Associate Director, Centre for Orthopaedics, BLK-Max Super Speciality Hospital, New Delhi
Part 10 of 11 in Diagnosis and Management of Arthritis in Joints
Joint Replacement Case Studies: Patients Who Travelled From Africa for Surgery
September 6, 2026
Dr. Mannu Bhatia illustrated his Jivo Masterclass session with real patients he has treated, several of whom travelled from across Africa for surgery in India.
A knee replacement, and dancing within days
A woman from Cameroon, around 75 years old, arrived with an X-ray showing severely narrowed joint space and curved bones. Dr. Bhatia performed a total knee replacement. Around eight to nine days after surgery, before her stitches had even been removed, she was shown dancing. A month later, while doing physiotherapy in India, she sent Dr. Bhatia a video of herself exercising on the ground.
Bilateral hip replacement after steroid-related joint damage
A gentleman from Ethiopia, a scientist in his mid-thirties, had taken high doses of steroids for a chest condition during the COVID-19 pandemic and developed bilateral hip osteoarthritis as a result, leaving him wheelchair-bound and unable to walk. Dr. Bhatia operated on both hips. Around twelve days after surgery he was rehabilitating, and a month after surgery he was walking, and in Dr. Bhatia's account, whistling and singing.
Restoring a fused elbow
A young woman from Gambia, who also had a background of anaemia, came to Dr. Bhatia with an elbow she could not move at all. Her joint was ankylosed, or fused solid, and part of the bone was missing on imaging, making it an unusually difficult case. Before surgery she could not use the limb; afterward, in Dr. Bhatia's description, she could use it fully and normally.
A second chance after a failed elbow surgery
A 34-year-old man from Cameroon had an elbow fracture operated on six or seven times already, in Yaounde and Douala, without success. He then had surgery in Mumbai, where a bone-cutting procedure fused the elbow, leaving him with a short and completely stiff hand. Dr. Bhatia operated on him a second time, replacing the elbow rather than fusing it, restoring movement to the joint.
Reconstructing a hip after a failed spine surgery
A patient whose spine surgery in Yemen had failed twice was left wheelchair-bound with severely weakened, osteoporotic bone. Her family asked Dr. Bhatia to help her walk again despite the bone deficiency he saw on imaging. He performed a more extensive hip replacement to accommodate the bone loss; she is now walking, though no video exists of her recovery due to the family's religious observance.
In October, Dr. Bhatia travelled to Cameroon on a personal visit and met several of these patients and their families in person, describing it as one of the more meaningful parts of his practice.
This article is based on a Jivo Masterclass session conducted by Dr. Mannu Bhatia, Associate Director, Centre for Orthopaedics, BLK-Max Super Speciality Hospital, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Mannu Bhatia taught doctors across Africa on February 2, 2025.
FROM THE LIVE Q&A
Moderator
Is it possible to do a bilateral hip replacement in a patient with a slipped hip joint?
Dr. Mannu Bhatia
Bilateral hip replacement can always be done, either in the same sitting or with a gap between the two sides, depending on the patient's condition. If the body can tolerate it, both sides can be done together. If the body, or the finances, don't allow that, there can be a gap in between, but rehabilitation and the expected result need to be planned accordingly.
Frequently Asked Questions
What is the best NSAID to use for osteoarthritis?▼
I would not advise continuous use of NSAIDs, since they can have a harmful effect on the kidneys over time. Short-term use for pain relief is fine.
How affordable are these surgeries at your facility?▼
They are very affordable in India, around half the cost of the same surgery in Nigeria, and much less than the cost in Europe or the US, with better results.
What is the definitive treatment for osteoarthritis?▼
The definitive treatment is that the patient should be visiting the doctor regularly. If the condition is detected and treated at an early stage, that is the definitive treatment. A patient who ignores an ACL injury, skips the recommended MRI, skips the recommended surgery and skips the medicines is the one who progresses to osteoarthritis and eventually needs a knee replacement. Patients with a problem in one knee who don't get it treated often go on to develop the same problem in the other knee, then the hips, then the spine. The definitive treatment is listening to the doctor and following through, whether that means physiotherapy or treatment for rheumatoid arthritis.
I have a patient with intermittent elbow pain, treated with oral and topical NSAIDs followed by PRP injections. What is the outcome of PRP for this patient in Ethiopia?▼
I am not a strong advocate for PRP. Once the joint surface and the cartilage are already gone, PRP cannot regenerate them, so I don't believe it delivers a real result. I would want to see the patient's X-rays, and an MRI if needed, before deciding what should actually be done.
What are the absolute contraindications for joint replacement?▼
As surgical techniques progress, more countries are attempting these surgeries, but two things need to be in place regardless: a genuinely sterile operating theatre, and excellent post-operative facilities, since that is what actually gets the patient the benefit of the surgery. There are no absolute contraindications beyond the patient having a poor overall medical condition, for example a cardiac condition that would make operating on them risky.
What kind of patients has Dr. Bhatia treated from Africa?▼
Cases have ranged from advanced knee and hip osteoarthritis to a fused, immobile elbow and a failed prior spine surgery, involving patients from Cameroon, Ethiopia, Gambia and elsewhere.
How quickly can patients recover after joint replacement, based on these cases?▼
In the cases Dr. Bhatia presented, patients were shown dancing within eight to nine days of a knee replacement and walking within a month of a bilateral hip replacement, though recovery speed varies by patient and procedure.
In This Series: Diagnosis and Management of Arthritis in Joints
- 1.Diagnosis and Management of Arthritis in Joints
- 2.What Is Arthritis? Understanding Its Main Types and Causes
- 3.Who Is at Risk of Osteoarthritis: Age, Weight, Occupation and Injury
- 4.Recognising Joint Arthritis: Pain, Swelling, Crepitus and Instability
- 5.Diagnosing Joint Arthritis: Why X-Rays Come Before an MRI
- 6.Non-Surgical Management of Arthritis: Weight, Physiotherapy and Mobility Aids
- 7.Medicines and Joint Injections for Arthritis: What Works and What Doesn't
- 8.When Arthritis Needs Surgery: Hip, Knee, Shoulder and Elbow Replacement
- 9.Recovery After Joint Replacement: Rehabilitation and Activity Limits
- 10.Joint Replacement Case Studies: Patients Who Travelled From Africa for Surgery
- 11.The Cost of Joint Replacement Surgery in India for International Patients