Mr Paul Nicolai, FRCS (Tr & Orth)


Consultant Orthopaedic Surgeon


Specialist Knee Surgeon

Bury St Edmunds




United Kingdom

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The knee is a fascinating joint. Unstable in design, it relies on the interaction between different tissues, such as cartilage, ligaments and muscles. It is supposed to last and function much longer than engineered bearing surfaces, despite increasing demands of faster and more intense leisure activities. Add to that the fact that cartilage is a tissue without healing or regeneration abilities, and the scene is set for the challenge a knee surgeon faces.

A damaged or worn knee joint can result in significant restriction in professional and recreational activities. But also day-to-day tasks, such as stair climbing or walking a long distance can be limited. Typical symptoms and signs include knee pain, instability, clicking or grating, giving way, locking and swelling.


The contents of this website is meant to be informative, and reflects my practice. It is not fully comprehensive and does not cover all aspects of knee pathology, treatment and the consequences of treatment. It cannot replace diagnostic and treatment processes, and when symptoms arise a consultation with an appropriate health care professional is required. No funds have been received from external sources. Pictures were kindly provided by Smith & Nephew Orthopaedics, Zimmer and Synthes.



© Paul Nicolai - All rights reserved


Numerous conditions can affect the knee joint from childhood to old age. Treatment options, non-surgical and surgical, are aimed at preserving normal knee function, even in the presence of joint damage. Extensive research is going on worldwide by healthcare professsionals, engineers and implant manufacturers to find better prostheses, to regenerate cartilage by tissue engineering and to find the best ways to regain stability.