Nottingham Elective Orthopaedic Service

Theatre staff in theatre

Nottingham Elective Orthopaedic Services (NEOS) is a specialist clinical unit based at City Hospital.

We undertake the highest volume of orthopaedic surgery in the region and perform over 1,800 joint replacements a year, including hip, knee shoulder and ankle replacements.

NEOS logo We offer a wide variety of routine and complex orthopaedic procedures for joint and soft tissue pain.

Because we carry out so many operations, our patients have better outcomes and fewer complications (1).

Our Nottingham Shoulder and Elbow Unit is one of the largest upper limb units in the country.

Our team have an international reputation in both upper and lower limb surgery. Peter James was named as one of the top 10 consultant knee surgeons in the UK by the Daily Mail and Andrew Manktelow received similar recognition for hip surgery.

The Department of Health recognises the benefits of specialised orthopaedic centres and in 2014 NHS England commissioned NEOS to host a regional specialised orthopaedic network (EMSON). This was one of only two chosen sites in the UK. Following the trial year EMSON has become part of our regular work. Our expert clinicians support other centres in the East Midlands to help improve the delivery of complex and revision joint surgery.

1Briggs T (2012) Getting it Right First Time: Improving the Quality of Orthopaedic Care within the National Health Service in England

Why choose NEOS?

We provide an internationally-renowned service to patients in Nottingham, the East Midlands and further afield.

The unit has a dedicated team who continually monitor patients' outcomes and complications. NEOS out performs NHS England average scores in many categories, including outcomes in joint replacements/revision, readmissions rates, infection rates and waiting times.

Common operations include:

  • hip, knee, shoulder, elbow, and ankle replacement
  • knee, shoulder and ankle arthroscopy (keyhole surgery)
  • soft tissue surgery including: ACL reconstruction, rotator cuff repair, Achilles tendon debridement
  • revision joint replacement surgery (we host the East Midlands Specialised Orthopaedic network - EMSON)
  • ankle fusion and reconstruction, bunion surgery, toe alignment surgery

NEOS is based at City Hospital and due to its specialist staff, facilities and support services it can provide the full breadth of orthopaedic services. Other local providers are required to send patients to NUH for specialist requirements related to complexity or patients' medical history.

Choosing NUH as your orthopaedic provider reduces the risk of seeing an alternative provider who cannot deliver your surgery. Being assessed by the NUH team directly will allow a more seamless patient journey if you require specialist surgery or if you have more complex health problems including heart problems, diabetes, sleep apnoea, weight problems or previous anaesthetic problems.

NEOS does not just provide care for the more specialist patients with medical problems. We provide care for all types of patients including treatment all athletes from elite level to weekend ramblers. We work in collaboration with Loughborough University at the National Centre for Sports and Exercise Medicine (NCSEM) to provide orthopaedic intervention for sports injuries of an elite and amateur nature and we have a relationship with Nottingham Rugby, and the Panthers Ice Hockey Club who use our expertise for their players and staff.

Choosing NUH also supports the development of medical, nursing and allied health professional under-graduate and post-graduate training and national/international research.

NUH appointments are available at City Hospital or in community locations (including Castle Healthcare Practice, West Bridgford and the NC-SEM at Loughborough University). These may be via direct ‘Choose and Book’ GP referrals or within ‘community triage’ services such as the Rushcliffe triage services.

If you see a consultant within other community services within Nottingham you can ask for your treatment to be undertaken by NEOS. Please ask your GP or contact us if you require advice on how to access our service.

Our theatres

Our award-winning state-of-the-art theatres opened in May 2015, after a £12.5 million investment.

The new NEOS theatre block, designed specifically for orthopaedic surgery, is at City Hospital. The building design has won a BEEAM award for environmental sustainability.

All five operating theatres contain laminar flow technology and have the most up-to-date specification to enhance patient safety and experience.

This major investment has increased NEOS' capacity to deliver orthopaedic surgery to patients throughout the East Midlands and beyond and will contribute to support shorter waiting lists, enhanced surgical safety and excellent patient experience.

Community clinics

As well as providing care in hospital, we also offer community clinics at the following locations:

  • National Centre for Sports and Exercise Medicine, Loughborough University, Epinal Way, Loughborough LE11 3TU
  • Castle Healthcare Practice, Embankment Primary Care Centre, 50-60 Wilford Lane, West Bridgford, Nottingham NG2 7SD
  • Clinics are staffed by orthopaedic surgeons and advanced role physiotherapists

Services available include:

  • Expert advice and opinion
  • Joint or soft tissue injections
  • Referral on for surgery including hip replacements and knee replacements
  • Expert physiotherapy including exercise, advice, manual therapy and acupuncture
  • Referral for investigations (MRI scans, X-rays, ultrasound scans)


NEOS has an experienced team of specialist physiotherapists and occupational therapists who prepare you for surgery, assist your inpatient recovery and plan your personalised rehabilitation after discharge.


Your physiotherapist may:

  • help you with pre-operative lifestyle changes and exercise programmes
  • carefully record your pre-operative status for audit purposes
  • provide education about post-operative expectations
  • help to get you mobile after your surgery and teach you exercises to perform in hospital and at home so you get the best result after surgery
  • follow you up on behalf of the surgeon to check you are meeting your post-operative goals

Occupational therapy

Your occupational therapist may:

  • organise equipment for you at home to support safe discharge from hospital
  • co-ordinate follow up care so that you feel supported and safe after discharge
  • assist with pre-operative education to ensure that you are confident about what to expect before your hospital admission
  • provide tailor made splints or braces after surgery


Therapists are actively involved in the Care4Today® programme, which involves patients in their pre-operative care and supports them after their discharge from hospital. Therapists and nurses from NEOS have helped to develop the package. More information is available from

Patient feedback

"Everything has been excellent. All the staff have gone above and beyond the call of duty. Nothing was too much trouble… It has been more like a holiday than a major operation. I cannot thank the staff enough."

"Staff couldn't have been more helpful."

"Everyone has been very helpful. I would definitely recommend this hospital to others for treatment."

"I was completely satisfied with all the treatment. The doctors and nurses were brill. I can’t see where you could improve here."

"The ward staff were fantastic."


"The care given was top quality. All staff great at their job and very friendly."


"Very happy with the service. Friendly helpful staff."


"We wouldn't change anything, the level of care has been excellent."


"Everything was perfect!"


"Nothing but praise for a large group of dedicated staff working all shifts and maintaining standards throughout - many thanks."


"It is the best I have been in, good luck to all of you."


"Nothing could have been better. Delighted with everything."

Useful links

Arthritis Research UK

Patient information leaflets/ publications on on a variety of subjects including: 

  • Back pain
  • Carpal Tunnel Syndrome
  • Complex regional pain syndrome
  • Elbow pain
  • Feet, footwear and arthritis
  • Hip pain
  • Osteoarthritis
  • Shoulder pain

Evidence-based information on a wide range of medical and health related topics for both the patient and the health professional including: 

  • Achilles tendon rupture
  • Hamstring injuries
  • Knee ligament injuries
  • Knee cartilage injuries
  • Low back pain
  • Neck pain
  • Osteoarthritis
  • Pelvis pain syndrome
  • Repetitive strain injury
  • Sports injuries
  • Thoracic outlet syndrome
  • Whiplash

Total Knee Replacement Patient Information Guide

Total Hip Replacement Patient Information Guide

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