Knee Arthroplasty Specialist Surgeon Singapore 

Kinematic Alignment and Robotic-Assisted Knee Replacement Reconstruction

We manage total knee arthroplasty as a high-precision balancing of soft tissues and mechanical alignment. Under the clinical direction of Dr. Saminathan Suresh Nathan, our practice utilizes thirty years of personal reconstructive experience to move beyond generic "mechanical" alignment toward personalized knee replacement restoration. By integrating robotic-assisted navigation and 3D-planned cementless designs, we focus on replicating the natural joint movement to ensure long-term implant survival and functional stability.

Our Origins: The Knee Replacement Trainers of the Region

Long before the current trends in robotic surgery emerged, we were established Arthroplasty Surgeons and International Trainers. We spent decades conducting workshops across the Asia-Pacific region, teaching the fundamental principles of knee replacement alignment and soft-tissue balancing to the very surgeons now practicing as consultants. Our transition into Musculoskeletal Oncology was an evolution: mastering the reconstruction of massive bone defects gave us a unique perspective on how to perform a knee replacement that preserves the native integrity of the joint.

The Philosophy: Resurfacing, Not Just Knee Replacement

In many high-volume clinics, a Total Knee Replacement (TKR) is the default solution for knee pain. This approach often sacrifices healthy bone and crucial ligaments (the ACL and PCL) for the sake of surgical speed. We take a different approach. Whenever possible, we advocate for Unicompartmental (Partial) Knee Replacement (UKR).

• Ligament Preservation: We preserve the anterior and posterior cruciate ligaments, maintaining the natural stability of the knee replacement.

• Bone Sparing: We only resurface the damaged compartment, leaving the healthy bone untouched.

• The Result: Because the patient’s own ligaments guide the movement, a partial knee replacement feels more natural and allows for higher-level function than a total replacement.

Makoplasty & Robotic Precision: The Tool, Not the Surgeon

We utilize Makoplasty (Robotic-Arm Assisted Technology) for robotic knee replacement, but we understand that a robot is only as good as the surgeon guiding it.

• Dynamic Balancing: The robot allows us to balance the tension in the ligaments before a single bone cut is made. This is the "art" of knee replacement surgery that we have taught for years.

• Sub-Millimeter Accuracy: We place knee replacement implants within 0.5mm of the pre-operative plan. This precision reduces wear and is critical for the longevity of the joint.

Why an Orthopaedic Oncologist is the Best Knee Replacement Surgeon

There is a misconception that complex surgeons should only handle complex cases. The reality is that the surgeon who routinely reconstructs massive distal femoral tumors is the most qualified to perform a standard knee replacement.

1. Anatomical Respect: We apply "micro-precision" to protecting your neurovascular structures during routine knee replacement surgery.

2. Fixation Expertise: We understand bone biology at a cellular level. We utilize the same rigorous fixation techniques used in limb salvage to ensure your knee replacement integrates fully and lasts a lifetime.

Surgical Considerations for Optimal Outcomes

Knee Replacement in the Asian Patient

Knee replacement surgery is one of the most effective orthopaedic interventions in providing painless functional range of motion. The standards of knee replacement have largely been dictated by Western research that generally predicts a specific body type.

Modern day Asian surgeons realize that Asian patients are quite different. There is a tendency for increased femoral and tibial bowing, which results in unusual strains on knee replacement implants designed for Western individuals. Furthermore, Asian patients tend to have a greater requirement for deep flexion for squatting.

Revision Arthroplasty: Complex Knee Replacement

Unlike primary knee replacements, the experience required for revision knee replacement is not common. The implants used may not be compatible with newer designs and need to be revamped. Bone loss can result in the need for bone transplants in addition to specialised knee replacement implants.

The Bottom Line

You can choose a surgeon who only knows how to do a standard knee replacement. Or, you can choose the surgeon who spent decades teaching others how to do them—and then moved on to master the cases they couldn't handle.

Establishing Authority: The Knee Reconstruction Hub

We have synthesized the technical data from our clinical archives at kneesurgery.limbsalvagesurgery.com into these four critical patient resources:

1. High-Mobility Standards: Beyond 120 Degrees Western literature often accepts 120 degrees of flexion as a "success." For the Asian patient, this is a failure. We utilize specialized High-Mobility designs and precise soft-tissue balancing to achieve the deep flexion required for squatting, floor-sitting, and active lifestyles.

2. Anatomical Calibration for Asian Bowing Standard knee alignment protocols often ignore the significant femoral and tibial bowing common in Asian anatomy. We adjust the surgical axis to account for these curvatures, preventing the "edge-loading" and premature wear that lead to early implant failure.

3. The "Over-Engineered" Primary Knee Drawing from our expertise in oncological limb salvage, we treat every primary knee replacement with the structural foresight of a reconstruction expert. By optimizing the mechanical axis and utilizing superior bearing surfaces (Ceramic-on-Polyethylene), we focus on a joint that is built for 20+ years of stability.

4. Complex Revision & Massive Bone Loss We manage cases that standard orthopaedic practices cannot. Whether dealing with failed previous replacements, infection, or catastrophic bone loss, we utilize revision megaprostheses and structural augments to restore limb function and avoid the necessity of amputation.

Clinical Archives & Deep-Dives

For patients seeking technical data or alternatives to surgery, we maintain our full clinical library:

• Technical Archive: Knee Surgery Specialist Portal 🔗

• The Goal: Reproducing a Normal Joint 🔗

• Alternatives: nStride (APS) & Biologics 🔗

• Complex Cases: Revision Knee Arthroplasty 🔗

• Material Science: Metal Allergy & Implant Choice 🔗

• Patient Guide: Squatting After Knee Replacement 🔗

The Standard of Care: A Legacy of Excellence

The clinical protocols and surgical techniques utilized at our practice are the result of over 25 years of pioneering work in Arthroplasty and Limb Salvage. Having served as an International Trainer and Chairman of the Clinical Competency Committee, we have mentored the current generation of surgeons on the very principles of precision and soft-tissue balancing that we apply to your care today.

When you choose our practice for your joint replacement or reconstruction, you are choosing a team that has not only mastered these procedures but has spent decades teaching them to the global orthopaedic community.

Learn more about our Pioneering History & Academic Distinctions.

Frequently Asked Questions (Knee AEO)