• Director of research for implant science and the RNOH / UCLH Biomedical Research Centre
  • Professor of Orthopaedic Surgery
  • Consultant Orthopaedic Surgeon

NHS Contact Details

Email: manora.fothergill@nhs.net

Telephone: +44 (0)20 3947 0041

Private Care Enquiries

Email: Rno-tr.PPUBusiness@nhs.net

Hip replacement and hip replacement revision surgery

Hip replacement and revision surgery and prevention of osteoarthritis through exercise

Professor Alister Hart is a consultant orthopaedic surgeon, specialising in hip problems, and director of implant and surgical planning research at the Royal National Orthopaedic Hospital (RNOH) NHS Trust in Stanmore, London, UK.  His research has featured in the media:

The BBC nicknamed him the “Hospital Hip Detective” 

The New York Times 

The Times

The Guardian

BBC Radio 4

He trained at Caius College, Cambridge, and then Guy's and St Thomas' and the Royal National Orthopaedic Hospital. He was appointed in 2012 to the Action Medical Research Chair of Orthopaedics at UCL and honorary consultant orthopaedic surgeon at the Royal National Orthopaedic Hospital (RNOH).

He is director of implant science at the RNOH (largest orthopaedic hospital in the UK), and member of The EFORT (European Federation of National Associations of Orthopaedics and Traumatology) committee of Implant and Patient Safety Initiative. He leads the RNOH collaboration with UCLH for NIHR BRC with the theme of quantitative musculoskeletal imaging.

He has pioneered the use of 3D printing for precision hip surgery (www.complexhipsurgery.com), robotic surgery and the analysis of removed implants (www.lirc.co.uk). His implant research has led to changes to international health policy ; development of clinical guidance in the UK and abroad; changes to clinical practice and subsequent cost savings. His work on prevention of osteoarthritis and running can be found here (www.runningforscience.org).

He has published this work in >180 papers (first or last author on >100) with 200 co-authors, including in the journal Nature. These papers have had >4000 citations and an h index of 36 

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 (received 30,000 visitors including HM The Queen), 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 > 180 papers, with total citations in scopus of >4500, an H index of 37.

Prof Hart's 20 most highly cited papers (as of Nov 2019):

       Paper                                                                                                             Scopus citations

Alister J Hart, Keshthra Satchithananda, Alexander D Liddle, Shiraz A Sabah, Donald McRobbie, Johann Henckel, Justin P Cobb, John A Skinner, Adam W Mitchell: Pseudotumors in association with well-functioning metal-on-metal hip prostheses: a case-control study using three-dimensional computed tomography and magnetic resonance imaging.. The Journal of Bone and Joint Surgery 02/2012; 94(4):317-25.

248

A J Hart, S A Sabah, A S Bandi, P Maggiore, P Tarassoli, B Sampson, J A Skinner: Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip replacement.. Journal of Bone and Joint Surgery - British Volume 10/2011; 93(10):1308-13.

237

F S Haddad, R R Thakrar, A J Hart, J A Skinner, A V F Nargol, J F Nolan, H S Gill, D W Murray, A W Blom, C P Case: Metal-on-metal bearings: the evidence so far.. Journal of Bone and Joint Surgery - British Volume 05/2011; 93(5):572-9.

236

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.

194

AK Matthies, JA Skinner, H Osmani, J Henckel, AJ Hart

Pseudotumors are common in well-positioned low-wearing metal-on-metal hips. CORR 2012, 470 (7), 1895-1906

159

Cup inclination angle of greater than 50 degrees increases whole blood concentrations of cobalt and chromium ions after metal-on-metal hip resurfacing

AJ Hart, P Buddhdev, P Winship, N Faria, JJ Powell, JA Skinner

Hip International 18 (3), 212-219

156

Material loss at the taper junction of retrieved large head metal‐on‐metal total hip replacements. AK Matthies, R Racasan, P Bills, L Blunt, S Cro, A Panagiotidou, G Blunn, ...

Journal of Orthopaedic Research 31 (11), 1677-1685

121

A review of rapid prototyped surgical guides for patient-specific total knee replacement. SP Krishnan, A Dawood, R Richards, J Henckel, AJ Hart

The Journal of bone and joint surgery. British volume 94 (11), 1457-1461

110

Retrieval analysis of 240 metal-on-metal hip components, comparing modular total hip replacement with hip resurfacing. A Matthies, R Underwood, P Cann, K Ilo, Z Nawaz, J Skinner, AJ Hart. The Journal of bone and joint surgery. British volume 93 (3), 307-314

108

The chemical form of metallic debris in tissues surrounding metal-on-metal hips with unexplained failure. AJ Hart, PD Quinn, B Sampson, A Sandison, KD Atkinson, JA Skinner, ...Acta biomaterialia 6 (11), 4439-4446

97

Circulating levels of cobalt and chromium from metal-on-metal hip replacement are associated with CD8+ T-cell lymphopenia. AJ Hart, JA Skinner, P Winship, N Faria, E Kulinskaya, D Webster, ...The Journal of bone and joint surgery. British volume 91 (6), 835-842

91

The relationship between the angle of version and rate of wear of retrieved metal-on-metal resurfacings: a prospective, CT-based study. AJ Hart, K Ilo, R Underwood, P Cann, J Henckel, A Lewis, J Cobb, ...The Journal of bone and joint surgery. British volume 93 (3), 315-320

90

Edge loading in metal-on-metal hips: low clearance is a new risk factor

RJ Underwood, A Zografos, RS Sayles, A Hart, P Cann. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of …

89

An analysis of metal ion levels in the joint fluid of symptomatic patients with metal-on-metal hip replacements. K Davda, FV Lali, B Sampson, JA Skinner, AJ Hart

The Journal of bone and joint surgery. British volume 93 (6), 738-745

88

Insufficient acetabular version increases blood metal ion levels after metal-on-metal hip resurfacing. AJ Hart, JA Skinner, J Henckel, B Sampson, F Gordon

Clinical Orthopaedics and Related Research® 469 (9), 2590-2597

78

Magnetic resonance imaging findings in painful metal-on-metal hips: a prospective study. SA Sabah, AWM Mitchell, J Henckel, A Sandison, JA Skinner, AJ Hart

The Journal of arthroplasty 26 (1), 71-76. e2

78

Modular neck femoral stems. H Krishnan, SP Krishnan, G Blunn, JA Skinner, AJ Hart

The bone & joint journal 95 (8), 1011-1021

77

Surveillance of patients with metal-on-metal hip resurfacing and total hip prostheses: a prospective cohort study to investigate the relationship between blood metal ion levels …AJ Hart, SA Sabah, B Sampson, JA Skinner, JJ Powell, L Palla, ...JBJS 96 (13), 1091-1099

68

Revision of metal-on-metal hip arthroplasty in a tertiary center: a prospective study of 39 hips with between 1 and 4 years of follow-up. AD Liddle, K Satchithananda, J Henckel, SA Sabah, KV Vipulendran, ... Acta orthopaedica 84 (3), 237-245

67

Which factors determine the wear rate of large-diameter metal-on-metal hip replacements?: Multivariate analysis of two hundred and seventy-six components

AJ Hart, S Muirhead-Allwood, M Porter, A Matthies, K Ilo, P Maggiore, ... JBJS 95 (8), 678-685

63