Professor Alister Hart

Professor Alister Hart

Portrait of Professor Alister Hart
Professor Alister Hart
Director of Research and Development
Professor of Orthopaedic Surgery
Consultant Orthopaedic Surgeon
NHS Contact Details:
Contact Name/Title:
Manora Fothergill
+44 (0)20 8909 5279
Private Care Enquiries:
Hip and knee replacement, rehabilitation and cartilage transplantation
Specialist clinical interests:
Revision hip surgery. Optimising function and survival of hip and knee replacements for patients with arthritis.
Professional profile:

Professor Alister Hart is a consultant orthopaedic surgeon, specialising in hip and knee problems, and director of research at the Royal National Orthopaedic Hospital (RNOH) NHS Trust in Stanmore, London, UK.

He has done more than 3000 operations including 1000 primary or revision hip and knee replacements. He undertakes 1600 patient consultations per year. He is part of a multidisciplinary team that reviews 500 patients per year with complex joint replacement problems.

He has reviewed for 8 journals and 4 grant awarding bodies. He has given invited lectures in the USA, Canada, Japan, Egypt, Dubai, Finland, Italy, Germany, Switzerland, Ireland, and Poland. He won international competitions to run the global implant retrieval programs for Johnson and Johnson in 2011 and Stryker in 2014. He has won awards from the British Hip Society, American Academy of Orthopaedic Surgeons, Radiological Society of North America and University College London. His “Hip Detectives” work was featured by the Royal Society Summer Science Exhibition, The Diamond Light Source and the BBC.

Professor Alister Hart's research interests focus on how to achieve lifelong function for the 3 million patients that undergo hip and knee replacements worldwide every year. His successful Impact Case study for the 2014 UCL REF return had the following impact for patients with hip replacements:

  • Changes to international health policy on which implants to use
  • Development of new clinical guidance on how to implant them
  • Pioneering use of blood metal ions and MRI of implants
  • Evidence for the US FDA and UK MHRA on how to monitor them
  • Accountability within industry

His research has been funded by over £5 million from Innovate UK, the British Orthopaedic Association, the Engineering and physical sciences research council (EPSRC), many medical charities and nine orthopaedic manufacturers. In collaboration with John Skinner he brought together an industry consortium of all 9 major orthopaedic implant manufacturers (Depuy, Zimmer, Smith & Nephew, Biomet, JRI, Finsbury, Corin, Mathys and Stryker) so that it was free from industry bias. This enabled the set up of a centre to examine hip replacement failures (London Implant Retrieval Centre) with a contract allowing 100% freedom for publication of data.


Alister Hart has published more than 90 papers with 200 co-authors. His collaboration network includes surgeons in 25 countries that have contributed 6000 failed implants to his research.

Three most downloaded papers from research gate:

  1. S P Krishnan, A Dawood, R Richards, J Henckel, A J Hart: A review of rapid prototyped surgical guides for patient-specific total knee replacementThe Bone & Joint Journal 11/2012; 94(11):1457-61. PMID: 23908413. (DOWNLOADED 1484 times by Sept 2015)
  2. T M Parsons, K Satchithananda, R Berber, I A Siddiqui, E Robinson, A J Hart: Magnetic resonance imaging investigations in patients with problems due to metal-on-metal implants. Der Orthopäde 08/2013; 42(8):629-36. PMID: 23912305 (DOWNLOADED 309 times by Sept 2015)
  3. Barry Sampson, Alister Hart: Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants.. Annals of Clinical Biochemistry 12/2011; 49(Pt 2):118-31. PMID: 22155921 (DOWNLOADED 239 times by Sept 2015)

Three most cited papers on scopus:

  1. A J Hart, S Sabah, J Henckel, A Lewis, J Cobb, B Sampson, A Mitchell, J A Skinner: The painful metal-on-metal hip resurfacing.. Journal of Bone and Joint Surgery - British Volume 07/2009; 91(6):738-44. (Cited 131 times) PMID: 19483225
  2. A J Hart, T Hester, K Sinclair, J J Powell, A E Goodship, L Pele, N L Fersht, J Skinner: The association between metal ions from hip resurfacing and reduced T-cell counts.. Journal of Bone and Joint Surgery - British Volume 04/2006; 88(4):449-54. (Cited 120 times)
  3. Hart AJ, Sabah SA, Bandi AS, Maggiore P, Tarassoli P, Sampson B, Skinner JA: Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip replacement. J Bone Joint Surg Br. 2011 Oct;93(10):1308-13. PMID: 21969427. 

3 papers in journals with highest impact factor

  1. L S Jen, A J Hart, A Jen, J B Relvas, S M Gentleman, L J Garey, A J Patel: Alzheimer's peptide kills cells of retina in vivo.. Nature 03/1998; 392(6672):140-1
  2. Angela E Goode, James M Perkins, Ann Sandison, Chithra Karunakaran, Huikai Cheng, David Wall, John A Skinner, Alister J Hart, Alexandra E Porter, David W McComb, Mary P Ryan: Chemical speciation of nanoparticles surrounding metal-on-metal hips.. Chemical Communications 07/2012; 48(67):8335-7. PMID: 22801350
  3. Nyga A, Hart A, Tetley TD: Importance of the HIF pathway in cobalt nanoparticle-induced cytotoxicity and inflammation in human macrophages. Nanotoxicology. 2015 Oct;9(7):905-17. PMID: 25676618.

Other published papers:

  • Matthies, A. K., Racasan, R., Bills, P., Blunt, L., Cro, S., Panagiotidou, A., . . . Hart, A. J. (2013). Material loss at the taper junction of retrieved large head metal-on-metal total hip replacements. J Orthop Res. doi:10.1002/jor.22431
  • Krishnan, H., Krishnan, S. P., Blunn, G., Skinner, J. A., & Hart, A. J. (2013). Modular neck femoral stems. Bone Joint J, 95-B (8), 1011-1021. doi:10.1302/0301-620X.95B8.31525
  • Cross-sectional imaging of the metal-on-metal hip prosthesis: The London ultrasound protocol. Siddiqui IA, Sabah SA, Satchithananda K, Lim AK, Henckel J, Skinner JA, Hart AJ. Clin Radiol. 2013 May 16. doi:pii: S0009-9260(13)00081-0. 10.1016/j.crad.2013.02.003. [Epub ahead of print] 3684517
  • Revision of metal-on-metal hip arthroplasty in a tertiary center.Liddle AD, Satchithananda K, Henckel J, Sabah SA, Vipulendran KV, Lewis A, Skinner JA, Mitchell AW, Hart AJ.Acta Orthop. 2013 Jun;84(3):237-45. doi: 10.3109/17453674.2013.797313. Epub 2013 Apr 28. PMID: 23621810
  • Which Factors Determine the Wear Rate of Large-Diameter Metal-on-Metal Hip Replacements?: Multivariate Analysis of Two Hundred and Seventy-six Components. Hart AJ, Muirhead-Allwood S, Porter M, Matthies A, Ilo K, Maggiore P, Cann P, Underwood R, Cobb J, Skinner J.  The Journal of bone and joint surgery. American volume 2013;95(8):678-85.
  • Cobalt and Chromium Measurement in Patients with Metal Hip Prostheses. Estey MP, Diamandis EP, Van Der Straeten C, Tower SS, Hart AJ, Moyer TP.Clin Chem. 2013 Jun;59(6):880-6
  • A review of rapid prototyped surgical guides for patient-specific total knee replacement. Krishnan SP, Dawood A, Richards R, Henckel J, Hart AJ. J Bone Joint Surg Br. 2012 Nov;94(11):1457-61.
  • Cobalt from metal-on-metal hip replacements maybe the clinically relevant active agent responsible for periprosthetic tissue reactions. Alister J Hart *a, Paul D Quinnb, Ferdinand Lalia, Barry Sampsonc, John A Skinner, Jonathan J Powelle, John Nolanf, Keith Tuckerf, Simon Donellf, Adrienne Flanaganh, J Fred W Mosselmans. Acta Biomater. 2012 Jun 8. [Epub ahead of print]
  • Pseudotumors in Association with Well-Functioning Metal-on-Metal Hip Prostheses: A Case-Control Study Using Three-Dimensional Computed Tomography and Magnetic Resonance Imaging.
 Hart AJ, Satchithananda K, Liddle AD, Sabah SA, McRobbie D, Henckel J, Cobb JP, Skinner JA, Mitchell AWJ Bone Joint Surg Am 94(4):317-325 15 Feb 2012
  • Introducing new joint replacements to clinical practice. John A Skinner, Peter R Kay, Alister J Hart. BMJ. 2011 Dec 20;343:d8188. doi: 10.1136/bmj.d8188
  • Understanding why metal-on-metal hip arthroplasties fail: A Comparison Between Patients With Well Functioning and Revised Birmingham Hip Resurfacing Arthroplasties. Hart AJ1, Matthies A1, Henckel J1, Ilo K1, Skinner J2, Noble PC3. J Bone Joint Surg Am. 2012 Feb 15;94(4):e22.
  • Pseudotumors are Common in Well-positioned, Low Wearing Metal-on-Metal Hips. Ashley Matthies, John Skinner, Humza Osmani, Johann Henckel, Alister Hart, Clin Orthop Relat Res. 2012 Jul;470(7):1895-906
  • A retrieval analysis of explanted Durom metal-on-metal hip arthroplasties. Matthies AK, Henckel J, Skinner JA, Hart AJ. Hip Int. 2011 Nov-Dec;21(6):724-31. doi: 10.5301/HIP.2011.8885.
  • Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal orthopaedic implants.  Sampson B, Hart AJ. Ann Clin Biochem. 2012 Mar;49(Pt 2):118-31. Epub 2011 Dec 7.
  • Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip arthroplasty. Hart AJ, Bandi A, Sabah S, P. Maggiore, P. Tarassoli B. Sampson, J. Skinner. J Bone Joint Surg [Br] 2011;93-B:1308–13.
  • A comparison of explanted Articular Surface Replacement and Birmingham Hip Resurfacing components. Underwood R; Matthies A; Cann P; Skinner JA; Hart AJ. (Sep 2011). J Bone Joint Surg Br. 93:1169-1177. DOI.
  • Insufficient Acetabular Version Increases Blood Metal Ion Levels after Metal-on-metal Hip Resurfacing. Hart AJ; Skinner JA; Henckel J; Sampson B; Gordon F. (Sep 2011). CLIN ORTHOP RELAT R. 469:2590-2597. DOI.
  • Magnetic resonance imaging findings in painful metal-on-metal hips: a prospective study. Sabah SA; Mitchell AW; Henckel J; Sandison A; Skinner JA; Hart AJ. (Jan 2011). J Arthroplasty. 26:71-76.e2. DOI.
  • 19. Quantification of the difference between 3d ct and plain radiograph for measurement of the position of medial unicompartmental knee replacements. Holme T; Henckel J; Cobb J; Hart A. Knee. 2011 Oct;18(5):300-5.
  • The chemical form of metallic debris in tissues surrounding metal-on-metal hips with unexplained failure. Hart AJ; Quinn PD; Sampson B; Sandison A; Atkinson KD; Skinner JA; Powell JJ; Mosselmans JF. (Nov 2010). Acta Biomater. 6:4439-4446. DOI.
  • Large ball metal on metal hips obscure cup angle measurement on plain radiographs. Hart AJ; Dandachli W; Schlueter-Brust K; Henckel J; Cobb J. (Oct 2009). Hip Int. 19:323-329.
  • The painful metal-on-metal hip resurfacing. Hart AJ; Sabah S; Henckel J; Lewis A; Cobb J; Sampson B; Mitchell A; Skinner JA. (Jun 2009). J Bone Joint Surg Br. 91:738-744. DOI.
  • Cup Inclination Angle Of Greater Than 50 Degrees Increases Whole Blood Concentrations Of Cobalt And Chromium Ions After Metal-On-Metal Hip Resurfacing. Hart AJ; Buddhev P; Winship P; Faria N; Powell J; Skinner J. (Sep 2008). Hip Int. 18(3):212-219. Author weblink.
  • Alzheimer's peptide kills cells in retina in vivo. Jen LS; Hart AJ; Jen A; Relvas JB; Gentleman SM; Garey LJ; Patel AJ. (12 Mar 1998).NATURE. 392:140-141.
  • The association between metal ions from hip resurfacing and reduced T-cell counts. Hart AJ; Hester T; Sinclair K; Powell JJ; Goodship AE; Pele L; Fersht NL; Skinner J. (Apr 2006). J Bone Joint Surg Br. 88:449-454. DOI.
  • Assessment of osteoarthritis after reconstruction of the anterior cruciate ligament - A study using single-photon emission computed tomography at ten years. Hart AJ; Buscombe J; Malone A; Dowd GSE. (Nov 2005). J BONE JOINT SURG BR. 87B:1483-1487. DOI.
  • The London nail bombings: the St. Thomas' Hospital experience. Hart AJ; Mannion S; Earnshaw P; Ward A. (Nov 2003). Injury. 34:830-833.
  • The treatment of unstable, extracapsular hip fractures with the AO/ASIF proximal femoral nail (PFN)--our first 60 cases. Banan H; Al-Sabti A; Jimulia T; Hart AJ. (Jun 2002). Injury. 33:401-405.
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