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Mr Rob Pollock, consultant orthopaedic surgeon at The Princess Grace Hospital and The Wellington Hospital at Elstree Waterfront â€“ shared with us the benefits of robotic orthopaedic surgery, how COVID-19 has impacted his way of working and why we should all be aware of the symptoms of bone cancers. 

What are the top orthopaedic conditions you see and treat?

I split my time between seeing patients with general orthopaedic complaints, specifically in the hip or knee, as well as seeing patients who have, or suspect that they could have, bone or soft tissue cancer. 

For my orthopaedic patients, some will be older patients who will come to me with arthritis in their hips or knees and might require a partial or total knee replacement or a hip replacement, but many will have inflammatory pain and only need physiotherapy or an injection. Patients with a torn cartilage in the knee sometimes require a keyhole operation (arthroscopy). I also see younger patients with more complex hip or knee problems; for example, a patient might have been born with a deformed hip and require surgery, or they might have had blood cancer when they were younger and were treated with a high dose of steroids, which could lead to a degenerate hip at a much younger age. 

I also see patients who are diagnosed with primary or secondary bone cancer. Primary bone cancer is rare – only around 550 patients are diagnosed in the UK each year and it usually affects teenagers or young adults. Secondary bone cancer is where cancer cells from a primary tumour somewhere else in the body spreads to the bones and can occur in any bone in the body. 

What are the biggest changes in the diagnosis and treatment of orthopaedic conditions?

Firstly, it’s important to say that with my orthopaedic patients, surgery as a treatment option is the last resort. It's important to try other routes where possible. 

Where surgery is deemed appropriate, we now have the option of performing knee replacement surgery with the help of a robot. The Princess Grace Hospital was the first private hospital in the UK to offer robotic orthopaedic procedures with the Mako. This robotic arm guides the surgeon within a pre-defined area during surgery, enabling us to only remove the diseased bone, whilst preserving the healthy bone areas. This provides even greater precision when aligning and placing implants. 

Operating using this robotic arm means patients are likely to have fewer complications, less pain post-op, a shorter length of stay in hospital and quicker recovery time. Due to the accuracy of the placement, it also means that patients are likely to have better motion and function. This should lessen the need for revision surgery. 

What are the three things you should know about bone cancer?

  1. Not many people know the symptoms of bone cancer. If you have constant pain that doesn’t go away with rest or painkillers and this pain wakes you up during the night, it’s important you book an appointment with your GP. It’s likely not to be bone cancer, but it’s so important that it is ruled out.
  2. Whilst it’s rare it is also often diagnosed at a late stage. Around 550 people are diagnosed with bone cancer each year in the UK, which makes it quite rare. However, due to the fact that the symptoms of bone cancer e.g., leg pain, can often be misdiagnosed as pain from an injury or wear and tear, it can be diagnosed late. 
  3. There are lots of ways it can be treated. For patients who are diagnosed with bone cancer at The Princess Grace Hospital, their care is discussed in a multidisciplinary team (MDT) meeting, where the most appropriate treatment plan will be devised, and the options will be discussed with the patient. Treatment options include surgery, chemotherapy, radiotherapy and targeted therapy. 

Due to COVID-19, has the care you provided differed in the last six months?

The main thing that changed for me and my patients was the move to virtual consultations. Even now, I would say that around 50% of my consultations, particularly my initial consults, are happening via video call. With my specialties in particular, via video you can see the patients and you can look at how their hip or knee is looking when they walk via video. It works both ways, as I’m also able to explain their scan results and show them detailed pictures of their scans too. My patients much prefer this level of interaction as they can easily fit our phone calls around their daily lives and it means not needing to travel unnecessarily. 

In some cases, I do need to see the patient in person, and my patients are fine with that too as they know that all of the necessary precautions are in place to keep them safe when they’re at hospital. 

Why choose The Princess Grace Hospital?

I can honestly say I have never worked in a hospital before where everything runs as seamlessly as it does at The Princess Grace Hospital. I truly am surrounded by not only the very best medical minds, but also the equipment that I have at my disposal is the very best – which means I can give the best care to my patients. Put simply, if a member of my family was unwell and didn’t know where to be treated, I would know exactly where to send them. Everyone who works here works so well together – it runs like a well-oiled machine! 

Book an appointment with Mr Pollock here
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