Osteoarthritis

of knees affects pred ominantly the senior citizen age group. Increasingly large numbers of these elderly people in our towns and cities are electing to have a total knee replacement to end their agony and lead a better quality of life. They survey the market and hope to get the best deals in terms of functional outcome, surgical and post surgical care and costs. Many a time they are dissuaded by skeptical relatives or friends to have the surgery. Since cultural, social and religious requirements of Indians are different from the West, the operation has to be tailored to the specific needs of our countrymen. In this article I shall discuss some recent advances and the implications of these on the outcome of the surgery.

The main factors that deter people from having any major operation for a non life threatening condition are fear and perceived high cost. Fear may stem from the thought of postoperative pain the risks of anesthesia, surgery itself. Specifically the fear of infection is a big bugbear. Ideally a major replacement should be done by well trained and qualified surgeons. Experience of joint replacement is gained by overseas or Indian fellowship training. Infrastructure of the hospital is vitally important. The operating theatres should provide