One surgeon did 10 hip and knee replacements in a day at King George Hospital on 22 October, for patients who had waited up to 45 weeks. How HULK-10 worked.
A surgical team at King George Hospital carried out ten joint replacements in a single day last week, working across two operating theatres with one lead surgeon, to treat patients who had waited up to 45 weeks for a new hip or knee.
The hospital is run by Barking, Havering and Redbridge University Hospitals NHS Trust, the trust for the London boroughs on Brentwood’s western border. For anyone in Brentwood, Shenfield or Hutton waiting on a joint replacement, it is a look at how one neighbouring hospital is trying to shorten the queue.
The trust called the day HULK-10: hip, unicompartmental (partial) and knee, plus the number of operations. On Thursday 22 October the team completed:
- five hip replacements
- four knee replacements
- one partial knee replacement
All ten were led by orthopaedic surgeon Shivakumar Shankar, who moved between the two theatres all day, with an assistant surgeon in each. The operations took place in the trust’s Elective Surgical Hub at King George Hospital.
How one surgeon did ten
The method was about overlap, not speed in the operation itself. Mr Shankar said:
“We’ve not done anything like this before, I’m not sure if anyone has. Efficiency was key.
“When I was three quarters through one operation, our anaesthetists would begin preparing the next patient. I would finish the current joint replacement, then my assisting surgeon would close the wound while I moved to the theatre next door to start another procedure. We have lots of patients waiting and I wanted us to push ourselves to safely maximise the work we could do in one day. I’m immensely grateful to everyone involved, it was a true multidisciplinary achievement.”
Mr Shankar has been at the trust for ten years and did some of his training there in 2012. He said the planning mattered more than anything on the day:
“I’m really happy with how it went. The planning was hugely important to ensure everything could be executed. I’ve been operating for many years now, but I still had butterflies hoping everything would go to plan.
“Our aim is never to rush surgery, but to eliminate avoidable delays and maximise efficiency while providing high quality, safe, care to every patient. I went to check on them afterwards, they were recovering well and it was nice to see happy, smiley faces. Now they’ve had their operations they can regain mobility and get on with their lives.”
Why this one is different
The trust has run blitz weeks before. Its Bones R Us week in June 2021 put 60 patients through orthopaedic surgery in five days, as part of its recovery from the pandemic backlog. The trust says those earlier pushes focused on high volume, low complexity operations. HULK-10 also took on patients who needed more complex procedures, and who had often waited longest.
14 knee ligament operations the week before
Just before HULK-10, the surgical hub ran an ACL (anterior cruciate ligament) week and completed 14 knee ligament operations in six days. Roxy Dinka, the trust’s Patient Pathway Manager, said:
“In an average week we’d usually do just one or two of these, so it took six weeks of planning to ensure we could treat this many patients. One had waited 48 weeks, so we really wanted to prioritise getting them, and others who’d had long waits, treated. When one operation overran, we added an additional twilight session to ensure no one was cancelled.
“Most of the patients were able to go home on the same day. This will make a real difference to their lives.”
At a glance
| HULK-10 | ACL week | |
|---|---|---|
| When | Thursday 22 October 2026 | The week before |
| Operations | 10 (5 hip, 4 knee, 1 partial knee) | 14 knee ligament repairs |
| Time taken | One day, two theatres | Six days |
| Longest wait treated | Up to 45 weeks | 48 weeks |
Source: Barking, Havering and Redbridge University Hospitals NHS Trust. More from the trust at bhrhospitals.nhs.uk.
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