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About Us

Working together as a team in the world-renowned Imperial College Healthcare NHS Trust and the North West London Major Trauma Centre, OTL represents a group of medical professionals dedicated to providing pioneering, evidence based, innovative, world class care. The philosophy and vision is to translate the high quality care provided by the team into the private sector. We endeavour to offer personalised, patient-specific care with an emphasis on providing the best patient experience and outcomes. With regular multidisciplinary team meetings, access to the most modern imaging modalities, a focus on pre-conditioning, rehabilitation and wellbeing, OTL offers complete patient care.

Our Specialists

Conditions

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Hand & Wrist

The hand and wrist is composed of intricate small bones, small joints, ligament complexes, flexor tendons, extensor tendons and nerves which are all finely balanced to achieve both fine movements and powerful actions.

The hand and wrist can suffer from numerous conditions including:

  • Fractures
  • Osteoarthritis
  • Tendon inflammation
  • Tendon ruptures
  • Tendon lacerations
  • Rheumatoid arthritis
  • Nerve entrapment
  • Infection

At OTL we offer a comprehensive range of therapies for conditions of the hand and wrist.

Knee

The knee is a complex joint consisting of three compartments (medial tibiofemoral, lateral tibiofemoral and patellofemoral).

The knee joint is stabilised by:

  • The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) which are in the centre of the knee
  • The medial collateral ligament MCL) and the lateral collateral ligament (LCL)
  • The posterolateral corner structures and the posterior medial oblique ligaments

The knee contains cartilage which acts as a shock absorber to protect the bone surfaces of the femur (thigh bone), tibia (shin bone) and patella (kneecap) that form the knee joint from excess stress.

Articular cartilage is made of type 2 collagen and lies over the joint surfaces of the femur, tibia and patella.

The knee contains the medial meniscus and the lateral meniscus which are C-shaped discs of collagen that act to provide additional cushioning in the medial and lateral compartments of the knee respectively.

Knee movements are initiated, maintained and controlled by a group of primary large muscle groups and secondary accessory muscle groups.

It is very important that the muscles are well conditioned, balanced and co-ordinated to optimise the performance of the knee and prevent injury.

The quadricep muscles produce extension of the knee. The hamstring muscles produce flexion of the knee. The iliotibial band acts as an accessory muscle to flex and extend the knee. The popliteus muscle acts in controlling rotation of the knee.

Weakness of these muscles, overuse or overtraining and tears of these muscles can lead to instability, knee pain, inflammation, tendinopathy and loss of function.

Thus treatment of the knee must take into account knowledge and appreciation of the numerous structures both inside and outside of the knee and how they function together in order to plan the most appropriate and best treatment.

At OTL we strive to provide a multidisciplinary approach to the management of your knee condition with the aim of providing the best outcomes.

Conditions
Treatments

Shoulder

The shoulder joint is the most mobile joint in the body. For this reason it plays an essential, but often overlooked role in daily life and sports. Conditions affecting the shoulder include

  • Fractures
  • Tendon rupture
  • Stiffness (frozen shoulder)
  • Bursitis/ Impingement
  • Osteoarthritis
  • Rheumatoid arthritis

At OTL we approach the shoulder with an open mind, taking into account the numerous pathologies that can affect the shoulder, and the joints close to it. With a focus on appropriate diagnosis and a multidisciplinary approach with expert radiologists and physiotherapists, we endeavour to treat your shoulder condition holistically, with surgery reserved for conditions that have not responded to non-operative treatment.

Conditions
Treatments

Elbow

The elbow is a complex joint consisting of three articulations-

  • The radio-capitellar joint
  • The ulna-humeral joint
  • The proximal radio-ulnar joint

It plays an essential role in daily life facilitating the hand being able to work and function in a sphere and in sporting life it has an important role as a shock absorber.

The elbow joint can suffer from a number of conditions including:

  • Fractures
  • Osteoarthritis
  • Rheumatoid arthritis
  • Tendinopathy
  • Tendon rupture
  • Bursitis
  • Nerve entrapment
  • Stiffness

At OTL we aim to provide a comprehensive assessment and management of your elbow condition, exploring all treatment options with you with the aim of restoring function and activity.

Conditions
Treatments

Hip & Pelvis

Hip and pelvis injuries can be a serious source of pain and disability, preventing a return to normal life. They include a wide variety of problems from sports related problems to high-energy industrial injuries of the pelvis.

The team at OTL are experts at managing these conditions. They are regularly referred patients with difficult and complex injuries from other consultants nationwide.

The wide range of conditions we treat include

  • Hip fractures
  • Acetabular (hip socket) fractures
  • Pelvic fractures
  • Hip arthritis
  • Loosening and pain from a previous hip replacement
  • Avascular necrosis of the hip
  • Femoroacetabular impingement
  • Snapping iliotibial band syndrome and lateral hip pain
  • Osteitis pubis/Adductor problems
  • Tendonitis

Conditions
Treatments

Foot & Ankle

The foot and ankle is a unique part of the human body - containing 28 bones in total and 25 joints.

For this reason the foot and ankle is subject to a number of conditions including

  • Fractures
  • Osteoarthritis
  • Rheumatoid arthritis
  • Tendon rupture
  • Tendinopathy
  • Impingement
  • Hallux valgus
  • Infections

These conditions can interfere with daily life, work and sports.

At OTL we approach your condition in a multidisciplinary manner, with appreciation of not just the local condition but any associated biomechanics and alignment factors in the lower limb. With expert radiologists, physiotherapists, orthotists and surgeons, our aim is to restore your quality of life and activities.

Conditions
Treatments

Spine

The spine contains 7 vertebra in the neck, 12 vertebrae in the thorax and 5 vertebra in the lumbar spine, the sacrum and the coccyx.

Intervertebral discs separate the vertebra form one another.

The bony vertebra protect the spinal cord that run in the middle of the vertebral canal. Nerve roots exit the spinal cord at each vertebral level.

The spine is dependent on both its bone structure for its support, but also the numerous ligaments that link the vertebra and the muscles around the spine which help balance the motion in the spine.

The spine is subject to a number of conditions including

  • Fractures
  • Disc proplases
  • Nerve entrapment
  • Osteoarthritis (degenerative disease)
  • Spinal stenosis
  • Infection

At OTL a multidisciplinary approach is essential to the correct diagnosis and management of your spinal problem.

Conditions
Treatments

Ribs

The rib cage is a protective skeleton for the underlying structures in the thorax - namely the lungs, heart, great vessels and upper abdominal organs (liver and spleen).

For this reason the ribs are quite common bones to fracture (break).

Ribs can be fractured following falls, road traffic crashes and sports (contact sports such as rugby, boxing and more extreme sports such as snowboarding).

As we breathe, the lungs and ribcage expand as we inhale air and then return to their resting position when we breathe out (exhale).

On average humans breathe 16 times per minute, 960 times per hour and an amazing 23,040 times over 24 hours.

Thus fractured ribs are moved 23,040 times per day - hence the pain commonly associated with them.

Fractures in the limbs are normally immobilised in slings, splints or plaster casts - this is not possible with rib fractures.

Conditions
Treatments

Hamstring

The hamstrings are a group of muscles originating from the pelvis and inserting below the knee joint into the tibia and fibula.

The hamstrings original and insertions are tendons with a large muscle belly in-between.

The hamstrings play an important role in core stability and stability of the knee.

A common injury to the hamstrings is an intrasubstance tear of the muscle belly. This can be graded with ultrasound and MRI scans.

On some occasions the hamstring tendons can pull off from their bony insertions (avulsion).

Treatments

Calf

The calf is composed of two muscles - the deeper muscle is the soleus and the superficial muscle is the gastrocnemius. These two muscles insert into the heel as the achilles tendon. The gastrocnemius originated from just above the knee joint and the soleus from the tibia below the knee joint. The calf-achilles muscle tendon has an important role in plantar flexion of the foot (heel raising).

The calf muscle is susceptible to muscle tears, delayed onset muscle soreness and the achilles tendon can tear, suffer from inflammation and tendinopathy.