Qualifications:
BMedSci (Nottingham) Physiology 1974
MB, BS, (Nottingham) 1976
FRCS (England) 1981
Positions Held:
Professor Sport and Exercise Medicine
Consultant Orthopaedic Surgeon
Consultant Trauma and Orthopaedic Department Surgeon – Cardiff and Vale NHS TrustPast President of the British Orthopaedic Sports and Trauma Association (BOSTA)
Awards:
Porritt Sports Fellowship 1988
Academic Leadership:
Course Director – MSc Sports and Exercise Medicine
Current practice:
Specialist knee surgeon.
1986 - established the first day case arthroscopy unit in Wales and the unit at the UHW later moved to Rydlafar became a national arthroscopic teaching unit sponsored by "Linvatec".
Developed a national and international referral pattern for knee ligament surgery acting a tertiary referral and hosting surgeons both nationally and internationally.
Established collaborative links with the Kennedy Institute in London establishing research programs into the development of osteoarthritis.
Developed methods of assessing the development of osteoarthritis in the knee; and have recently been involved in the patenting of a method of assessing degenerate changes in the hyaline cartilage from standard X Rays.
Developed a special interest in knee ligament surgery and its relation to the development of osteoarthritis.
Established teaching courses for medical and non medical staff in the 1980's which later became formalised with the establishment of the diploma in Sports and Exercise medicine.
Opened a specialist centre "Centre for Musculoskeletal Analysis and Therapy" to provide modern biomechanical and radiological assessment of the painful joins and limbs especially in the dysfunctional sporting joint.
Surgical practice
Exclusively in lower limb surgery and mainly knee.
Specific area of interest - osteoarthritis and its management
PREVIOUS APPOINTMENTS
Senior Lecturer, Trauma & Orthopaedic Surgery 1986 – 1990
Prince of Wales Orthopaedic Hospital, Cardiff.
Senior Registrar Trauma & Orthopaedic Surgery 1985 – 1986 Prince of Wales Orthopaedic Hospital, Cardiff.
Senior Registrar Trauma & Orthopaedic Surgery 1984 – 1985 Cardiff Royal Infirmary.
Senior Registrar Trauma & Orthopaedic Surgery 1983 – 1984 Royal Gwent Hospital, Newport, Gwent.
Career Orthopaedic Registrar 1982 – 1983
Nottingham University Hospital and Nottingham General Hospital Apr'83 - Sep'83
Nottingham University Hospital and Nottingham City Hospital Sep'82 – Apr'83
Orthopaedic Surgery
Senior House Officer and Career Orthopaedic Registrar in Nottingham
Completed higher surgical training in Cardiff.
Nottingham University, City And General Hospitals
Royal Gwent Hospital
Cardiff Royal Infirmary
Prince Of Wales Orthopaedic Hospital
Specific experience in paediatric surgery, including that for talipes equinovarus, congenital hip disorders and the treatment of the orthopaedic problems of spina bifida.
Senior Lecturer
In this position in addition to the role as a member of the academic staff I was an honorary consultant responsible for general trauma and orthopaedics.
The investigation of patients undergoing joint replacements of the knee enabled the development of research on the aetiology and monitoring of osteoarthritis.
Guidelines for national Best practice in ACL Surgery
I am a co-author of the document written for national distribution for best practice for Anterior Cruciate surgery. The document written on behalf of the BOA is an attempt to define and advise on the Best Practice for both Clinicians and management.
President of the British Orthopaedic and Sports Trauma Association.
The increasing profile of Sports medicine and the increasing demands of both athletes and the media have led to a major difficulty in the provision and control in standards in Sports Medicine. As a key role as the only surgical sports representative the role of president has demanded a planning and development role in a politically sensitive area. Currently I have achieved links with several International organisations.. There will be a major meeting of BOSTA with the BOA in Cardiff in 2002.
PUBLICATIONS
Toumi H, Best TM, Benjamin M and Fairclough J. New Insights Into The Function Of The Vastus Medialis With Clinical Implications. Med Sci Sports Exerc. 39(7):1153-9, 2007).
Grover JP, Toumi H, Manthei DM, Oza AL, Vanderby R Jr, Best TM.. The effect of stretch rate and activation state on skeletal muscle force in the anatomical range. Clin Biomech (Bristol, Avon). Mar;22(3):360-8, 2007.
Toumi H, Best TM, Martin A, Poumarat G, Fairclough J, Benjamin M. What is the primary factor responsible for a decreased muscle performance after stretch-shortening cycle fatigue? Is it central or peripheral or reflex? Canadian Journal of Applied Physiology and Nutrition. Volume 31, Number 5, October 2007.
Benjamin M, Toumi H, Suzuki D, Redman S, Emery P and McGonagle D. Microdamage and altered vascularity at the enthesis-bone interface provides an anatomic explanation for bone involvement in the HLA-B27-associated spondylarthritides and allied disorders.. Arth Rheum. Jan;56(1):224-33, 2007.
Benjamin M, Theobald P, Suzuki D, Toumi H. The anatomy of the Achilles tendon. In: The Achilles tendon, Eds Maffulli N and Almekinders L, pp. 5-16. Springer –Verlag ISBN 184628628X .255, 2007.
Toumi H, Best TM, Martin A, Poumarat G, Fairclough J, Benjamin M. Fatigue and muscle-tendon stiffness after stretch-shortening cycle and isometric exercise. Appl Physiol Nutr Metab. Oct;31(5):565-72, 2006.
A. L. Tan, M. Benjamin, H. Toumi, A. J. Grainger, S. F. Tanner, P. Emery and D. McGonagle. The relationship between the extensor tendon enthesis and the nail in distal interphalangeal joint disease in psoriatic arthritis—a high-resolution MRI and histological study. Rheumatology (Oxford). 2006 Jul 11.
Toumi H., Fagier S, Best TM. The Myotendinous Junction: Response to Injury and Repair. J Anat. 2006 Apr;208(4):459-70.
Fairclough J Hayashi K, Toumi H, Benjamin M. A re-investigation of the clinical anatomy of the iliotibial tract. J Anat. 2006 Mar;208(3):309-16.
Toumi H, Higashiyama I, Suzuki D, Kumai T, Bydder G, McGonagle D,
Emery P, Fairclough J, Benjamin M. The functional anatomy of proximal patellar tendinopathy ('jumper's knee') – a biomechanical analysis of the trabecular architecture of the patella and the proximal enthesis of the patellar tendon. J. Anat. 2006; 208: 47-57.
Toumi H, Hedge J, Subbotin V, Noble M, Herweijer H, Best TM and Hagstrom JE. Rapid intravascular injection into limb skeletal muscle: A damage assessment study. Journal of Molecular Therapy, Mol Ther. 2006 Jan; 13(1):229-36. Epub 2005 Sep 26.
Toumi H, Fitzsimons D.P., Best T.M. Exercise Induced Myopathys. Basic Appl Myol. 2005, 13: 163-170.
Toumi H, Nicola Phillips, Mike Benjamin, Thomas M. Best and Georges Poumarat. An Anatomical and Electrophysiological Study of Vastus Medialis - How Distinct is its Distal Oblique Component? Control/Tracking Number: 06-SA-1794-ACSM, Denver, June 2006.
John Fairclough, Hechmi Toumi, Graeme Thomas M. Best and Mike Benjamin. The Structure of the Iliotibial Band in Relation to Iliotibial Band Friction Syndrome. Control/Tracking Number: 06-SA-1791-ACSM June 2006.
Toumi H, Thomas M. Best, John Fairclough. Mike Benjamin. Regional Variations in the Structure and Histopathology of the Achilles Tendon 'Enthesis organ'. Control/Tracking Number: 06-SA-1798-ACSM Denver, June 2006.
Fairclough J, Hayashi K, Toumi H, Benjamin M. A re-investigation of the clinical anatomy of the iliotibial tract.
Journal of Anatomy, , Vol. 208, No. 3. (March 2006), pp. 309-316.
Toumi H, Best TM, Martin A, Poumarat G, Fairclough J, Benjamin M.
What is the primary factor responsible for a decreased muscle performance after stretch-shortening cycle fatigue? Applied Physiology, Nutrition and Metabolism (in press, accepted in May 2006).
Toumi H, Higashiyama I, Suzuki D, Kumai T, Bydder G, McGonagle D, Emery P, Fairclough J, Benjamin M. The functional anatomy of proximal patellar tendinopathy ('jumper's knee') * a biomechanical analysis of
the trabecular architecture of the patella and the proximal enthesis of the patellar tendon.
J. Anat. 2006; 208: 47-57.
Toumi H, Best TM, Martin A, Poumarat G, Fairclough J, Benjamin M. What is the primary factor responsible for a decreased muscle performance after stretch-shortening cycle fatigue? Journal of Applied
Physiology.
Toumi H, Best TM, Martin A, Poumarat G, Fairclough J, Benjamin M.An Anatomical and Electrophysiological Study of Vastus Medialis - How Distinct is its Distal Oblique Component? Control/Tracking Number: 06-SA-1794-ACSM June 2006.
Fairclough J, Hayashi K, Toumi H, Benjamin M. The Structure of the Iliotibial Band in Relation to Iliotibial Band
Friction Syndrome. Control/Tracking Number: 06-SA-1791-ACSM June 2006.
Koji Hayachi, Hechmi Toumi, Thomas M. Best, John Fairclough and Mike Benjamin. Regional Variations in the Structure and Histopathology of the Achilles Tendon 'Enthesis organ'. Control/Tracking Number:
06-SA-1798-ACSM June 2006.
Williams RL. Williams LA. Watura R. Fairclough JA. Impact of MRI on a knee arthroscopy waiting list. [Journal Article] Annals of the Royal College of Surgeons of England. 78(5):450-2, 1996 Sep.
Identification of Human Chondroprogenitor cell populations GP Dowthwaite, SN Redman, LM Haughton, JA Fairclough, AS Williams, CW Archer.
"European Cells and Materials VI" Davos June 2006.
Isolation of chondroprogenitors from human articular cartilage.
Dowthwaite, G P, Redman, S N, Haughton L M, Fairclough, J A, Williams R, Williams, A S, Archer, C W
Orthopaedic Res Society USA Annual Meeting, Santa Monica, March 2007.
Fairclough JA. BASK Instructional Lecture 2: Long-term effects of anterior cruciate injury. [Review] [13 refs] [Journal Article. Review] Knee. 8(1):73-4, 2001 Mar.
Jibuike OO. Paul-Taylor G. Maulvi S. Richmond P. Fairclough J. Management of soft tissue knee injuries in an accident and emergency department: the effect of the introduction of a physiotherapy practitioner. [Journal Article] Emergency Medicine Journal. 20(1):37-9, 2003 Jan.
Debnath UK. Fairclough JA. Williams RL. Long-term local effects of carbon fibre in the knee. [Journal Article] Knee. 11(4):259-64, 2004 Aug.
Toumi H. Higashiyama I. Suzuki D. Kumai T. Bydder G. McGonagle D. Emery P. Fairclough J. Benjamin M. Regional variations in human patellar trabecular architecture and the structure of the proximal patellar tendon enthesis.]
Journal of Anatomy. 208(1):47-57, 2006 Jan.
P Lakshmanan,s Hemadi,Fairclough JAManagement of mild to moderate limb-length discrepancy :percutaneous epiphseodesis
Welsh Paed J 2004, 20.19-22
Debnath.U.K., Fairclough JA. ,Williams RL. Long Term effect of carbon fibre in the knee
Knee. 11(1):259-264, 2004 Mar.
Fairclough JA.: Long-term effects of anterior cruciate injury. Knee. 8(1):73-4, 2001 Mar.
Williams RL. Williams LA. Watura R. Fairclough JA.Impact of MRI on a knee arthroscopy waiting list.
Annals of the Royal College of Surgeons of England. 78(5):450-2, 1996 Sep.
Hazell PK. Dent C. Fairclough JA. Bayliss MT. Hardingham TE.Changes in glycosaminoglycan epitope levels in knee joint fluid following injury.Arthritis & Rheumatism. 38(7):953-9, 1995 Jul.
Marshall PD. Patil M. Fairclough JA.Should Esmarch bandages be used for exsanguination in knee arthroscopy and knee replacement surgery? A prospective trial of Esmarch exsanguination versus simple elevation.
Journal of the Royal College of Surgeons of Edinburgh. 39(3):189-90, 1994 Jun.
Dent CM. Patil M. Fairclough JA.Arthroscopic ankle arthrodesis.
Journal of Bone & Joint Surgery - British Volume. 75(5):830-2, 1993 Sep.
Marshall PD. Fairclough JA. Johnson SR. Evans EJ.Avoiding nerve damage during elbow arthroscopy.
Journal of Bone & Joint Surgery - British Volume. 75(1):129-31, 1993 Jan.
Graham GP. Johnson S. Dent CM. Fairclough JA.Comparison of clinical tests and the KT1000 in the diagnosis of anterior cruciate ligament rupture..British Journal of Sports Medicine. 25(2):96-7, 1991 Jun.
Dent CM. Graham GP. Fairclough JA.A solution for arthroscope misting.Arthroscopy. 7(4):389, 1991.
Graham GP. Dent CM. Fairclough JA.Preparation of skin for surgery.
Journal of the Royal College of Surgeons of Edinburgh. 36(4):264-6, 1991 Aug.
Fairclough JA. Graham GP. Dent CM.Radiological sign of chronic anterior cruciate ligament deficiency.
Maylia E. Fairclough J.A Noakes D. Can thigh girth be measured accurately
Journal Sport Rehab 8(1) 43-9.Feb1999
Williams RL. Williams LA. Watura R. Fairclough JA.Impact of MRI on a knee arthroscopy waiting list.
Annals of the Royal College of Surgeons of England. 78(5):450-2, 1996 Sep.
Maylia E. Fairclough J.A Noakes D.
Estimation of muscle power compared with thigh bulk
Journal Sport Rehab 8(1)50-58. Feb1999
Hazell PK. Dent C. Fairclough JA. Bayliss MT. Hardingham TE.
Changes in glycosaminoglycan epitope levels in knee joint fluid following injury.
Arthritis & Rheumatism. 38(7):953-9, 1995 Jul.
Dent CM. Patil M. Fairclough JA.Arthroscopic ankle arthrodesis.
Journal of Bone & Joint Surgery - British Volume. 75(5):830-2, 1993 Sep.
Marshall PD. Fairclough JA. Johnson SR. Evans EJ.Avoiding nerve damage during elbow arthroscopy.
Journal of Bone & Joint Surgery - British Volume. 75(1):129-31, 1993 Jan.
Graham GP. Johnson S. Dent CM. Fairclough JA.
Comparison of clinical tests and the KT1000 in the diagnosis of anterior cruciate ligament rupture.
British Journal of Sports Medicine. 25(2):96-7, 1991 Jun.
Graham GP. Dent CM. Fairclough JA.Preparation of skin for surgery.
Journal of the Royal College of Surgeons of Edinburgh. 36(4):264-6, 1991 Aug.
Farquhar I. Fairclough JA.Sciatic block in lower limb surgery.
Injury. 21(2):107-9, 1990 Mar.
Fairclough JA. Graham GP. Pemberton D.Local or general anaesthetic in day case arthroscopy?.
Annals of the Royal College of Surgeons of England. 72(2):104-7, 1990 Mar.
BOOKS
Rheumatology "The Knee"
Mosby Dec 2001-08-01
Soft tissue trauma and rheumatology surgery in sports injury.
In Press, September 1992.
The knee in rheumatology.
Rheumatology. In Press 1993.
Sports injuries second edition.
Brooks M MD, Evans R and Fairclough J A
London: Gower January 1992.
Sports Medicine.
Evans R and Fairclough J A
London: Gower February 1990.
The soft tissues: trauma, rheumatism and sports injury.
Davies J, Fairclough J A and McLatchie G.
Oxfordf; Heinemann Medical Press (In Press 1990).
Chapter in book "Infection in the Orthopaedic Patients"
"Surgical Skin Preparation – A Scientific Approach"
Butterworths Press. London 1989.
Cruciate ligaments are crucial.
RCollSurg FA annual meeting Daventry July2001-08-01
Osteoathritis and ACL injury
European Society of Sports trauma Sept 2000
Current practice in ACL surgery
Oman Sports meeting Aug 2000
Anterior cruciate sugery and osteoarthritis
Middle East Sports Soc Quatar Oct 2000
Cruciate ligaments are Crucial
Medical Conference of Football Association Geneva Feb 2001
Osteoarthritis and the footballer BRUGGES June 2002
Complications of unicondylar joint replacement
Every Sport Should Carry a Govt Health Warning Welsh Surgical Society
Bridgend 7/5/04
Great Expectations – Treatment of osteoarthritis of the knee GP Meeting Cardiff May 05
Complications Unicondylar Knee Replacement Wrightington 2004
Principles of Unicondylar Knee Replacement South African Arthroplasty Conference 2005 April
Selection 0f patients Unicondylar Knee Replacement South African Arthroplasty Conference 2005 April
Technique of Unicondylar Knee Replacement South African Arthroplasty Conference 2005 April
Golf and Knee Arthroplasty –A Biomechanical analysis South African Arthroplasty Conference 2005 April
Interactions In Arthroplsyty 17th May 2005 Cambridge
Unicompartmenmtal Arthoplasty Zurich Sept 8 2005
European Infection Prevention Expert Conference 18-19 Oct 20005 Neuss Germany
Treatment of the young Osteoarthritic knee Canterbury 20/10/05
Awards
Porritt Fellowship from the Royal College of Surgeons to investigate the long term effect of meniscectomy in the prognosis of osteoarthritis of the knee.
Research Grants
I obtained a Special Trustees Grant of £1500 from the Nottingham University Hospital in 1982 for the Clinical Application of Vibrational Analysis.
Much of the initial research application into the clinical use of time domain analysis of fracture healing was performed with the help of this grant and led to our research group being granted a Medical Research council Grant for the development of the techniques which is currently still running.
I received a £2500 grant from the Minnesota Mining and Minerals Company for the investigation into the microbiology of surgical skin preparation – the work of which has now been completed.
I worked in collaboration with basic scientists from the Kennedy Institute, Guys Hospital and The University of Manchester on the detection of early osteoarthritis. At present I am in receipt of a personal grant of £7,500 from the International Hyaline Cartilage Project, (funded by Ciba-Geigy). This annual grant is expected to be run for three years.
A Grant of £15,000 was received from the Welsh Rugby Union for the investigation of rugby injury.
£40,000 from the Arthritis and Rheumatology council to support projects in:
1. The biochemical changes of early osteoarthritis in the patient with anterior cruciate deficiency. This is a joint application with Professor Helen Muir and Dr Michael Baliss from the Kennedy Institute.
2. The inflammatory biochemical changes of synovial fluid in early osteoarthritis.
Current Research
My continuing research is based on an investigation into the development of osteoarthritis. In this study evaluation of the hyaline cartilage and synovial fluid is being made on patients undergoing joint replacement.
I have organised a collaborative study on the quantitative evaluation of hyaline cartilage degeneration in the knee using a newly established technique.
The ongoing research is funded by both grants and by personal funding from income received from private practice.
Further prospective clinical work is in progress monitoring the results of operative and non-operative treatment of the anterior cruciate deficient knee.
vitro study.
I at present supervise the research of a post doctorate student working through the University of Wales Institute Cardiff. who is investigating muscle function in fitness and injury in the human knee.
We were the recipients of a grant from the Arthritis and Rheumatism Council which was a collaborative project investigating the development of osteoarthritis of the human knee.
Society Memberships
British Orthopaedic Sport and Trauma Association (Past President)
British Orthopaedic Research Society
British Association for Surgery of the Knee
British Orthopaedic Association
Foundation Fellow Sports and Exercise Medicine Collage
Sports Representative
Nottingham University XI
Association Football 1972 – 1973
1973 – 1974
Nottingham University XI
Cricket 1972 – 1973
1973 – 1974
Nottingham University XI 1974 – 1975
Senate cricket
Tenovus Rugby IX 1980-1985
Chairman Medical Committee of Surgeon to the Football Association of Wales
Honorary Consultant to Cardiff Rugby Football Club and Glamorgan County Cricket Club.
Medical Committee Welsh Rugby Union
