Clinical
We have over 20 surgeons and consultants in the department working across the whole spectrum of orthopaedic conditions. We are proud to employ some of the leading experts in the field working across all areas of joint surgery and musculoskeletal rehabilitation, keyhole surgery, day case hip replacement, arthroscopic knee surgery and specialist hand and wrist procedures.
We routinely treat common joint and musculoskeletal conditions and have recently started to offer same day surgery for many conditions including hip replacement surgery to eligible patients. Our care opinion feedback is second to none as you can read in our testimonals section. We do this from state-of-the-art facilities such as our National Treatment Centre for Orthopaedics in the grounds of the Victoria Hospital Kirkcaldy and in our dedicated Day Surgery Unit at Queen Margaret Hospital in Dunfermline.
Research
Our team is committed to providing top-quality orthopaedic care and advancing treatments through innovative research and clinical trials.
Orthopaedic research is a ‘joint’ effort within NHS Fife between staff in the orthopaedic and trauma clinical service and the research innovation and knowledge (RIK) orthopaedic clinical research team.
One of the most long-established research departments in Scotland, we pride ourselves in our robust research methods and the breadth of our study areas. For over 20 years we’ve run an interdisciplinary research team working with a variety of commercial and non-commercial sponsors and funders, investigators, and researchers across a wide range of interests and experience, members of the public and service users and colleagues from across Scotland, the UK and further afield.
Background
What we now know as the Orthopaedic Clinical Research Team actually started in 2020 with just one dedicated research nurse who along with two consultants, managed three studies. Fast forward five years, and as of August 2024, we have a team of five research staff who support commercial and non-commercial studies which span both elective (planned) surgery and trauma (emergency) research. The team benefits from having a close working relationship with staff in the National Treatment Centre at the Victoria Hospital and is lucky to have the support of orthopaedic consultants directly involved as Principal Investigator, Co-Investigator or Chief Investigator for orthopaedic and trauma studies in NHS Fife.
A recent achievement for the team was reaching their recruitment target for PANACHE on their last recruiting day for the study.
Recent studies which NHS Fife has supported*
*not including commercial studies
AFTER: Ankle Fracture Treatment: Enhancing Rehabilitation trial
CRAFFT; Children’s Radius Acute Fracture Fixation Trial
COREKids; Development of a core outcome set for childhood lower limb fractures
FAME: The Fractured Ankle Management Evaluation Trial
MOTION: What is the clinical-effectiveness and cost-effectiveness of surgery with medial opening wedge high tibial osteotomy (HTO) compared with non-surgical treatment in the management of osteoarthritis (OA) of the knee in patients younger than 50 years?
PANACHE: Absorbable versus Non-Absorbable sutures for Carpal Tunnel Hand surgery
PROFHER-2 Trial: PROximal Fracture of the Humerus: Evaluation by Randomisation Trial no.2
SCIENCE: Surgery or Cast for Injuries of the EpicoNdyle in Children’s Elbows
WORKWELL: Testing work advice for people with arthritis
Studies in more detail
The AFTER trial – The Ankle Fracture Treatment: Enhancing Rehabilitation
AFTER: Ankle Fracture Treatment: Enhancing Rehabilitation trial
The AFTER trial – The Ankle Fracture Treatment: Enhancing Rehabilitation trial is trying to find out if attending physiotherapy after an ankle fracture really does help improve recovery. There is currently no scientific evidence
showing that seeing a physiotherapist after an ankle fracture improves recovery. The trial will be facilitated by PI, Mr Adeel Akhtar and co-investigator Mr Phil Walmsley and supported by the Orthopaedic research
team. NHS Fife will be the first hospital in Scotland to open the AFTER study. For more information click on the link below.
CRAFFT: Children’s Radius Acute Fracture Fixation Trial
CRAFFT – The Children's Radius Acute Fracture Fixation Trial is trying to find out the best way to treat children who have broken their arm at the wrist, and the bones have moved out of place. The study is comparing the two most common treatments used throughout the UK. The first treatment is to put the arm in a plaster cast for four to six weeks, allowing the broken bones to heal, and grow back to the right position naturally. The second treatment is to put the bones back into the right position which requires a procedure or operation. The study is facilitated by PI, Mr Muhammad Adeel Akhtar and CI, Mr Phil Walmsley and supported by the Orthopaedic research
FAME: The Fractured Ankle Management Evaluation Trial
FAME - Fractured Ankle Management Evaluation is facilitated by Principal Investigator (PI), Mr Phil Walmsley and supported by Co-Investigator (CI), Mr Muhammad Adeel Akhtar. The study is investigating two different types of treatment for broken ankles. Treatment often involves an operation involving plates and screws which are fitted against the bone fragments to
keep them in place. An alternative non-surgical treatment involves applying a snug plaster cast called a close contact cast, carefully shaped to the ankle, to hold the bones correctly while they heal. This study will investigate whether the non-surgical treatment option will provide patients with comparable ankle function and quality of life to those treated with surgery.
Congratulations to the Orthopaedic team who have smashed their original recruitment target of 15 and successfully recruited 18 patients to date. Well done!
A link to the FAME study publication is found here: ‘understanding the
experience of recovery from ankle fracture at 6 months in people aged 50 years and over’
COREKids: Development of a core outcome set for childhood lower limb fractures
Development of a core outcome set for childhood lower limb fractures was a study facilitated by PI, Dr Melvin Carew, Emergency Department Consultant. The study closed to recruitment early after the UK target of 300 was successfully reached. NHS Fife’s R&D Department helped recruit 95 of the overall UK target - an amazing achievement!
COREKids: Development of a core outcome set for childhood lower limb fractures
Training
At Fife Trauma and Orthopaedic department we are also justly proud of our training record. We score consistently high in our training offer according to GMC reviews.
We offer in house training in a number of areas such as joint injection which are run face-to-face for our own orthopaedic practitioners but also open to colleagues in medical education, simulation and A&E. The department also regularly runs practical courses in fracture fixation, total knee replacement surgery and uni knee replacement surgery alongside bespoke training in orthopaedic emergencies, joint examinations, and casting for junior doctors, ANPs and research colleagues.
We also offer patient education in for arthroplasty/pre assessment video and provide patient information online via our online information library. Patient advice | NHS Fife
Departmental activity
Annual Roy Petrie Research Meeting
This annual meeting brings together groups of the wider orthopaedic community in Scotland. We’re delighted to announce that this meeting has recommenced after a break caused by the pandemic. In October 2024, delegates from Dundee, Forth Valley, Edinburgh and Glasgow joined us at in the Seminar Room at the NTC in Fife. We were joined by speakers such as Gareth Turnbull and Nick Heinz who talked to us on topics such as
- Femoral Stem Design Influences Post Operative Periprosthetic Femoral Fracture (POPFF) Risk – A Multi-Centre United Kingdom Study
- A retrospective 10-year review of patient reported outcome measures comparing unstable ankle fractures with and without a posterior malleolus fracture
There were other speakers on the day delivering interesting talks and a forum in which to discuss important research and developments in orthopaedics. You can see the full programme here. LINK
International Fellows September visit 2024
International Fellows joined us from Dubai and India in September to discuss hip replacement and soft tissue knee injury.
(Short Travelling Fellowship) of the ACL-VTRAIN programme from SICOT
We concluded the final module (Short Travelling Fellowship) of the ACL-VTRAIN programme from SICOT The feedback has been very positive and we look forward to 2025’s programme which we hope to hone with the help of feedback from recent delegates.
Well done and congratulations to Team # ACL-VTrain for concluding this pioneering program for SICOT ! Many generations of global orthopaedic surgeons are set to reap the benefits from future programs to come. Thanks to this milestone!
Follow the research team
Research Innovation and Knowledge - NHS Fife: Posts | LinkedIn
NHS Fife Research & Development (@NHSFifeResearch) / X
Get in touch with the Orthopaedic Research Team
Orthopaedic Clinical Research Team: fife.orthopaedicresearch@nhs.scot
