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Research

Evidence-based medicine in the foundation of modern medicine. Studies have shown that research active hospitals have better patient care outcomes. Put simply, research improves results for both current and future patients. Nick Smith started his research training at undergraduate level, obtaining a BMedSci at the University of Nottingham. He then went on to be awarded a Masters in Health Sciences (Trauma and Orthopaedics) with a distinction, at the University of Warwick. Subsequently, he was awarded a research grant to complete a PhD at the University of Warwick on the outcomes of meniscal allograft transplantation. This research won a number of awards and has been published and cited in others’ work across the world.

Nick Smith has a number of active research projects, with a focus on evaluating new technologies, and clinically assessing established procedures and treatments. This section summarises a selection of recent and active projects.

  • ACL recon LET vs no LET

    STABILITY Study (Getgood et al., 2020) Lateral Extra-articular Tenodesis (LET) in ACL Reconstruction 🔗 https://pubmed.ncbi.nlm.nih.gov/31940222/ Getgood AMJ, et al. Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial. Am J Sports Med. 2020 Feb;48(2):285-297. doi: 10.1177/0363546519896333. Epub 2020 Jan 15. PMID: 31940222. Key

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  • ACL Reconstruction and the “Delta Angle”

    https://pubmed.ncbi.nlm.nih.gov/40690738/ Evidence base Ayuob A, Raj S, Jessup J, Searle HKC, Ahmed I, Thompson P, Shah F, Metcalfe A, Smith N. Introducing “Delta Angle” of Posterior Tibial Slope and Its Impact on ACL Reconstruction Failures: A Regression Analysis of 1174 Patients. Am J Sports Med. 2025 Aug;53(10):2387-2396. doi: 10.1177/03635465251355213. Epub 2025 Jul 21. PMID: 40690738.

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  • ACL reconstruction with quadriceps or patellar tendon grafts, and tenodesis (STABILITY 2 trial)

    One of the most important research projects in ACL reconstruction came from the STABILITY 1 trial, which was a randomised trial comparing ACL reconstruction with or without lateral extra-articular tenodesis (an extra part to the operation, in which a section of iliotibial band on the outside of the knee is connected in to the thigh

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  • Meniscal Root Tears

    https://pubmed.ncbi.nlm.nih.gov/35755791/ Diagnosis, Consequences and Treatment Evidence Base Banovetz MT, Roethke LC, Rodriguez AN, LaPrade RF. Meniscal Root Tears: A Decade of Research on their Relevant Anatomy, Biomechanics, Diagnosis, and Treatment. Arch Bone Jt Surg. 2022 May;10(5):366-380. doi: 10.22038/ABJS.2021.60054.2958. PMID: 35755791; PMCID: PMC9194705. Key Points Meniscal root tears are serious injuries that can behave like complete

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  • Recovery After ACL Injury

    https://pmc.ncbi.nlm.nih.gov/articles/PMC12582240/ Evidence base Ridha A, Raj S, Searle H, Ahmed I, Smith N, Metcalfe A, Khatri C. The recovery trajectory of anterior cruciate ligament ruptures in randomised controlled trials: A systematic review and meta-analysis of operative and nonoperative treatments. Knee Surg Sports Traumatol Arthrosc. 2025. https://doi.org/10.1002/ksa.12626 This study was conducted by our team to better

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  • Return to Sport After Knee Replacement

    https://pmc.ncbi.nlm.nih.gov/articles/PMC5765989/ Evidence base Dagneaux L, Bourlez J, Degeorge B, Canovas F. Return to sport after total or unicompartmental knee arthroplasty: an informative guide. EFORT Open Rev. 2017. This review summarises the current evidence on returning to sport after knee replacement, including both total knee replacement (TKR) and partial knee replacement (UKR). Key points Most patients

    Read more

  • TKR vs UKR

    TOPKAT Trial – 5-Year Outcomes (Beard et al., 2019) Total vs Partial Knee Replacement for Medial Knee Arthritis 🔗 Beard DJ, et al. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Lancet. 2019 Aug 31;394(10200):746-756. doi: 10.1016/S0140-6736(19)31281-4. Epub 2019 Jul

    Read more

  • ACL reconstruction vs rehab

    https://pubmed.ncbi.nlm.nih.gov/38940695/ ACL SNNAP Trial (Beard et al., 2022) Rehabilitation versus ACL Reconstruction for Persistent Instability Beard DJ, Davies L, Cook JA, Stokes J, Leal J, Fletcher H, Abram S, Chegwin K, Greshon A, Jackson W, Bottomley N, Dodd M, Bourke H, Shirkey BA, Paez A, Lamb SE, Barker K, Phillips M, Brown M, Lythe V,

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  • Cartilage outcomes

    Recovery After Cartilage Treatment Evidence base Searle HKC, Raj S, Ridha A, Ahmed I, Khatri C, Metcalfe A, Smith N. The recovery trajectory of people undergoing treatment for knee articular cartilage damage: A systematic review and meta-analysis. Knee. 2025 Oct;56:211-223. doi: 10.1016/j.knee.2025.05.031. Epub 2025 Jun 4. PMID: 40472679. This study was conducted by our team

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  • Meniscal allograft transplantation

    Nick Smith has published numerous research papers on meniscal allograft transplantation: He has published systematic reviews on the patient outcomes following transplant surgery, and also whether it reduces the risk of future osteoarthritis. These papers showed that on average, meniscal allograft transplantation improves results for patients. There is some early evidence that shows meniscal allograft

    Read more

  • Meniscal transplant outcomes in patients with cartilage damage

    https://pubmed.ncbi.nlm.nih.gov/39506549/ Evidence base Ahmed I, Khatri C, Spalding T, Smith N. Meniscal allograft transplantation in patients with substantial cartilage disease led to a sustained long-term improvement in patient-reported outcome measures. Knee Surg Sports Traumatol Arthrosc. 2025 Aug;33(8):2771-2780. doi: 10.1002/ksa.12536. Epub 2024 Nov 7. PMID: 39506549. Key points Meniscal transplantation improves pain and function for up

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  • Meniscal transplant return to sport

    https://pubmed.ncbi.nlm.nih.gov/41144796/ Evidence base Ahmed I, Khatri C, Davidescu A, Spalding T, Smith N. Returning to competitive sport after meniscal allograft transplant is associated with sustained graft survival and improved patient-reported outcomes. Knee Surg Sports Traumatol Arthrosc. 2025 Oct 27. doi: 10.1002/ksa.70137. Epub ahead of print. PMID: 41144796. Key points Returning to competitive sport after meniscal

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  • Meniscal transplantation vs physiotherapy

    https://pubmed.ncbi.nlm.nih.gov/29305451/ Evidence base Smith NA, Parsons N, Wright D, Hutchinson C, Metcalfe A, Thompson P, Costa ML, Spalding T. A pilot randomized trial of meniscal allograft transplantation versus personalized physiotherapy for patients with a symptomatic meniscal deficient knee compartment. Bone Joint J. 2018 Jan;100-B(1):56-63. doi: 10.1302/0301-620X.100B1.BJJ-2017-0918.R1. PMID: 29305451. Key points Meniscal transplantation improves pain and

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  • Partial knee replacement

    Nick Smith has published the clinical outcomes following partial knee replacement using the newer Oxford Cementless partial knee implant.

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  • Allografts in knee surgery

    https://pubmed.ncbi.nlm.nih.gov/30721344/ https://pubmed.ncbi.nlm.nih.gov/30903218/ https://pubmed.ncbi.nlm.nih.gov/30982109/ Nick Smith was involved in a programme of work looking at the clinical and cost effectiveness of allografts (donor tissue) in knee surgery. This was subdivided into four main projects: ACL reconstruction, PCL reconstruction, meniscal allograft transplantation and osteochondral allograft transplantation. Osteochondral allograft transplantation Osteochondral allograft transplantation (OCA) is a procedure where

    Read more

  • Daycase knee replacement

    Nick Smith helped to introduce daycase partial knee and total hip replacement at South Warwick University NHS Foundation Trust and has published this experience. The implementation was successful and the results showed that patients were happy with their care. Clinical scores were similar between daycase patients and patients that previously stayed in hospital for longer.

    Read more

Our Laboratory

  • STABILITY Study (Getgood et al., 2020) Lateral Extra-articular Tenodesis (LET) in ACL Reconstruction 🔗 https://pubmed.ncbi.nlm.nih.gov/31940222/ Getgood AMJ, et al. Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial. Am J Sports Med. 2020 Feb;48(2):285-297. doi: 10.1177/0363546519896333. Epub 2020 Jan 15. PMID: 31940222. Key

    Read more

  • https://pubmed.ncbi.nlm.nih.gov/40690738/ Evidence base Ayuob A, Raj S, Jessup J, Searle HKC, Ahmed I, Thompson P, Shah F, Metcalfe A, Smith N. Introducing “Delta Angle” of Posterior Tibial Slope and Its Impact on ACL Reconstruction Failures: A Regression Analysis of 1174 Patients. Am J Sports Med. 2025 Aug;53(10):2387-2396. doi: 10.1177/03635465251355213. Epub 2025 Jul 21. PMID: 40690738.

    Read more

  • One of the most important research projects in ACL reconstruction came from the STABILITY 1 trial, which was a randomised trial comparing ACL reconstruction with or without lateral extra-articular tenodesis (an extra part to the operation, in which a section of iliotibial band on the outside of the knee is connected in to the thigh

    Read more

  • https://pubmed.ncbi.nlm.nih.gov/30721344/ https://pubmed.ncbi.nlm.nih.gov/30903218/ https://pubmed.ncbi.nlm.nih.gov/30982109/ Nick Smith was involved in a programme of work looking at the clinical and cost effectiveness of allografts (donor tissue) in knee surgery. This was subdivided into four main projects: ACL reconstruction, PCL reconstruction, meniscal allograft transplantation and osteochondral allograft transplantation. Osteochondral allograft transplantation Osteochondral allograft transplantation (OCA) is a procedure where

    Read more

  • Nick Smith helped to introduce daycase partial knee and total hip replacement at South Warwick University NHS Foundation Trust and has published this experience. The implementation was successful and the results showed that patients were happy with their care. Clinical scores were similar between daycase patients and patients that previously stayed in hospital for longer.

    Read more

  • https://pubmed.ncbi.nlm.nih.gov/35755791/ Diagnosis, Consequences and Treatment Evidence Base Banovetz MT, Roethke LC, Rodriguez AN, LaPrade RF. Meniscal Root Tears: A Decade of Research on their Relevant Anatomy, Biomechanics, Diagnosis, and Treatment. Arch Bone Jt Surg. 2022 May;10(5):366-380. doi: 10.22038/ABJS.2021.60054.2958. PMID: 35755791; PMCID: PMC9194705. Key Points Meniscal root tears are serious injuries that can behave like complete

    Read more

  • https://pmc.ncbi.nlm.nih.gov/articles/PMC5765989/ Evidence base Dagneaux L, Bourlez J, Degeorge B, Canovas F. Return to sport after total or unicompartmental knee arthroplasty: an informative guide. EFORT Open Rev. 2017. This review summarises the current evidence on returning to sport after knee replacement, including both total knee replacement (TKR) and partial knee replacement (UKR). Key points Most patients

    Read more

  • TOPKAT Trial – 5-Year Outcomes (Beard et al., 2019) Total vs Partial Knee Replacement for Medial Knee Arthritis 🔗 Beard DJ, et al. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Lancet. 2019 Aug 31;394(10200):746-756. doi: 10.1016/S0140-6736(19)31281-4. Epub 2019 Jul

    Read more

  • Nick Smith has published numerous research papers on meniscal allograft transplantation: He has published systematic reviews on the patient outcomes following transplant surgery, and also whether it reduces the risk of future osteoarthritis. These papers showed that on average, meniscal allograft transplantation improves results for patients. There is some early evidence that shows meniscal allograft

    Read more

  • Nick Smith has published the clinical outcomes following partial knee replacement using the newer Oxford Cementless partial knee implant.

    Read more

About Us

Mr Nick Smith is a consultant specialist knee surgeon based at the University Hospitals Coventry and Warwickshire NHS Trust and Warwick Nuffield Hospital.

NHS Clinic

  • University Hospitals Coventry and Warwickshire NHS Trust,
    Clifford Bridge Road,
    Coventry, West Midlands,
    CV2 2DX
  • Secretary Pravina Mistry
  • 02476 965 080
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