I had always remembered Mother as a very active, enduring woman. She pounded spices, squatted down to shred whole coconuts, climbed up and down our massive home, bustled around busy markets, and did all that was necessary to keep a household running. It was rare for her to mention that she was in pain.
So when I saw her falter at a friend’s doorstep one evening—her purse falling to the ground as she struggled for support—I realized that she was suffering badly, and mostly in silence.
Osteoarthritis—a degenerative joint disease—had eaten away my mother’s knee cartilage, hindering her mobility and altering her lifestyle in a drastic way. An X-ray report revealed immense damage to her knees; it was too late to rely on exercises, massage or alternative therapies. Doctors pushed for knee replacement surgery. We searched for other options but there were none.
It took two weeks, dozens of tests and many medications for the knee implants to be inserted into my mother’s legs. There were physiotherapists encouraging her to walk while doctors and nurses worked round the clock to keep her health stable. About a week after she was discharged from the hospital, she began to walk without support—slowly but steadily, and without the crippling pain she had endured for many months.
As per the World Health Organisation, osteoarthritis will be the fourth biggest cause of immobility in India by 2020. It is also one of the major causes of knee replacement surgeries worldwide. India sees up to 150,000 knee replacement surgeries every year, with doctors aiming for affordability and better technology in the days to come.
Dr. Pradeep Bhosale, who has performed more than 11,000 joint replacement surgeries in the past 32 years, operated on my mother in October 2017. I met him one afternoon in his brightly lit office at Nanavati Hospital in Mumbai where phones rang non-stop as patients sat outside awaiting their turn.
Highly passionate about his work, he began by telling me the story of a 39-year old female patient who was wheelchair-bound for a very long time. Rheumatoid arthritis had distorted her knee joints, which fused with her femur. “We cut the fused joint and replaced it with a very modern implant,” he said, his face breaking into a smile. The joy of seeing a patient recover and walk is immeasurable to Dr Bhosale. “My wish is for India to provide its citizens with treatment options that are as effective and advanced as those found in foreign countries,” he said.
Fear of surgeries (especially of implants) and affordability are the two major factors that discourage many suffering patients from opting for knee replacements. Raising awareness among people is as important as having skilled doctors around, he said. “There is such irrational fear around operations and implants because few are aware of technological advancements in medical science.”
Dr. Bhosale ensures his patients walk the very day that they are operated upon so as to minimize fear by maximizing their level of confidence. “Every step they take after surgery reassures them,” he said. The Indian government recently capped the prices of knee implants, bringing down the cost of knee replacement surgeries. The country is bound to see a rise in the number of such surgeries as they become more affordable, but is affordability the only answer to resolving arthritic joints?
“India hasn’t done much in terms of research. It doesn’t manufacture implants that can match the quality of those from foreign nations,” Dr Bhosale said, hoping doctors do not have to compromise on the quality of implants they use now that the government has capped the price. There is little understanding about all that goes into the success of joint replacement techniques. As Director of Arthritis and Joint Replacement Surgeries at Nanavati Hospital, Dr Bhosale has made it his mission to help people sit up and take note of how his country could be at the forefront of joint replacement techniques. “I want people from other countries too to come to India for such operations.” For this to succeed, it is essential to pour funds into research and train doctors who are passionate about their work, he says.
Dr. Bhosale’s days seem to pass in a blur with daily rounds and several surgeries every day. He was recently conferred with a fellowship in Joint Replacement by The Maharashtra University of Health Sciences. He has also shared his experiences as guest speaker at many global conferences. Has he ever felt the burden of the human condition as it unfurled before him almost every waking hour? It’s a question many interviewers have asked. Dr. Bhosale seems almost surprised with it. “It is my greatest joy to see my patients walk without pain,” he says. “It is how I practice my idea of God. It is in my work. I look for God in the work that I do.”
Mother has almost forgotten that she has man-made implants in her legs. She continues to exercise and be active to prevent weight gain. Though some patients do complain of complications arising out of surgeries (recovery depends on a multiplicity of factors), surgical knee replacement technologies have offered us a way out of needless suffering. Here’s hoping more effort is put into research, awareness campaigns and development of techniques that are as effective as they are affordable.
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