Research

Clinical and Research Fellowships

Jan 1988 – 1989
Fellow to Dr RH Jinnah and Dr L Riley
Total Joint and Reconstructive Surgery
The Johns Hopkins University
Baltimore, Maryland, U.S.A.

AO Fellowship
Mar 1992 – Apr 1992
Kantonsspital, Chur, Switzerland under Prof Thomas Ruedi

February 1989
Orthopaedic Service – Lord Mayor Treloar Hospital, Alton, Hampshire

June 1989 – August 1990
Trauma Service – Southampton University Hospital
Trauma Manager

Sept 1990
Orthopaedic Service – Lord Mayor Treloar Hospital

Southampton and SW Hants, Portsmouth and Wessex Regional Orthopaedic Centre
Senior Orthopaedic Registrar Rotation

October 1990 – June 1994

March 1992 – April 1992 AO Fellowship, Kantonsspital, Chur, Switzerland

ORTHOPAEDIC EXPERIENCE

TRAUMA

I received a good training in a wide variety of orthopaedic trauma operations having worked at 5 different district general hospitals. The trauma loads were busy in all of the centres, with up to 1:2 and 1:3 on call rotas. This has provided me with a broad depth of training. I have an aggressive policy of early fixation of patients using a broad range of implants and my experience of multiple trauma patient is good. I have a large experience of interlocking nails as well as classic AO techniques. I have some experience in pelvic fracture fixation. During my surgical rotation at the Whittington I was the co-ordinating surgical officer for the major accident service during the Tottenham riots and have also been involved in major incidents at Southampton.

ELECTIVE

Adult
My general experience has been wide becoming familiar with many different primary arthroplasties of hip, knee and shoulder due to the opportunity of working with 14 consultants through the Wessex Orthopaedic Centre in 5 years. This included both cemented and uncemented techniques. I have developed an interest and expertise in revision hip surgery and bone grafting techniques which has been of great interest to me. My fellowship in prosthetic joint reconstructive techniques at the John Hopkins University was very stimulating which started my interest in developing a revision joint replacement service for the Portsmouth region. I developed a full bone grafting service for our area after generous help from the Portsmouth Health Commission.

In addition I have an interest in operative arthroscopy using modern camera and video facilities.

I have an elective practice predominantly in lower limb reconstructive surgery. I developed the hip resurfacing service for the Portsmouth area in the last 6 years. This has provided a new method of treatment for the younger osteoarthritic hip patient allowing many to return to activities such as high level sports.

FELLOWSHIP IN RECONSTRUCTIVE SURGERY

I was fortunate in having the opportunity of studying at the Johns Hopkins University in the United States with a specific interest in total joint arthroplasty. On the clinical side I saw major reconstructive surgery using massive bone grafting and custom total hip replacements and the use of several uncemented prostheses.
My research projects have been diverse. My two main experimental studies included a canine and clinical study of the osseointegration of bone grafts into porous coated materials, and a cadaveric study of dynamic tibio-talar contact areas using a computer model. I completed two other biomechanical studies looking at the strengths of different modes of initial acetabular fixation, and the strength of a new anterior cruciate augmentation graft which had been treated with organic solvents. I have continued my research interests coordinating studies with our junior staff and research fellows particularly looking at long term joint arthroplasty studies.

DESIGN
I was involved on the New York panel for CAD/CAM designing of the new Allo Pro (synthes-A.O. group) cemented and uncemented acetabulum for the introduction of the U.S. market.

I was nominated as an associate reviewer for the American JBJS in 1988.

I recently developed the resurfacing drape, which is going into production with Finsbury Orthopaedics Ltd, to reduce the amounts of debris and trauma during hip resurfacing surgery.

AO CLINICAL FELLOWSHIP

I was accepted for a scholarship to visit the Kantonsspital, Chur under Prof Thomas Ruedi in 1993. This allowed me to observe the management of their major trauma service, and gave me the most up to date clinical developments and research into trauma and prostheses. I was able to observe their methods of treatment of multiple injuries, and fixation techniques, in addition to many differing approaches to their elective surgery. I spent some time at the research laboratories in Davos observing development in dissolvable fixation and minimal contact plating.

I also visited Prof Ganz in Berne to observe the Berne Periacetabular osteotomies for hip dysplasia.

ORIGINAL PUBLICATIONS

Anaerobic Septic Arthritis due to Bacteroides species.
H J Clarke, R Allum
J.Bone Joint Surg [Br] 70-B: No 5; 857-858, Nov 1988

Total Hip Replacement in Sickle Cell Disease
H J Clarke, R H Jinnah, A Brooker, J Michelson
J.Bone Joint Surg [Br] 71-B: No 3; 465-70, Aug 1988

Clinical study of comparison of the Low Contact Stress and the Porous Coated Anatomic-1
Total Knee Replacement in a clinical and radiological manner.
H J Clarke, R H Jinnah, R P Byank, D Martin.
Advances in Orthopaedics., Vol 13, No 1, 10-14 July 1989

The effect of loading on tibio-talar alignment in cadaver ankles.
J D Michelson, H J Clarke, R H Jinnah.
Foot and Ankle, Vol 10, No 5, 280-284, April 1990

Clostridium Difficile Infections in Orthopaedic Surgery
H J Clarke, R H Jinnah, R P Byank.
J.Bone Joint Surg.[Am], 72-A, No 7, 1056-59. Aug 1990

Osseointegration of bone graft in porous coated Total Hip Arthroplasty.
H J Clarke, R H Jinnah, D Lennox
Clinical Orthopaedics and Related Research. No. 258, 160-167 Sept 1990

The treatment of severe slip in Slipped Upper Femoral Epiphysis
H J Clarke, J A Wilkinson
J.Bone Joint Surg [Br], Vol 72-B, No. 5, 854-58, Sept 1990

Tibio-Talar stability in bimalleolar ankle fractures.
A dynamic in vitro contact area study
H J Clarke, J D Michelson, R H Jinnah.
Foot and Ankle. Vol 11:4, 222-27, Feb 1991

The biology of osseointegration in bone grafting.
T Gross, H J Clarke, R H Jinnah, Q G N Cox.
Orthopaedics, Vol 14:5, 563-68, May 1991

“The Biology of Bone Grafting”
Gross TP, Jinner RH, Clarke HJ, Cox QG
Orthopaedics 1991, May 14(5): 563-8 review

The evaluation of initial stability in uncemented acetabular components
H J Clarke, R H Jinnah, K E Warden.
J. of Arthroplasty, No 4: 335-40 Dec 1991

Computer templating in uncemented total hip arthroplasty to assess component fit and fill.
H J Clarke, R H Jinnah, Q Cox, M Curtis.
Journal of Arthroplasty [Am] Vol 7, No 3: 235-39 Sept 1992

A Biomechanical analysis of Solvent dehydrated and Freeze Dried Human Fashia Lata Allografts.
R Hinton, H J Clarke, C Johnson
American Journal of Sports Medicine, Sept/Oct 20(5) 607-12 1992

“The Stanmore Total Hip Replacement. A Fifteen to Twenty year follow up.”
Emery D, Clarke H, Britton A, Grover M
Accepted by the Journal of Arthroplasty, February 1997

“The Stanmore Hip replacement in Young patients. A review of a group of patients under the age of fifty at implantation.”
Emery D, Clarke H, Grover M
Journal of Bone and Joint Surgery, March 1997

“The Long Gamma Nail – A DGH Experience”
Edwards SA, Pandit HG, Clarke HJ,
Injury 2000 November 31 (9) 707-709

“The Treatment of Impending and Existing Pathological Fractures using the Long Gamma Nail”
Edwards SA, Pandit HG, Clarke HJ,
Injury 2001 May 32 (4) 299-306

“Atypical Presentation of Septic Arthritis in the Immunosuppressed Patient”
Edwards SA, Cranfield T, Clarke HJ
Orthopaedics, 2002 October; 25 (10): 1089-90

“Impaction Bone Grafting in Revision Hip Surgery”
Edwards SA, Pandid HG, Grover ML, Clarke HJ
J Arthroplasty 2003, October; 18(7): 852-9

“Incomplete seating of the liner with the Trident Acetabular System: A cause for concern?”
Langdown AJ, Pichard RJ, Hobbs CM, Clarke HJ, Dalton DJ, Grover ML
Journal of Bone and Joint Surgery BR, 2007 March; 89(3):291-5

BOOK CHAPTER

Orthopaedic for Essential Surgical Techniques
Edited by Johnson and Cummin
Publishers: Chapman and Hall

ABSTRACTS

The treatment of Avascular Necrosis in Sickle Cell anaemia by Total Hip replacement.
H J Clarke, R H Jinnah, A F Brooker, J Michelson.
Orthopaedic Transactions, Proceedings of the Eastern Orthopaedic Association 13:61, 1989.

Total hip replacement in Sickle cell anaemia.
H J Clarke, R H Jinnah, A F Brooker, J Michelson
Orthopaedics Transactions. 13(3):598; 1989

Clostridium Difficile infections in Orthopaedic Surgery.
Q G N Cox, H J Clarke, R H Jinnah.
Orthopaedic Transactions 14(1):115; 1990

Computer templating in Uncemented Total Hip replacement.
H J Clarke, R H Jinnah.
J Bone Joint Surg. 72-B:931-32; 1990

Acetabular stability in hemispherical uncemented prostheses
H J Clarke, R H Jinnah, K E Warden, Q G N Cox.
J Bone Joint Surgery. 72-B:1109, 1990.

Ankle stability in Bimalleolar ankle fractures.
A Dynamic contact area analysis.
H J Clarke, J Michelson.
Orthopaedics Proceedings J.Bone Joint Surg 1991: 135

Functional and Anatomical results of Solvent treated Allograft in comparison with autograft in tibial plateau fractures.
H J Clarke, J A Robertson, J R Shearer.
Orthopaedic Proceedings of British Association of the Knee – BOA, London 1992.

PRESENTATIONS TO LEARNED SOCIETIES

Life and works of Gathorne Robert Girdlestone.
H J Clarke
The Royal Society of Medicine. March 1987

The Surgical Results of Cervical Osteotomy for Slipped Upper Femoral Epiphysis
H J Clarke, J A Wilkinson
British Orthopaedic Association, London, September 1987

Indications for Custom Total Hip replacement
R H Jinnah, H J Clarke, S M Toote
East and West Combined Orthopaedic Meeting – SICOT, Belgrade, Sept 1988

Total Hip Replacement in Sickle Cell Anaemia
H J Clarke, R H Jinnah, A F Brooker
American Academy of Orthopaedic Surgeons, Las Vegas, Nevada, Feb 1989

Pathophysiology and Treatment of Avascular Necrosis in Sickle Cell Disease.
R H Jinnah, Q Cox, H J Clarke,
National Institute of Health Washington DC, USA, March 1989

Bone grafting for acetabular deficiency utilising porous ingrowth titanium prostheses.
H J Clarke, R H Jinnah, D Lennox
Southern Orthopaedic Association (USA), Antigua, May 1989

The treatment of Avascular necrosis in sickle cell disease by total hip replacement
H J Clarke, R H Jinnah, A F Brooker, J Michelson.
Southern Orthopaedic Association (USA), Antigua, May 1989

Computer templating in Uncemented Total Hip replacement.
H J Clarke, R H Jinnah.
British Orthopaedic Association, London, Sept 1989

Clostridium Difficile infections in Orthopaedic surgery.
H J Clarke, Q Cox, R H Jinnah.
American Academy of Orthopaedic Surgeons, New Orleans, Feb 1990

Acetabular stability in hemispherical uncemented prostheses
H J Clarke, R H Jinnah, K E Warden, Q G N Cox
Orthopaedic Research Society, Belfast, March 1990

Ankle stability in Bimalleolar ankle fractures.
A dynamic contact area analysis.
H J Clarke, J Michelson.
British Orthopaedic Foot Surgical Society, Liverpool, Nov 1990
Functional and Anatomical results of Solvent treated Allograft in comparison with autograft in tibial plateau fractures.
H J Clarke, J A Robertson, J R Shearer
British Association of the Knee – BOA, London 1992

Tibial allograft for comminuted tibial plateau fractures.
H J Clarke, J R Shearer
1st European Congress of Orthopaedics, Paris, April 1993

PRESENTATIONS

The Stanmore Total Hip Replacement. A 15-20 year follow up.
Emery D, Clarke H, Britton A, Grover M
Presented to The Gauvain Society, November 1995

The Stanmore Total Hip Replacement. A Fifteen to Twenty year follow up.
Emery D, Clarke H, Britton A, Grover M
Presented to the British Orthopaedic Association Spring Meeting
April 1996, Llandudno.

The Stanmore Total Hip Replacement. A Fifteen to Twenty year follow up.
Emery D, Clarke H, Britton A, Grover M
Invited Faculty at the Fifth Symposium on Primary and revision Arthroplasty
May 1996, Cannes

The Stanmore Hip replacement in Young patients. A review of a group of patients under the age of fifty at implantation.
Emery D, Clarke H, Grover M – Accepted for EFORT, April 1997, Barcelona

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