 Dr. Vinayak Dhanate, Consultant and Orthopedic Surgeon in Manipal Hospital, Mahadev. I look after the patient's joints and bones. So today we'll talk about arthritis in patients' knees. So arthritis is a very common condition and millions of patients in India suffer from knee arthritis. And the successful operation which is performed very routinely in India is knee replacement surgeries. Knee replacement is so successful that millions and millions of patients worldwide have undergone this surgery and technology advancement has made this implant last longer than ever. So let's first talk about arthritis in the knee. What is arthritis in the knee? So knee joint, if you see here at the model, it is covered with a glistening white structure what we call cartilage. There is also a layer of cushion in the knee what we call the meniscus. So when this cartilage gets damaged either because of the injury or because of the age related process, this cartilage starts bearing out. If you concentrate on the model number two here, you can see there is some early degenerative changes in the knee joint here. So these changes when they progress, they expose the raw bone underneath. And when this raw bone comes in contact with each other, the patients start getting lot of pain in their knee. This pain can give pain around their knee joint, they wake up there, disturb the sleep in the nighttime, patients get intense spasm back side of their knee and it also affects their daily routine activities and walking distance. Patients usually take support of the painkiller medications. But eventually when the arthritis progresses, these painkiller medications stops working. So when the arthritis becomes grade four and when it is a bone and bone arthritis if you concentrate here on the model number three, the cartilage is completely worn out and the bone is in complete contact with each other. That is the point when people should consider a replacement. So what are the symptoms that somebody should look for when they want to think about replacement and getting an expert opinion about it. So when the pain is severe enough to not respond the painkiller medications, it is disturbing patients daily sleep and it is affecting their walking distance and restricting it to less than one kilometer. And they require some kind of support or sitting while walking because of the pain. So that's when somebody should consider a knee replacement surgery. So what is a knee replacement surgery? What we do is we take out the worn out portion to the joint and replace it with an artificial joint. If you see at the model here, the top portion is replaced with a metallic bit. The bottom portion has two parts. One is a metallic bit which replaces the worn out portion of the bone and then there is a plastic insert which acts as a cushion replacing the natural meniscus and that gives a smooth gliding movement in the knee joint. So knee replacement is one of the most successful surgeries. More than 97% patients are successful after the surgery. With the technological advancement, these processes are lasting as long as 25 to 30 years and patients who are nearing their 60s undergo this surgery. They may not require another surgery later on in their life. So knee replacement is a kind of surgery which is performed in old age. So one should not fear that they are older, they have blood pressure, diabetes and it is going to affect their surgical outcome. It is operation meant to be performed in old age and they are very successful. After the surgery, one can be independent and do all their activities on their own. They can walk long distances. The only restriction that one should keep in mind after the knee replacement is not to squat too much in using Indian toilets and avoid seating cross-legged on the floor. So if you are suffering from knee pain, which is not responding to painkillers, we have the latest advancement at Mudipal Hospital Baden and we will look after your knees and perform successful operations. Thank you.