Alongside his clinical practice, Mr Kosuge remains closely involved in the training of the next generation of surgeons. A surgeon who teaches has to keep his knowledge current, articulate his reasoning clearly and hold himself to the standard he sets for others, all of which patients benefit from directly.

Faculty at the AO Trauma course in Leeds

In June, Mr Kosuge was a member of the faculty at the AO Trauma Basic Principles of Fracture Management Course in Leeds. The AO courses are internationally recognised as the foundation of orthopaedic trauma training. The Basic Principles course teaches orthopaedic trainee doctors the core principles of managing fractures. Contributing as faculty involves both classroom teaching and hands-on instruction, passing on the fundamentals that these trainees will build their careers upon.

Nominated for Trainer of the Year 2026

Mr Kosuge was also nominated for Trainer of the Year 2026 for Trauma and Orthopaedics by trainees for the East of England Deanery. The nomination reflects the value that trainee surgeons place on his teaching and mentorship within the region.

Recognition for Excellence in Educational Supervisor at The Princess Alexandra Hospital NHS Trust

Mr Kosuge’s supervises Foundation Year Doctors and his consistently high quality reports were recognised at the recent Annual Awards Event at The Princess Alexandra Hospital NHS Trust. Mr Kosuge is delighted that his dedication to training, mentoring and assessing doctors in training has been recognised.

To book an appointment with Mr Kosuge at The Rivers Hospital:

• Online booking

• Telephone: 01279 602675

Hip replacement is one of the most successful operations in modern medicine, but it should not be the first step in management of your hip osteoarthritis. Understanding this helps you make better decisions about when and whether to act. Mr Kosuge sees many patients who are unsure whether their hip pain is “bad enough” to see a specialist. Here is how to think about it.

Recognising the early signs

Hip osteoarthritis is the gradual wearing of the smooth cartilage that lines the hip joint. The early signs are often subtle. Many people feel it first as pain in the groin rather than over the outer hip. It may spread towards the front of the thigh, or even the knee. Stiffness after sitting, difficulty putting on socks or shoes, a reduced range of movement and pain that worsens with activity are all common. In the early stages the discomfort tends to come and go, which is one reason people put off seeking advice.

What is happening in the joint

As the cartilage thins, the joint moves less smoothly and the surrounding tissues become irritated. This is a slow process and its pace varies enormously from person to person. Some people remain comfortable for years with simple measures, while others progress more quickly. An X-ray confirms the diagnosis, but the decision about treatment rests on your symptoms and how much they affect your life, not on the X-ray alone.

What to try before considering surgery

For most people the first steps are non-surgical and they are worth taking seriously. Keeping active with low-impact exercise such as swimming, cycling or walking helps maintain strength and movement. Losing excess weight reduces the load through the joint. Physiotherapy can improve the muscles that support the hip. Simple pain relief used sensibly can keep you moving. A steroid injection into the hip can also provide a period of relief for some patients. None of these measures reverses the arthritis, but they can control symptoms and, for many, delay surgery for a long time.

When it is time to see a specialist

The right time to seek an opinion is not a fixed point on an X-ray. It is when the pain is disturbing your sleep, limiting the things you want to do, or no longer responding to the measures above. Seeing a specialist does not commit you to an operation. It simply gives you an accurate picture and a clear set of options, so that if the time for a hip replacement does come, it is a decision you make on good information.

Arranging an assessment

Mr Kosuge will examine your hip, review any imaging and explain the full range of options, surgical and non-surgical. To arrange a consultation at The Rivers Hospital, High Wych Road, Sawbridgeworth CM21 0HH with Mr Kosuge:

• Online booking

• Telephone: 01279 602675