NOT every medical story in Marbella begins under the Mediterranean sun.

Mine began thousands of kilometres away in Paraguay, where resources were often limited, but discipline, ambition and the conviction that excellence is earned rather than inherited, were abundant.

I understood early that to become a leading surgeon, I would need to travel abroad, challenge myself continuously and learn from those shaping modern orthopaedic surgery at the highest level.

That cross-borders journey defined me. And it continues to shape the way I practise medicine today.

AN INTERNATIONAL CAREER BUILT STEP BY STEP

Although my postgraduate medical journey began in Italy, it was in Spain and the UK where the foundations were truly shaped.

Italy gave me my surgical base – the place where I first entered an operating theatre as a young surgeon determined to understand every principle, responsibility and detail necessary.

Spain later became my professional home, where I developed both as a surgeon and as a physician, discovering the key values of rigour, humanity and a willingness to innovate whenever it can benefit a patient.

Then came England, where my training reached another level.

Working in some of Europe’s leading orthopaedic centres, I had the opportunity to learn from internationally-known surgeons in hip and knee reconstruction, pioneers whose influence continues to shape every decision I make – from surgical planning to execution and recovery.

Today, after years of training and experience across different healthcare systems, I practise on the Costa del Sol in Marbella and Estepona, as well  as nearby Gibraltar… and in each hospital with a simple objective: to bring the standards I learned abroad over here.

MY PHILOSOPHY: OPERATE ONLY WHEN NECESSARY — BUT, WHEN NECESSARY, PURSUE EXCELLENCE

Many patients arrive at my consultation having already been told that surgery is ‘inevitable’.

Often, it isn’t. And my first responsibility is honesty.

But when surgery genuinely becomes the right option, then every detail matters: the surgical technique, the implant and the overall strategy surrounding recovery.

Because surgery should not simply be performed. It should be performed exceptionally well.

ADVANCED HIP REPLACEMENT: A MUSCLE-SPARING APPROACH

Hip replacement surgery has evolved dramatically over the last decade, yet many techniques still rely on approaches that unnecessarily disrupt muscles and surrounding tissues.

For selected patients, my practice focuses on an anterior-based, muscle-sparing philosophy designed to preserve anatomy and accelerate recovery.

This includes:

• Muscle-preserving techniques that minimise tissue disruption

• An anterior-based approach designed to improve stability and reduce postoperative discomfort

• Modern implant technology including dual mobility systems and ceramic bearings for durability and lower dislocation risk

• Personalised planning based on joint mechanics, pelvic tilt, and functional anatomy

The difference is often evident immediately.

Patients frequently begin walking within hours of surgery, return home within days, and recover confidence and mobility far sooner than many expect.

ADVANCED KNEE REPLACEMENT: MOVING AWAY FROM ‘ONE-SIZE-FITS-ALL’

The knee is not a simple hinge.

It is a highly complex and asymmetric joint, yet many traditional techniques still rely on standardised alignment methods that ignore natural individual variation.

My approach focuses on restoring anatomy rather than forcing patients into generic templates.

This includes:

• Soft-tissue-friendly techniques designed to preserve muscles and ligaments

• Kinematic alignment tailored to each patient’s natural anatomy

• Personalised instrumentation and advanced implant materials

• Enhanced recovery protocols developed through international experience and adapted to modern practice in Spain

The objective is simple: to create a knee that feels natural, balanced and functional.

PARTIAL KNEE REPLACEMENT: WHEN LESS SURGERY IS BETTER SURGERY

One of the most common misconceptions I encounter is the belief that every patient with advanced knee osteoarthritis automatically requires a total knee replacement.

Many do not. In a large number of patients, osteoarthritis affects only one compartment of the knee while the remaining cartilage, ligaments and healthy structures remain preserved. 

Yet many patients still undergo total knee replacement when a more conservative and anatomical solution may be possible.

For carefully selected patients, Partial Knee Replacement can offer important advantages:

• Preservation of healthy bone, cartilage, and ligaments

• Smaller surgical exposure and less tissue disruption

• Faster recovery and earlier return to daily activities

• Less postoperative pain and fewer complications

• A more natural-feeling knee

• No specific restrictions regarding returning to sports and physical activity after recovery

The objetive is simple: replace only what is damaged and preserve everything that is healthy.

Because sometimes the best surgery is not doing more.

It is doing exactly what the patient needs — and nothing beyond that.

RECOVERY DESIGNED FOR LIFE IN THE COSTA DEL SOL

Surgery itself is only one part of the process. Recovery is equally important.

My enhanced recovery model prioritises early movement and rapid return to daily life:

• Walking within hours of surgery

• Returning home within one to two days

• Returning sooner to golf, padel, cycling, yoga, beach walks or simply enjoying life under the Spanish sun

People choose the Costa del Sol because of the lifestyle it offers. My role is to help them regain it safely and effectively.

WHY I CHOSE THE COSTA DEL SOL

After years working across Europe, I could have practised in many different places, also including Denmark and Italy.

I chose Marbella for a simple reason: many people living here are far from home and often uncertain about who to trust when facing important healthcare decisions.

I did not come here to follow the model of mass-market medicine. I came to offer an alternative — one built on discipline, evidence, precision and integrity.

Marbella is now my home and its locals are my community.

Yet my commitment remains simple: to bring international standards in hip and knee surgery to the Costa del Sol with honesty, excellence and a genuinely patient-centred approach.

Dr Fabian Poletti is a UK fellowship-trained Consultant Orthopaedic and Trauma Surgeon, FRCS (Eng), FEBOT, MSc (Imperial), DIC.

He held senior clinical posts at the UK’s NHS and is listed on the GMC Specialist Register.

He later served as Chief Physician in Denmark and has extensive experience across both the Spanish public and private healthcare systems.

He currently practises in Marbella, Estepona and Gibraltar.

Further information is available at www.drpoletti.com/en, with consultations in Marbella, Estepona and Gibraltar.

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