Mr Paul Trikha areas of expertise:

Professional statement

Mr Paul Trikha is a highly-skilled leading consultant orthopaedic surgeon who specialises exclusively in knee surgery. From the renowned Surrey Orthopeadic Clinic and various other Surrey and South London locations, he regularly operates on sports professionals in rugby, cricket, and athletics.

Mr Trikha sees patients presenting with sports-related injuries and osteoarthritis, and offers surgical treatments for joint preservation surgery in the young and active, including minimally-invasive ACL reconstruction, arthroscopic meniscus and cartilage surgery, as well as partial and total knee replacements.

Mr Trikha is a keen teacher, and continues to supervise the training of postgraduate knee surgery for specialist registrars, as well as teaching and lecturing frequently at conferences in the UK and abroad. In his practice Mr Trikha is committed to employing the latest techniques and technology in knee surgery. His current research interests include new techniques in knee preservation, anterior cruciate ligament (ACL) reconstruction, and meniscal (cartilage) repair.

Videos of doctor

Double Total Knee Replacement surgery -...

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Doctor's articles

Joint Preservation; how to keep the you...

Credentials

GMC: ‍4413769

Professional experience

• More than 20 years of experience
• Consultant Knee Surgeon, Surrey Orthopaedic Clinic (2011 - present)
• Consultant Knee Surgeon & Clinical Director for Strategy & Transformation, Ashford and St. Peter's Hospitals NHS Foundation Trust (2009 - present)

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Sub-specialties

• Sports knee injury
• Ligament injury
• Knee replacement
• ACL reconstruction
• Meniscal repair
• Knee arthroscopy
• Joint preservation
• PCL reconstruction
• Patella dislocation

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Teaching posts

• Teaches post graduate knee surgery to surgeons on the St. George’s Hospital Specialist Registrar training rotation
• Frequently lectures on knee surgery in the UK and abroad

Education

• FRCS( Tr & Orth), Royal College of Surgeons (2006)
• MBBS, St George's Hospital London (1997)
• Fellowship North Sydney Sports and Orthopaedic Centre, Australia (2008)

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Prizes and awards

• Professor Fred Heatley Research Award (2008)
• Raine Prize (2007)
• Sam Simmonds Prize (2004)
• Royal Society of Medicine Presidents Prize -2nd (2004)

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Professional membership

• British Association for Surgery of the Knee (BASK)
• European Society for Sports Traumatology, Knee Surgery, and Arthroscopy (ESSKA)
• International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine (ISAKOS)
• British Orthopaedic Association (BOA)
• The Royal College of Surgeons of Edinburgh
• British Medical Association (BMA)

...

Languages spoken

English

Diseases, Medical Tests and Treatments

ACL reconstruction

What is ACL reconstruction? The anterior cruciate ligament (ACL) is a band of connective tissue within the knee which, when over-stretched can get ...

Knee arthroscopy

What is knee arthroscopy? Knee arthroscopy is a minimally invasive procedure that allows access to and treatment of injuries affecting the various ...

Knee replacement

What is knee replacement surgery? Knee replacement surgery is a procedure that involves removing and replacing a damaged or worn knee joint with an ...

Knee surgery

Knee Surgery

Meniscus

What are the menisci (meniscus)? The menisci are two fibrocartilage structures located inside the knee. They improve joint function, acting like shock-absorbing cushions that help disperse the weight of the body and absorb forces exerted on the knee. They give the knee stability and play a key role in the proper functioning of the joint. The knee joints are among the most vulnerable joints of the body and can suffer serious injuries. They need to be able to withstand great pressure and to absorb and dissipate forces, which makes their role fundamental. Function of the menisci: The menisci have various functions: To absorb the shock waves generated when you walk or run. The menisci can absorb almost 20% of these shock waves. Force transmission: the fibres that make up the meniscus enable the transmission of compressive force by up to 50% when the knee is extended, and by up to 90% when the knee is bent. Joint stability: if the knee buckles, this may be due to laxity or tearing of the anterior cruciate ligament. Knee stability is influenced by the meniscus, the quadriceps and hamstring muscles. Proprioception: the menisci help to increase proprioception. Joint slippage: they contribute to the lubrication of the joint due to their shape and high water content. Pathologies of the menisci: Certain movements of the knee can cause injuries to the menisci, when they do not follow the movements of the femoral condyles over the tibial plateau. This happens if, for example, the knee is suddenly extended, which is very common in football players. In this case, there is no time for the meniscus to move forward, so it is trapped between the femoral condyle and the tibial plateau. Another type of injury is distortion of the knee joint, with external rotation and lateralisation, causing the meniscus to slide under the convexity of the internal condyle, resulting in a longitudinal tear of the meniscus. Moreover, a torn internal ligament can also lead to a torn meniscus. Meniscus tears are one of the most common injuries. Although common in athletes, anyone can suffer this injury. There can be different types of tears, but the most common tears are longitudinal, parrot beak, flap, bucket handle and mixed/complex. In the case of sports injuries, these are usually accompanied by ligament injuries. Treatments for meniscus pathologies: Conservative treatment is recommended for this type of injury, which is sometimes sufficient for meniscus tears, giving the knee time to heal itself. This process is known as RICE, which stands for rest, ice, compression and elevation. It may be supplemented with anti-inflammatory medication to reduce pain and inflammation. However, surgery may sometimes be necessary if symptoms do not abate. In this case, the orthopaedic surgeon will usually recommend knee arthroscopy. During arthroscopy, a mini camera is inserted into the knee through a small incision, allowing visualisation of the inside of the joint. The specialist will make two or three other small incisions to access the knee and repair the injury. After surgery, the specialist will immobilise the knee. When the wounds have healed somewhat, you should start rehabilitation exercises to restore joint mobility and strength. Which specialist treats meniscus pathologies? Orthopaedic surgeons treat problems relating to the knee and the menisci. ...

Sports injuries

What are sports injuries? Competitive and non-competitive sports injuries are injuries that occur in athletic activities or whilst exercising. Whilst some of these happen by chance, others are facilitated by inadequate practice or poor execution in terms of technique, as well as by not using sports equipment correctly. Sports injuries mainly consist of muscle injuries or joint and ligament injuries: Dislocations; Muscle injuries (sprains, pulled muscle, cramps); Knee or ankle sprain; Back injuries Bone fractures; Tendon injuries. Prognosis: The outlook of a sports injury greatly depends on what caused it and its severity. Imaging tests (ultrasound, MRI scan) can rule out structural injuries and help to assess the severity of the injury itself. Furthermore, based on the results, the specialist can estimate how long it will take for you to recover and get back to sports, as well as your risk of getting injured again. What are the symptoms? The symptoms of a sports injury depend on how big and how severe the injury is. They usually are: Immediate onset of pain; Stiffness of the affected muscle; Swelling; Bruising; Increased sensitivity of the affected area; A feeling of heat emanating from the affected area; Decrease in range of motion. How are they diagnosed? Sports injuries, especially muscular ones, can be diagnosed with a physical examination. The following tests may be prescribed to get further insight on where the injury is and how severe it is: X-ray scan; Computed tomography (CT) scan; Magnetic resonance imaging (MRI) scan; Ultrasound scan; Bone density scans. What causes them? As an example, the main risk factors for a football injury are: Not having exercised enough; Muscle fatigue; Age; Cold or wet weather; Poorly maintained training field; Quicker execution and overall rhythm of the game; Doing a movement too fast; A different or new training technique; Stumbling upon another player; Playing too fast or too slowly, without having warmed up adequately; Inadequate training program; Poor execution; Eating an unhealthy diet; Not resting enough. How can they be prevented? The main preventive measures are: Ensure you warm-up adequately; Eat a healthy diet; Stay hydrated; Use proper equipment; Wear good sportswear and shoes. How are they treated? Treatment largely depends on how severe the injury is. It usually consists of physical therapy, surgery, applying ice packs, taking painkillers or anti-inflammatory medications and bed rest. Which doctor should I talk to? You should see a specialist in sports medicine, but you may also be treated by physiotherapists and orthopaedic surgeons, depending on your treatment plan and injury. ...

Arthritis

What is arthritis? Arthritis is a disease that causes inflammation of the membrane that covers the joints. There are more than 100 different types of arthritis, but the most common are: Osteoarthritis: the most common type of arthritis. It usually starts with age and affects the fingers, knees and hips. In some cases, it develops in areas where there was a previous hit or injury. Inflammatory arthritis: There are many types of inflammatory arthritis, the most common of which is rheumatoid arthritis, which occurs when the body's defenses do not work properly. It affects both joints and bones, often in the hands and feet. What are the symptoms of arthritis? The symptoms of arthritis can be: Joint pain Joint inflammation Redness and heat of the skin around the joint Decreased ability to move the joint Joint stiffness, especially in the morning What are the causes of arthritis? This pathology can be a consequence of: Bone fracture Autoimmune disease Infection by bacteria or viruses Joint wear Crystals (such as uric acid or calcium pyrophosphate dihydrate) Can arthritis be prevented? Joint damage can be prevented with timely and adequate diagnosis and treatment. Also, if someone has a family history it is important to talk with the doctor, even if s/he does not have any symptoms. It is also recommended to avoid repetitive and excessive movements to prevent osteoarthritis. What is the treatment for arthritis? The treatment aims to alleviate the symptoms and prevent the disease from getting worse. The treatment can be covered by several aspects: Lifestyle changes: this is the preferred treatment, since exercises help to reduce pain and fatigue, relieve stiffness and improve muscle and bone strength. The doctor can also recommend physiotherapy. Other measures may include sleeping 8-10 hours a day, not staying in the same position for a long time, eating a healthy diet, avoiding alcohol and tobacco, among others. Medicine: can be added to the changes in lifestyle. Surgery: is performed if the other treatment methods have not worked. The main intervention is arthroplasty, which consists of replacing the affected joint with an artificial one. ...

Joint injections

Joint injections are a treatment against joint pain that involves the injection of anti-inflammatory drugs and analgesics to improve joint mobility. It is a quick and simple technique, is minimally invasive, and produces longer-lasting effects compared to those obtained through a drug administered orally or intramuscularly. ...

Knee

What is the knee? The knee is the central joint of the legs. It is formed by the meeting of two important bones: the femur and the tibia, and it joins the thigh and the lower leg. Inside the knee is a small bone called the patella or kneecap, which articulates with the anterior and inferior part of the femur. The knee also houses two fibrocartilage discs, the menisci, and it is surrounded by a joint capsule and ligaments, which give it stability. The main ligaments are the external lateral ligament, the internal lateral ligament, the anterior cruciate ligament and the posterior cruciate ligament. Important muscles surround the knee to allow for flexibility and extension movements of the knee and leg. Knee function: The knee supports most of our body weight when standing. The main movement of the knee is flexion-extension, although it can also rotate slightly when flexed. Pathologies of the knee: The knee is vulnerable to serious injury from impact and trauma, usually the result of sports injuries. Osteoarthritis is common in older people and can be very disabling. The most frequent knee injuries are: Simple contusions : minor trauma without damage to the main structures of the joint (meniscus, bone or ligaments). These are considered benign, without complications, and are usually resolved in a short time using conservative measures such as anti-inflammatories, rest and ice applied to the joint. Ligament and meniscus injuries : these are common injuries in sport, as they cause tension in the joint. The most frequent injuries are torn menisci, lateral ligaments and cruciate ligaments. Tendon injuries : the tendons that suffer the most serious injuries are the quadriceps tendon, patellar tendon, goosefoot tendon, and the tendon of the popliteus muscle. Fractures : these can occur in the lower femur, upper tibia, or kneecap. They are generally complex fractures that can affect several bones, ligaments and the menisci and are usually caused by severe trauma. Dislocation : dislocation is considered to be any injury that causes a permanent loss of contact between the joint surfaces. Joint effusion : the joint space usually contains synovial fluid, which serves to nourish the cartilage and provide lubrication, thus reducing friction of the joint and consequent wear. An excess of this fluid leads to joint effusion, which causes pain and an inability to move the knee. Osteoarthritis of the knee: this condition affects more women than men and generally occurs from the age of 50 onwards. Arthritis Osgood-Schlatter disease : this affects the tibial cartilage, causing pain during exercise. It improves with rest. Chondromalacia patella : this is common in young people and sportspersons. It is the degeneration of the cartilage between the kneecap and the femur. Hoffa's disease : chronic inflammation of the area of fat behind the patellar tendon and under the kneecap. Baker's cyst : this is a lump that occurs on the back of the knee due to chronic inflammatory processes and increased production of synovial fluid. Bursitis: the knee has several fluid-filled sacs or bursae, which are particularly vulnerable to repeated trauma. They can cause chronic inflammation. Treatments for knee problems: Treatment for knee injuries will depend on the type and severity of the injury. First of all, you must follow the "PRICE" protocol: Protection, Rest, Ice, Compression and Elevation. To prevent further damage to the knee after injury you should not apply heat, not drink alcohol, not run or do any other exercise, and not massage the injured knee, as this can cause further swelling. Anti-inflammatory drugs may help with mild to moderate pain. If the pain becomes intense, a doctor may prescribe a stronger pain reliever. If the injury is severe, the specialist may recommend physiotherapy and will design a rehabilitation exercise programme that is appropriate for you and the type of injury. In some cases, the injury may require surgery; for example, if you have torn the external lateral ligament, if you have damaged the anterior cruciate ligament and do a lot of sport, or if you have torn the internal lateral ligament, which will require reconstructive surgery. Surgery is also indicated if the injury involves several ligaments or if you have torn a patellar tendon. Which specialist treats knee problems? Orthopaedic surgeons treat problems relating to the knee joints. ...

Knee

The knee joins the thigh to the lower part of the leg, connected by two joints. One is the tibiofemoral joint, between the femur and tibia, while the other is the paletellofemoral joint, between the femur and patella. The knee is the largest of the joints in the human body, but it is also one of the most easily injured. What is the knee made up of? The knee is made up of bone, ligaments, tendons, and ligaments. They work together to allow the knee to move smoothly and support the body. The knee joint is complex, and therefore it can be injured in a manner of different ways. Common knee injuries Some of the more common knee injuries include: Fractures Ligament injuries (such as anterior or posterior cruciate ligament injuries) Tears in tendons or meniscus Dislocation Symptoms of a knee injury The knee can be injured in many ways, but some of the most common symptoms include pain, especially while walking or moving, a feeling of instability, and swelling in the knee or around it. If you are in severe pain, cannot move your knee, have significant swelling, or cannot walk without limping, you should seek immediate medical attention. Treatment of knee injuries Treatment of knee injuries depends on the type of injury and the part of the knee affected. Some knee injuries can be treated through methods like physiotherapy or medication. Some can be treated simply by immobilisation – meaning you cannot move your knee. Usually in these cases a cast or brace will be fitted to ensure protection and help it to heal. In some cases, surgery may be the best course of treatment. Most surgical procedures these days are minimally invasive, using very small instruments and making minimal incisions, which usually allows for a faster healing process. In some cases, some injuries may need to be treated with open surgery which requires a larger incision. ...

Medial collateral ligament

What is the medial collateral ligament? The medial collateral ligament, also called the tibial collateral ligament, is one of the four most important ligaments of the knee. It extends from the inside of the lower thigh bone to the inside of the upper shin bone. Function of the medial collateral ligament: The medial collateral ligament provides stability to the knee and limits its movement from side to side. Injury to the ligament often results in a partial or complete tear or excessive stretching of the ligament. Pathologies of the medial collateral ligament: You may have damaged the medial collateral ligament if you have pain in the inner part of the knee, if the knee feels unstable and you think it might give way or become locked, or if you feel pain when bending or stretching the knee or when walking. Most injuries to the medial collateral ligament can occur if the lower leg is moved outward at the knee; if a blow is received to the lower outer thigh; or if you put one foot ahead of the other to increase momentum (in skiing, for example). This causes total or partial ligament distension due to the excessive stretching of the ligament by forcing the joint beyond its range of motion. This injury, which is very common in athletes, is known as a sprain or tear of the medial collateral ligament of the knee. It is common in football players but also in sports such as skiing, handball and rugby. There are different grades of injury: Grade I: There is moderate pain, little swelling, and you can move the joint. Grade II: You feel pain, accompanied by instability, inflammation and a loss of function. Grade III: Joint function is severely affected, with high instability, swelling, and pain. Treatments for pathologies of the medial collateral ligament: Treatment for a medial collateral ligament injury will depend on its stage. Thus, for grade I injuries, treatment will normally be conservative. This involves immobilising the joint and rehabilitation. For grade II and III injuries, the orthopaedic spealist should study the injury on an individual basis and decide whether definitive conservative treatment or a surgical procedure is most appropriate. Physiotherapy is essential for a complete recovery. The main objective is to reduce pain and inflammation so that you can walk correctly, and also do exercises with contrast hydrotherapy and electrotherapy without feeling pain. Hydrotherapy is also extremely helpful since it reduces stress during therapy and allows for painless movements against water resistance, which also strengthens the muscles. The physiotherapy exercise programme should aim at increasing knee flexion, recovering stability and gaining muscle. To this end, the exercises will be gradually increased. Also recommended is deep transverse friction massage of the muscle fibres, to promote the reorganisation of the ligament fibres and greater tissue regeneration, enabling nutrients to pass through more easily. Some specialists also recommend platelet-rich plasma therapy. These are proteins that are naturally made by your body and help repair and regenerate tissues after injury. Thus, after extracting a small amount of blood from your body, it is treated and platelet-rich plasma is obtained, which is then injected directly into the injury. Which specialist treats pathologies of the medial collateral ligament? Various specialists treat injuries to the medial collateral ligament. Thus, it is mainly orthopaedic surgeons specialising in knee problems who will assess the severity of the injury. However, depending on the injury grade, the physiotherapist may also be involved in treating pathologies of the medial collateral ligament. ...

Patellar luxation

What is it? Kneecap dislocation is a common injury in teenagers between 14 and 17, especially among the athletic population. The kneecap (patella) is displaced from its natural position within the patello-femural joint, being forced away from the midline. Kneecap dislocation often leads to ligaments and cartilage damage. It is important to make the distinction between kneecap dislocation and knee dislocation: a knee dislocation mainly affects the joints between the femur (thigh-bone) and tibia (shin-bone). Prognosis However painful and long-lasting it may be, if treated properly a kneecap dislocation can have no future consequences on your overall health. What are the symptoms? The main symptom is a sudden and acute pain in your knee, associated with a haematoma on the medial area of the joint, due to a blood backflow to your joint which will make it more evident. How is it diagnosed? If you have any of the above-mentioned symptoms, first of all you’ll need to have an X-ray scan. A CT scan and MRI scan can be helpful to rule out the possibility of ligament or meniscus damage, microfractures or loose segments of articular cartilage. What causes it? The main cause for dislocated kneecaps are trauma-related injuries or traumas due to a sudden movement of the joint. The most common one is where the quadriceps femoris muscle is contracted while the leg is still planted on the ground and the knee is partially flexed. It is also common for people to have an anatomical predisposition to these injuries, such as people with high knee. How can it be prevented? It is quite hard to prevent kneecap dislocation, especially if you have a structural predisposition to it or if you’re an athlete, due to very nature of the main cause of dislocated kneecaps. How is it treated? You should treat a dislocated kneecap as soon as possible after the injury. The treatment consists in reduction, that is, by manually pushing the kneecap towards the midline while straightening the knee. At first, your doctor will prescribe you to apply ice packs on the affected area and to take anti-inflammatory medication. You will only need to undergo arthroscopic surgery if there are microfractured segments of articular cartilage. Standard therapy consists in splinting the knee into a straight position with a cast for at least 15 days. In the following weeks, you will be gradually able to do more and more complex movements again. Once the cast is off, you’ll start doing physical therapy to rebuild the quadriceps muscle, which will be necessarily weakened by several weeks of bed rest. That will be helpful for the correct repositioning of the kneecap. Electrical stimulation, as well as using a dedicated splint for your knee, can be beneficial during recovery. You won’t be able to go back to sports again before eight to nine weeks, and you may have to wait longer if you underwent surgery. Which doctor should I talk to? If you have a dislocated kneecap, you should see an orthopaedic surgeon. ...

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Clinics

Surrey Orthopaedic Clinic

Other information about Paul Trikha

http://www.surreyorthopaedicclinic.com

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Mr Paul Trikha
Orthopaedic surgery
Chertsey

Mr Paul Trikha

Orthopaedic surgeon in
Chertsey
Woking
London &
Weybridge

FRCS(Tr & Orth)

Mr Paul Trikha areas of expertise:

Professional statement

Videos of doctor

Credentials

Diseases, Medical Tests and Treatments

ACL reconstruction

Knee arthroscopy

Knee replacement

Knee surgery

Meniscus

Sports injuries

Arthritis

Joint injections

Knee

Knee

Medial collateral ligament

Patellar luxation

Clinics

Other information about Paul Trikha

Mr Paul Trikha Orthopaedic surgeryChertsey

Mr Paul Trikha

Orthopaedic surgeon in Chertsey Woking London & Weybridge

FRCS(Tr & Orth)

Mr Paul Trikha areas of expertise:

Professional statement

Videos of doctor

Credentials

Diseases, Medical Tests and Treatments

Clinics

Other information about Paul Trikha

Mr Paul Trikha
Orthopaedic surgery
Chertsey

Orthopaedic surgeon in
Chertsey
Woking
London &
Weybridge