Knee pain can stop you from being active or even prevent you from doing day to day tasks. Painkillers and physiotherapy can help in many cases, but long-lasting or severe pain will sometimes need further treatment.

The Exeter Knee Reconstruction Unit (EKRU) is a team of specialist knee surgeons and health professionals. We aim to provide world class treatment for knee problems.

We are the largest knee unit in the South West, performing more than 150 ligament reconstructions, 600 knee replacements and more than 100 revision operations every year. We also act as a tertiary referral centre for the South West for complex knee problems. We also run specialist knee pain and infection clinics.

Patient Notification: Have you had a knee replacement under Professor Toms’ care in 2014 or 2015? If the answer to this question is yes, please click here.

More on what we do

We carry out knee replacement and reconstructive surgery, including ligament and cartilage restoration. We are also involved in the latest research and techniques in cartilage grafting, ligament reconstruction, management of complex lower limb trauma, post-traumatic reconstruction, primary knee replacement, computer navigated and robotic knee surgery and revision knee surgery.

We have access to a specialist physiotherapy gym and a cutting edge laboratory.


Our surgeons perform the following operations and treatments:

  • Sports surgery
  • Biologics
  • Cartilage and meniscal transplant
  • Ligament reconstruction
  • Osteotomy
  • Patellofemoral surgery
  • Partial knee replacement
  • Knee replacement
  • Revision surgery
  • Trauma and fracture surgery

Your knee replacement

  • Preparation for your knee replacement is important. We wish to make your journey as easy and as worry free as possible.
  • The sections on this website are aimed to help you prepare for surgery. If you have any further questions we would encourage you to contact your surgeon.
  • Our knee replacement programme has been designed to help you prepare for surgery, recover more quickly and help you get back to normal life and activities as soon as possible. Alongside surgery, physiotherapy and occupational therapy, the series of videos linked below are provided to guide you through your treatment and reduce your anxiety.
  • Due to current Covid-19 restrictions we are unable to deliver a ‘face-to-face’ joint school. We encourage all patients to review the information here and ask your surgeon any further questions you might have. There is a patient information leaflet available in the section below marked Patient leaflets and documents.

What is a knee replacement?

  • This surgery is performed for those with damage to their knee joint, relieving them from pain and providing better mobility. It is a major surgery and is performed under general anaesthetic, with a short inpatient stay in hospital required to recover.
  • A knee replacement is an artificial knee made from metal and plastic that replaces the existing ‘worn out’ joint.
  • You are likely to benefit from TKR if you have:
  • Severe knee pain that limits mobility and function.
  • Knee pain at rest or that disturbs your sleep.
  • Knee pain accompanied by progressive stiffness and deformity of the knee.

Your patient journey to a knee replacement

  • Consultant appointment​ - You will have been referred by your GP. The consultant will review the information and you will agree a course of action.
  • Pre-assessment​ - You will be seen by a nurse led team and anaesthetist if needed to plan your admission.
  • Admission - You will be admitted on the day of surgery at 0730 having starved from midnight.
  • Discharge​ - You will be discharged after 1-3 days when you are mobile and safe to go home.
  • Rehabilitation​ - You will  continue self-physio therapy at home or out patient if needed to continue to work on your mobility.
  • Follow up - You will be seen at 6 weeks in outpatients by a member of the team.
  • Stitches and staples​ - These will be removed and your dressing changed at 12 days, usually by your district/practice nurse. We encourage as few dressing changes as possible to reduce risk of infection.

Preparing for your knee replacement – joint school videos 

Due to covid-19 we are unable to offer a ‘face-to-face’ joint school. There is a series of videos designed to answer any questions you may in the section below marked Videos. We encourage you to contact your surgeon if you have any further questions.

Our team

We have six orthopaedic knee consultant surgeons:

  • Mr Keith Eyres (primary and revision knee arthroplasty, Osteotomy)
  • Professor Andrew Toms (primary and revision knee arthroplasty, Osteotomy)
  • Mr Vipul Mandalia (ligament reconstruction, cartilage & meniscus surgery and , Patellofemoral surgery and primary knee arthroplasty, Osteotomy)
  • Mr Jonathan Phillips (primary and revision knee arthroplasty)
  • Mr Simon Middleton (ligament reconstruction and meniscal surgery, primary arthroplasty)
  • Mr Ben Waterson (primary and revision knee arthroplasty)

They are each supported by a team of surgical care practitioners, extended scope physiotherapists, orthopaedic knee fellows, registrars and junior doctors.

There is a dedicated team of medical secretaries and clerks, as well as an experienced team of ward and theatre practitioners.

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Princess Elizabeth Orthopaedic Centre (PEOC)

There is a separate entrance and car park for orthopaedics. However if you are attending from the main entrance of the hospital, turn right onto the main corridor and you will find us right at the end, past area J. Our reception area is on level 0.

The wards where the team work are Knapp, Dyball, Robin Ling, Durbin, Bramble and the Orthopaedic Admissions Unit.

Contact us

Our medical secretaries manage all patient and professional enquiries in the first instance.

Mr Eyres’ secretary: 01392 403529

Professor Toms’ secretary: 01392 403562

Mr Mandalia’s secretary: 01392 403501

Mr Phillips’ secretary: 01392 404774

Mr Middleton’s secretary:  01392 403576

Mr Waterson’s secretary: 01392 403494

Patient leaflets and documents

Community services

We provide surgical and nursing care for patients of the PEOC in our community hospitals.


We have outpatient clinics running most days in the Outpatient Department of PEOC.

We also run a Virtual Knee Clinic which allows for some patients to have their X-rays at a department nearer their home and for their routine follow up care to be carried out without needing to come to the hospital. This is not available for all patients following surgery but we will invite patients that are suitable.


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