Private orthopaedics in Edinburgh: joint replacement and bone care

Spire's Edinburgh treatment list places bones and joints first and names an unusually wide set of operations: hip replacement, knee replacement, shoulder replacement, rotator cuff repair, ankle arthroscopy, ankle replacement and joint injections. It also names robotic-assisted joint replacement with the MAKO system as a featured treatment.

The hospital group operates from two sites, Murrayfield on Corstorphine Road and Shawfair Park in the south-east. The treatment page is shared between them and does not say which site hosts which orthopaedic theatre list, so ask the consultant's secretary before you travel. Murrayfield involves a short walk up a steep driveway from the nearest bus stop, which is awkward on crutches; Shawfair Park is a five-minute walk from the Sheriffhall Park and Ride, served by buses 33 and 49, and Spire describes plenty of free parking there.

Imaging named in the Spire list includes CT and MRI, which is relevant to planning a replacement or investigating a painful knee or shoulder.

Nuffield Health Edinburgh lists orthopaedics and knee replacement among its specialties, with diagnostic imaging available alongside outpatient appointments. The hospital is on Colinton Road, in the south-west of the city, and the page names Lothian Buses routes 10, 27, 38 and 45.

Its own page says it endeavours to see private patients within a week, and that referrals are preferred but not mandatory. Free on-site parking is available when you validate your number plate at reception, which is practical for the first weeks after knee surgery, when climbing onto buses is difficult.

The hospital is a planned-care site with no emergency department. If a wound or leg problem worries you after discharge, the route is back to the consultant's team, and for anything severe, 999 or NHS 24 on 111.

The Edinburgh Orthopaedics department is based at the Royal Infirmary of Edinburgh, 51 Little France Crescent, EH16 4SA. Its public site describes a trauma department for fractures and multiple injuries, an adult reconstruction service covering hip and knee replacement, foot and ankle surgery, upper limb surgery, musculoskeletal tumours and limb deformity correction, children's orthopaedics up to age 15, and a sports medicine service.

Because the Royal Infirmary is also the trauma centre, elective operations compete with emergency work for beds. That context partly explains why some patients choose a private hospital with a dedicated elective list, whilst others prefer the NHS for its on-site critical care and wider specialist back-up.

The NHS also publishes guidance on what to do while waiting; Lothian's own service page directs patients to the department site for details.

Hip and knee replacement are the commonest planned operations. They are considered when arthritis has worn the joint and pain has not eased with exercise, weight loss, walking aids and medicines. Shoulder problems are often tendon-related, with a rotator cuff tear causing weakness and night pain, and a repair is done by keyhole or open surgery depending on the tear. Ankle arthroscopy is a keyhole procedure used to clear scar tissue or loose fragments.

Robotic-assisted replacement helps the surgeon prepare the bone to a pre-set plan. Whether it brings better long-term outcomes than conventional methods is still being studied, so it is reasonable to ask the surgeon why it is advised, how many such operations they have done, and what happens if the system is not used on the day.

• Total and partial hip and knee replacement

• Shoulder replacement and rotator cuff repair

• Ankle arthroscopy and ankle replacement

• Joint injections for arthritis pain

• Spinal procedures listed by Spire, including decompression and discectomy

A few written questions often save a phone call later.

• Which site will host your operation, and whether you can reach it after surgery without climbing steep paths.

• The implant brand and whether the price changes if a robotic system is used.

• How many nights you are likely to stay and what physiotherapy is arranged before you leave.

• Who sees you if there is a wound or swelling problem a fortnight later.

• Whether insurance covers the surgeon, the implant, the anaesthetist and the follow-up.

• How your GP and any NHS orthopaedic team will be told what was done.

The Treatment Time Guarantee gives NHS patients in Scotland a legal 12-week limit from agreement of inpatient or day-case surgery to treatment, and NHS inform describes a 12-week target for a new outpatient appointment. Real orthopaedic waits fluctuate, so current figures should come from NHS Lothian or Public Health Scotland.

Private care shortens the wait for some, and for insured patients it may cost nothing beyond an excess. It does not change whether surgery is the right answer, and a second opinion can sometimes save an operation.