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Tim Theologis


Consultant Orthopaedic Surgeon

  • Honorary Senior Clinical Lecturer

Mr Tim Theologis has been a Consultant Orthopaedic Surgeon in Oxford since 1996 and a Honorary Senior Clinical Lecturer at the University of Oxford since 1999. His clinical and research work focuses on children with cerebral palsy and neuromuscular disorders. He maintains a strong clinical and research link with the Oxford Gait Laboratory at the Nuffield Orthopaedic Centre. He is Treasurer of the British Society for Children's Orthopaedic Surgery, Emeritus Editor of Gait and Posture and Clinical Lead for Paediatric Orthopaedics and the Gait Laboratory at Oxford.

Previous research has led to the development of the Oxford Foot Model, a biomechanical model for the study of foot motion during walking. This has been adopted internationally by researchers, clinicians and the motion analysis industry as the standard tool for analysis of foot motion in children and adults. The development of the Oxford Foot and Ankle Children's Questionnaire, a validated measure of foot-related disability, was also an important milestone in the understanding of paediatric foot conditions and their impact on lifestyle.

The 'keyhole' or 'minimally-invasive' technique in performing both bony and soft tissue procedures as part of multi-level surgery in children with cerebral palsy has been developed through research at the Oxford Gait Laboratory. It involves surgical techniques which are used in other conditions in children but have not previously been used in the context of surgery in cerebral palsy. It causes less trauma and scarring to the muscles and is quicker to perform compared to open, conventional techniques. Children are able to mobilise immediately following surgery and improvements in walking ability have been shown to be at least as good as with conventional multi-level surgery.

Current work in collaboration with Colleagues at NDORMS includes the development of a nationwide cohort of cerebral palsy patients to determine the case mix, risk factors, and variations in surgical interventions and to explore the outcomes of the surgery. Findings will be used to identify further areas of study in this population and also lead to longer term outcomes being assessed. This will be developed in collaboration with the BOSS (British Orthopaedic Surveillance Study, an NIHR funded project) who already have a cohort database established for other paediatric orthopaedic conditions with similar throughput in number of cases operated per annum. Overall, this work will provide the evidence base for best surgical practice in this challenging and under-researched area.

Alongside this, a specific outcome measure for gait-improving surgery in cerebral palsy will be developed with the support of local and national patient/parent groups. This will be patient focused and not reliant on clinical assessment. Qualitative colleagues from the Department of Primary Care will be involved in this aspect of the project. Interviews conducted will contribute to the development of an outcome measure and will also support the development of a Cerebral Palsy public portal via Healthtalk-online. Currently, on-line resources like this are lacking for this population. The qualitative approach is expected to reveal the patient-dependent parameters that affect the outcome of this treatment. This approach should also confirm which clinical outcome measures capture the results that are important to the patients and their families.

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