. Again this is daycase surgery under general anaesthetic using a number of small cuts to allow meniscal (cartilage) tears to be dealt with either by removal or repair, if appropriate, as well as other abnormalities. After surgery patients are able to move around putting full weight on the leg that’s been operated on, and can usually return to driving by day seven, return to work by day 10, and resume gym type exercise by day 14, and all sport after six weeks.

Knee arthritis treatment

Knee arthritis is an extremely common condition which affects an increasing proportion of the population. Treatment is based on symptoms and includes both operative and non operative options. There is good evidence that for early osteoarthritis of the knee physiotherapy and simple exercise can be very effective. For patients with significant swelling injection therapy can be very effective and this can be carried out in the primary care setting using either steroid or viscosupplementation. Operative intervention is extremely symptom dependent. For those patients with mechanical symptoms such as locking or intermittent sharp pain arthroscopy can be very useful. For those patients with significant limitation of function, pain, limited walking distance or night pain the only option may be to consider either partial or total knee replacement. There are a number of types of partial and total knee replacement available. Mr Ellis chooses to use the Biomet Oxford medial hemiarthroplasty for partial knee replacement and the Depuy PFC Sigma total knee replacement.

Total knee replacement

Where damage to the joint surface extends beyond a single compartment in the knee total knee replacement can be the option of choice. Mr Ellis chooses the Depuy PFC Sigma prosthesis which has the greatest market share in the UK due to its excellent track record and proven 25 year long term results. Once again surgery is carried out usually under spinal anesthetic which coupled with intra operative local anesthetic and anti inflammatory injection allows early mobilisation and discharge home around 48 hours after surgery. Once again patients are able to drive after six weeks and are often able to return to work by 2 months with recovery continuing up to a year following surgery. An exciting new development in this field is the use of personalised cutting jigs which allow extremely accurate placement of the replacement components and should promote even higher rates of long term joint replacement survival. This new technique utilises the PFC knee components but couples these with the Trumatch patient specific personalised cutting jigs to enhance the surgeon’s accuracy in component placement.

Practice details

Mr Simon Ellis MA (Cantab), MBBS FRCS (Orth) first sees patients at his outpatient clinics at the Somerfield Hospital in Maidstone, Fawkham Manor Hospital in Kent or The McIndoe centre in East Grinstead where he assesses their symptoms. He uses clinical assessment and magnetic resonance imaging (MRI) scan to diagnose and determine a personalised management plan, which may or may not include surgery.

Mr Ellis’s practice is run by Kent Medical Secretaries who can be contacted to make an appointment to see him either by telephone on 01622 620920 or email This email address is being protected from spambots. You need JavaScript enabled to view it.. Mr Ellis’s website www.mrsimonellis.com also has details of the accelerated rehabilitation programme following anterior cruciate ligament reconstruction.

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