Hillcrest Rockhampton Private Hospital
Part of Ramsay Health Care

Hillcrest Rockhampton Private Hospital specialist James Roche

Dr James Roche

BSc MBBS (Hons) FRCS (Tr&Orth) FRACS (Ortho)

Dr James Roche graduated from Imperial College School of Medicine, London in 1999 with distinction in Medicine and Surgery, winning the Norman Lake prize for the highest mark in Surgery. His subsequent Orthopaedic training was at Nottingham University Hospital – a world-renowned centre for Orthopaedic Trauma. He was admitted to Royal College of Surgeons of England in 2008.

Dr Roche spent a year working as Arthroplasty fellow in Perth gaining experience in complex joint replacement before returning to the UK. He completed a second fellowship specialising in Revision Hip and Knee Replacement.

In 2012, he was appointed as a Consultant Orthopaedic Surgeon at the Forth Valley Royal Hospital with a specialist interest in hip and knee surgery. During this time he was instrumental in transforming the care for hip fractures into one of the leading units in the country

Dr Roche moved directly to Rockhampton with his young family in early 2016 and in 2017 was admitted as a Fellow of the Royal Australasian College of Surgeons. Dr Roche performs a large number of hip and knee replacements per year. He uses various fixation methods and different bearing surfaces in hip surgery depending on patientsactivity requirements. He uses a minimally invasive Direct Superior Approach for hip replacements to minimise post-operative pain and maximise function.

Dr Roche has pioneered the use of Robotic Surgery in Central Queensland. Over 2 years ago Dr Roche recognised the benefits that could be brought to the population of Rockhampton and since then has worked hard to bring this technology to CQ.   As such he was very excited to be the first to use this technology in early September 2020.  This is the 44th Stryker Mako robot in Australia and the first to be available outside a major city. No longer is there any need for patients to travel to Brisbane to get the latest technology in joint replacement surgery.

Dr Roche has a strong partnership with Stryker, having used their implants extensively for nearly 5 years. He regularly teaches other specialists advanced techniques on their courses.  The Mako robot is a logical extension of this partnership. Surgery using the robotic system is not appreciably quicker but benefits include:


This ensures surgery can be planned to place the implants to within 0.5mm and 0.5 degrees with 6 degrees of freedom.

It also allows maximum bone preservation in case future surgery is required


This allows the plan to be adjusted intraoperatively depending on the tension or laxity in a patient’s ligaments. This has been shown to allow less soft tissue releases, less pain and quicker rehabilitation and better functional scores.


The robotic arm presents the saw or burr to the bone extremely precisely. This leads to better alignment and leads to more accurate implantation of the prosthesis. Whilst this is hoped to show improved longevity of hip and knee replacements it has already been shown with unicompartmental knee replacements with the Stryker Mako Partial Knee having an extremely low revision rate in the Australian Joint registry.

Dr Roche is using this technology exclusively at Ramsay Hillcrest Hospital Rockhampton and will be performing robotic surgery for all joints replacements including:

  • Total knee replacements
  • Unicompartmental knee replacements
  • Total hip replacements

He is the only surgeon in the region able to combine robotic surgery for hip replacement surgery with the minimally invasive and muscle sparing Direct Superior Approach to give his patients the very best functional outcome from this surgery.

This technology is currently available with no additional charge as Dr Roche continues to charge for all surgery on a known-gap basis. He will be delighted to discuss the benefits of robotic surgery in more detail at your consultation.

Dr Roche has published on numerous topics surrounding hip arthroplasty and his seminal article in the British Medical Journal on hip fracture surgery has been cited by over 1000 subsequent scientific papers.  He has had work presented at the British Orthopaedic Association and American Academy of Orthopaedic Surgeons.

Dr Roche has a general Orthopaedic practice including:

  • Robotic Assisted Primary Hip and Knee Replacement
  • Revision Hip and Knee Replacement
  • Arthroscopic knee surgery including ACL reconstruction.
  • Foot and ankle surgery 
  • Carpal tunnel and hand surgery
  • Broad trauma practice

Dr Roche participates in "Known Gap" Billing with all major providers. He is willing to accept after hours and trauma referrals, please refer where possible via Medical Objects to "CQ Orthopaedics"

Dr Roche visits the Gladstone Specialist Centre and Emerald Specialist Clinic on a regular basis. Appointments can be made by contacting Dr Roche's medical practice.

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