Mr Nishil Modi

Robotic assistance helps the surgeon work with a higher level of accuracy and gives much more information during the operation. Improved implant position leads to better outcomes.

• Hips: better leg length, and better offset, which helps the hip feel more stable and natural. Cup alignment helps stability and reduces impingement.
• Knees: balance of the soft tissues.

The surgeon remains fully in control of the surgery the whole time.

Arthritis is wearing of the cartilage that lines the ends of the bones. This puts greater forces through the bones. Symptoms include pain, stiffness, swelling, limping and reduced ability to exercise.

Diagnosis starts with a thorough review of your symptoms and an examination of the joint. Most of the time it is confirmed with X-rays. We cannot see cartilage directly on an X-ray, but we can see the space it occupies, and a reduced space is a clear sign of arthritis.

Other signs include bony spurs (osteophytes), cysts and bone thickening (sclerosis).

X-rays do not always tell the full picture. In that case a more specialist scan, such as an MRI, can help. This is combined with listening to your symptoms and examining the joint.

It is mostly related to family predisposition. Other factors can contribute, such as extreme overuse or a previous injury to the joint.

Consider specialist input if:

• your pain is becoming more frequent,
• it is stopping you doing activities you enjoy, and
• you have tried simple, mild painkillers and physiotherapy.

Getting fit helps. If you need to lose weight, or want to maintain a healthy weight, do it steadily. Avoid extreme diets before an operation, as they can affect your nutrition levels and your wound healing.

For hip replacement he uses a posterior approach. It has a lower infection rate, and because it spares muscle it helps a faster recovery.

Usually overnight.

Surgical time is 70 to 90 minutes. Anaesthetic time is typically 10 to 30 minutes. You will often spend time in recovery before going to the ward for the next stage of your recovery.

A titanium socket, a ceramic head, a stainless steel stem (the spike attached to the ball, which goes into the femur) and a plastic liner. Hybrid hips have generally shown the best longevity across all age groups.

A titanium socket, a titanium stem, a ceramic ball and a plastic liner. Uncemented hips have done very well, particularly in younger patients, in men, and in people with better bone stock.

A titanium tibial component, cobalt chromium and a plastic liner.

True nickel-related implant allergy is very rare, and rarer in hips than in knees. Mr Modi is happy to discuss options for hypoallergenic implants.

Your stitches are dissolvable. The dressing is waterproof, but keep it dry for 2 weeks. A small amount of dried blood is common and nothing to worry about. If the dressing becomes fully soiled, seek further medical attention.

Typically 4 to 6 weeks after surgery, once you feel safe getting in and out of the car and operating it. When you feel you are at that stage, try a dry run of an emergency stop before starting the car. Then try a short journey with a friend or relative and build up from there.

Hip: you will do exercises in hospital and be advised to keep doing them at home. Further physiotherapy can be arranged if needed, but it is rarely required.

Knee: you will have an appointment at 2 weeks.

The scar sits towards the inner (medial) side of the knee, and you will be given desensitising exercises. A balanced, stable knee allows the vast majority of patients to kneel if they want to.