
He is widely recognised for his expertise in complex cases, with a tertiary referral practice for advanced procedures such as meniscal transplant, meniscal root repair and cartilage repair procedures such as osteochondral allograft transplantation. Mr Smith has a high-volume meniscal repair practice, with particular expertise in difficult meniscal repairs and meniscal root repairs. He also has one of the highest-volume meniscal transplant practices in Europe, with outcomes published extensively in the scientific literature.
Alongside his clinical work, Mr Smith is a leader in orthopaedic research, driving innovation to improve patient outcomes. He leads research programmes in ACL reconstruction, including pioneering work identifying how variations in tibial slope can contribute to graft failure. He is Chief Investigator on a £1.9 million NIHR-funded randomised controlled trial comparing synthetic augmentation with standard ACL reconstruction, and a co-applicant on a £1.3 million NIHR-funded international trial investigating meniscal transplantation. In addition, he is actively involved in cartilage research, with ongoing studies and continues to contribute widely to advancing evidence-based knee surgery.

Mr Nick Smith leads an internationally recognised research programme focused on advancing the understanding and treatment of knee conditions. This section of the website provides up-to-date evidence on key topics in knee surgery, alongside original research that is helping to shape modern clinical practice.
His work spans ACL reconstruction, meniscal surgery, and cartilage restoration, including pioneering research into the role of tibial slope in ACL reconstruction failure. He is Chief Investigator on a £1.9 million NIHR-funded randomised trial evaluating synthetic augmentation in ACL reconstruction, and a co-applicant on a £1.3 million NIHR-funded international study on meniscal transplantation.
With nearly £4 million in research funding secured and a substantial portfolio of peer-reviewed publications, his work is widely recognised within the orthopaedic community. The research presented here is carefully broken down to highlight the key clinical messages, with full papers also available for those seeking greater detail—supporting both healthcare professionals and patients who want a deeper understanding of knee conditions and treatments.

Mr Nick Smith offers a range of knee treatments and surgical proceedures.
The anterior cruciate ligament (ACL) is one of the main stabilising ligaments in the knee. It prevents the shin bone from moving forwards and controls rotation.
A knee replacement is a surgical procedure in which the damaged surfaces of the knee joint are replaced with artificial components made of metal and plastic.
A meniscal transplant involves replacing a missing or severely damaged meniscus with a donor (allograft) meniscus.
Multi-ligament knee injuries are usually caused by significant traumatic injuries.
Patellofemoral instability refers to a condition where the kneecap (patella) does not move normally within its groove at the front of the knee.
A knee osteotomy is a surgical procedure used to realign the bones around the knee to improve joint function and reduce pain.
A multiligament knee injury occurs when two or more of the major stabilising ligaments of the knee are torn.
The meniscal roots are the points where the meniscus attaches to the bone (tibia). These attachments are critical for allowing the meniscus to function properly.
The meniscus is a C-shaped piece of cartilage in the knee that acts as a cushion and helps transmit load evenly across the joint.
The meniscus is a cushion in the knee that helps transmit load evenly through the joint.
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