Balachandran-Kajima Professorship in Academic Medicine Professor Howe Tet Sen 22

Clinical Professor Howe Tet Sen

Balachandran-Kajima Professor in Academic Medicine, October 2022 – Current

Academic Vice Chair, Research, SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme

Senior Consultant, Department of Orthopaedic Surgery, Singapore General Hospital

Professor Howe Tet Sen is a highly regarded senior consultant within SGH’s Department of Orthopaedic Surgery. He has an impressive clinical career spanning four decades. Professor Howe was the first Singaporean fellowship trained Orthopaedic Sports Medicine surgeon after completing a Sports Medicine fellowship at the Cleveland Clinic. On his return however, he led the Trauma Service for 20 years as there was a greater need for his services there. Professor Howe has held many leadership roles over the years including Director of Trauma Service from 1996 – 2016, AO Singapore’s Director of Education from 1997 – 2000, Chairman of the AO Scientific Committee from 2000 – 2005 and Chairman of the Emergency Operating Committee from 2001 – 2006. He has been appointed as Chairman on numerous AO Osteosynthesis courses. As a founding member of the International Geriatric Fracture Society, he also organized the first Ortho-Geriatric AO Course in the region in 2008.

Achievements in Research

Professor Howe’s achievements in terms of research is admirable and noteworthy. He has over 150 peer-reviewed research contributions, many of which are very well-cited. More importantly, some of his work has had far-reaching consequences in actual patient management. He was among the first in the field to bring bisphosphonate-related atypical femur fractures to international attention. Today, atypical femur fractures are recognized all over the world as an adverse effect of prolonged bisphosphonate use. Subsequently, he and his colleagues have done much to further characterize this fracture and document some management principles.

Professor Howe has also done significant work on osteoporotic and geriatric fractures. He has also published extensively on a variety of orthopaedic topics including hip fractures and outcomes research, meniscal injuries, knee biomechanics, ligament laxity as well as implant and technique evaluation. Professor Howe was an early adopter in the use of computer technology in orthopaedic surgery. Since 2000, he has published articles on the use of pattern recognition and machine learning in radiological detection of fractures as well as computer navigation in fracture fixation which culminated in the patent of an algorithm for early computer detection of fractures.

Contributions to Education

Professor Howe represents a role model for a good Orthopaedic surgeon with good ethics, a sound moral compass and a belief in leading by example. He has mentored a countless number of Orthopaedic residents and is a popular teacher and mentor for medical students and residents alike. He has also received multiple awards such as the Inspirational Surgical Teacher Award (SGH) in 2010, the Best Teacher Award (SingHealth Residency Programme) in 2013 and the YLLSoM Dean’s Award for Role Model in 2014. He is still actively involved in education under YLLSoM, LKCSoM and Duke-NUS and continues to take Orthopaedic residents under his wing. From 2016 – 2021, he also mentored a PhD candidate at the NUS School of Computing, with the candidate successfully completing his PhD in 2021.

Nurturing the Next Generation of Clinician Researchers

Professor Howe has served as the Academic Vice-Chair, Research for the Musculoskeletal Sciences Academic Clinical Programme (MSKSC ACP) since its advent in June 2016. Since then, the disciplines of Orthopaedic Surgery, Plastic, Reconstructive & Aesthetic Surgery as well as Hand & Reconstructive Microsurgery have come together to identify four pillars of research excellence:

Cellular / Tissue Based Therapy
Biomechanics
Device Development
Health Services Research

"To date, we are proud of the research work that our clinicians and researchers have achieved, and the infrastructures built to facilitate our research growth. Together, the research team has achieved far more than what we could individually. For example, our researchers from the Skin Bank have founded breakthrough methods to combine a human protein called laminin with human skin cells in the laboratory to grow new skin faster. In combination with the capabilities of the Biomechanics Lab, we are strengthening our biomechanics core by being the first institute in Asia Pacific to obtain a musculoskeletal robotic simulator for research. We are also proud to have a repository of large data in the Skin Bank and Orthopaedic Diagnostic Centre where clinicians and researchers can produce high impact clinical research with collaborations from other institutes for health services research.

Even as the ACP’s research efforts are recognized regionally, there is still room for growth and development. We are cognizant that research trends must benefit our patients and be cost effective. There is a pressing need to strengthen our capabilities and explore new frontiers in the identified research pillars. We look ahead to planning for the near future where our younger clinicians will delve deeper into their own research areas of interest and eventually take over the leadership reins and shape the landscape of the research within the ACP."

Balachandran-Kajima Professorship in Academic Medicine

Clinical Professor Howe Tet Sen

Prof Ivy Ng

SingHealth GCEO