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Alternate Knee Alignment Technique - Dr Kaushik Hazratwala

It is important to understand that there are multiple bony cuts that are delicately balanced with each other so that the knee moves in a balanced fashion on both sides, and the patient does not feel insecure or unstable.

I have created my own surgical technique for knee replacement that intricately predicts the ligament balance and accommodates the bony cuts to fit the ligament envelope. I call my technique the “Natural Knee Alignment”.

The traditional surgical technique cuts bone according to the paradigm that the joint needs to be parallel to the ground in order to last longer. The older instruments did not allow the surgeon to cut bones in 1 deg increments.

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However, if your native anatomy is not parallel to the ground (20% of population is not) and your surgeon positions your knee parallel to the ground, your ligament envelope will not be balanced. To balance the ligaments on the inside and the outside of the knee the surgeon will have to release or make these ligaments longer. This is the traditional teaching and it still works for 80% of patients reasonably well. Some patients report feelings of tightness and instability in a knee that has not been balanced correctly.

My “Natural Knee Alignment” technique requires detailed pre-operative templating of your knee from long leg standing x-rays and MRI scans. Since I already have a template of your natural anatomy, I can utilise the computer navigation to cut your bones according to the templated angles. With the real time feed of your knee, using Computer Navigation system and the infrared trackers, I can continuously assess the balance of your knee and the ligament envelope to 1mm accuracy. (See attached Video)

The main benefit of this technique is that the ligament envelope is preserved and the recovery time is reduced. The more the soft tissue is damaged, the longer it will take for swelling to subside and healing to occur. With this technique, the patient is allowed to walk the same day as the surgery. I have been able to reduce my hospital stay for my patients compared to the recorded National average of 5 days to my patients staying for 2 days.

If you would like to know more about the “Natural Knee Alignment” technique please contact Queensland Lower Limb  specialist Dr. Kaushik Hazratwala. Book appointment at 4727 4111 or email: and mention this post.