Knee surgeons from different parts of the country attending the Arthroplasty Arthroscopy Summit 2016, hosted by Apollo Hospitals in Hyderabad, discussed the need for documenting Indian knee sizes and methods to "Make in India" for knee implants.

Leading knee surgeons from across the country highlighted the problem that is frequently plaguing knee replacement surgeries in India. Most of the knee implants used for surgery are imported and are based on the sizes of American and European patients. These implants are a misfit for Indian patients and don't facilitate their regular activities like squatting for pooja or kneeling for namaaz. Thereby causing enormous distress for Indian patients. The cost of these imported implants are very high, adding to the woes of the Indian patient.

The current think tank consisting of Dr Mithin Aachi, senior Ortho & joint replacement surgeon, Apollo Hospitals, Secunderabad; Dr L Prakash, director & CEO, Institute for Special Orthopaedics, Chennai; Dr Vijay Sharma, HoD, Ortho & joint replacement, Narayana Multispecialty Hospital, Jaipur; Dr S Patil, Mumbai; Dr Anandakrishnan, Tirupur and Dr Simon Thomas, Delhi, deliberated on the problems and have embarked on a one year project for size standardization and identifying methods for producing high quality affordable implants, as part of the "Made in India" initiative. The number of centres will be expand and more centers added to participate in the study, including the government hospitals which have high load of patients and can give valuable inputs.

Over the next 12 months the team aims to screen more than 1.5 lakh patients in a multicentre trial throughout the country both radiologically and anthropologically to arrive at the ideal Indian size requirements. The data would be fed into a special software in collaboration with DRDO and IIT for further research.

Dr Mithin Aachi says, Indian knee morphology is totally different from European or American, they never sit down or squat, while we do, therefore our knees are flat and need customised implants of different sizes to fit different patients. Our study will indicate if knee sizes of North Indians is different from South Indians and such other variations. The currently available imported implants are in 5 to 6 sizes, often they fit on one side and not on the other for our patients. Through the study we will know the variation in knee sizes and intend to produce 30 to 35 sizes, which could fit for most Indians. We are confident of coming out with matching quality knee implants at a fraction of the cost of imported ones. There is no commercial intent in this initiative, but purely a social responsibility to reach out to more needy Indians patients. We already have data from 60000 patients and made an initial prototype, Dr Aachi added.

Dr Mithin Aachi announced that based on the research a new high quality but affordable knee would be developed which would help the patients suffering from this disease. He also stated that with Prime Minister's push for Make In India he was confident of many companies to come forward and help in building this implant so that patients will be benefited in the long run. He expects this knee production to be functional in the next two years.

Dr L Prakash further added, that we are already in the process of perfecting the prototype based on the teams vast experience and are confident that the standardised knee will be available in a year after the research ends after appropriate certification.

Currently 95% of our needs are met by imported implants from US, Germany, England, Turkey, Brazil and even China, when they can do, why can't India, says Dr Prakash. Indians have high rate of knee arthritis, almost 6 times of those in UK and 8 times of those in US, while the number of knee replacements done here is not even 1% of what is done in UK. We are doing 7 lakh knee replacements per annum, while 7 crore Indians are in need of it. The reason for most enduring the pain is the prohibitive cost of knee replacements, its beyond the reach of most Indians. Our knee implant will cost only a fraction of the imported ones, he adds.

The conference concluded with video lectures and training of the young surgeons by the faculty.