The RNOH multi-disciplinary team (MDT) for patients with painful metal-on-metal bearings in hip replacements

Complex primary and revision hip surgery patients have been treated for a long time within our Joint Reconstruction Unit.

In August 2012 we launched our clinical advisory service for patients with painful hip replacements. We provide up-to-date, high quality advice that utilises international guidelines, scientific publications and our clinical experience. We offer this as an international service to surgeons and general practitioners for patients with metal-on-metal, modular-neck or large diameter metal-on-polyethylene hips.

Our service is an MDT review of patients' clinical information, laboratory data and imaging.


Referrers will receive a report of recommendations following discussion at the MDT meeting.

Data collected at these reviews will be recorded in order to improve the process of monitoring and treating patients with painful hip replacements.

The Professional information for painful metal-on-metal bearings in hip replacements page is aimed at surgeons and general practitioners and provides further information and useful resources. To refer patients to the MDT, please visit the Painful metal-on-metal bearings in hip replacements referral form.

We recommend the following organisations for further information: British Orthopaedic Association (BOA); British Hip Society (BHS) and Arthritis Research UK (ARUK).

Our team includes four orthopaedic surgeons, musculoskeletal radiologists, two coordinators, a database manager and a clinical fellow.

Our MDT team

Orthopaedic surgeons Professor Alister Hart
Professor John Skinner
Mr Richard Carrington
Mr Jonathan Miles
Musculoskeletal radiologist Dr Michael Khoo
Coordinators Avril Power
Pamela Coward
Database manager Gwynneth Lloyd
Fellow Joint Reconstruction Fellow



Musculoskeletal Radiologists Dr Keshthra Satchithananda
Dr Adam Mitchell
Radiological Scientists Dr Donald Mcrobbie
Dr Annie Papadaki
Laboratory Analysis Histopathology: Professor Adrienne Flanagan
Metal ions: Dr Barry Sampson
Health Service Delivery Yannis Pappas