 but during the daily course, walking more than a-hundred-metre- acompañar without pain, climbing stairs and doing all other daysça activities was become increasingly painful. So we did x-rays to make up that share to what we called advanceuirase by turns are quite a great points which means the two bones were actually grinding on each other and that was a reason for pain and inability to walk. So, the only way treatment out of this was surgical treatment which is a bilateral totally replacement the patient was counseled for the surgery ahead with the one-stage bilateral totally replacement after all the necessary precautions were taken the surgery went well and she could walk immediately the next day after surgery with the help of a walker I have seen a lot of doctors before I have seen a lot of doctors before I have been to the hospital I have been to the hospital I have seen a lot of doctors before I have been next to Dr. Hind seen a lot of other doctors seen a lot of them this is what I have achieved got to know to better now the new clinical department will do more they think it will go better so these kinds of replacement surgeries are advocated in advanced stage arthritis స్ల్ధతుత్ల్స్మార్త్మాస్ల్ల్ిడ్ ప్న్రర్లానోలును క్ల్పర్బర్ండి. చనికిలుత్కాస్స్ల్రకన్. so we at Manipal Hospital can have a multi-discipline team wherein these kind of joint replacements, both primary and B2 are constantly being done with good success rate.