 Ms. Maryam Matau, a 56 year old teacher from Tanzania, met me around 3 weeks back at my outpatient clinic with increasing complaints of both knee pain for the past 6 years. The pain initially started in the right knee and then progressed to involve the left knee a couple of years later. At first she had difficulty only in doing activities like climbing stairs and walking long distances but later it involved to such an extent and progress that she found it difficult to even stand and do her teaching job for long times without pain. So doctors back home had advised her that she needed knee surgery and that's why she came over here. When I came to Manipur hospital I met Dr. Sunur Kin who investigated after a long discussion and after the review of the x-ray which they took he clearly advised me the proper medication that was a major operation for knee replacement. So I did x-rays to find out that she had what we call as advanced arthritis of both the knees. This was largely arthritis due to wear and tear and this has progressed to such an extent what we call as grade 4 or bone on bone appearance. So I advised her that the only treatment at this stage to give her pain-free mobility would be what we call as a total knee replacement surgery and these are surgeries which work very well and give extreme satisfaction to the patient and with the modern day joints that we have bearings we have they usually last easily more than a couple of decades. I agreed out of my own conscience and I underwent that operation it was very painful but with the assistance of my doctors the nurses physiotherapists I made it. The surgery went well that's a post-op x-rays which shows the satisfactory alignment and component positioning. Patient walked immediately the next day after surgery with the help of a walker and after three weeks she was doing extremely well and the physiotherapy is going on. I have a very good physiotherapist, Auma who works with me hand in hand, there is hope once again that since within this very short time I've managed to start walking then I believe in a couple of months I'll be back in my normal walking and without pain as I used to be. Knee replacements are usually advocated for advanced arthritis or grade 4 arthritis what we call for due to any cause and they give good satisfaction rates and outcomes and last for more than a couple of decades. So we at Manipal Hospital routinely carry out these kind of primary and revision joint replacement surgeries.