Charu Bhatia, Senior News Editor, Business Remedies, in conversation with Dr. Ramnivas Swarnkar, a leading orthopaedic and joint replacement surgeon at Rishabh Multispecialty Hospital, Jaipur
Joint pain and mobility-related problems are no longer concerns limited to advanced age. With changing lifestyles, sports injuries, accidents and increasing awareness around treatment options, orthopaedic care has evolved significantly. At the same time, technologies such as robotics, navigation and artificial intelligence are transforming the way joint replacement surgeries are planned and performed.
Dr. Ramnivas Swarnkar, a renowned orthopaedic and joint replacement surgeon at Rishabh Multispecialty Hospital, Jaipur, shares insights into his professional journey, the changing face of orthopaedics, implant selection, common myths surrounding joint replacement and the importance of personalised treatment.
Question: You are a renowned orthopaedic and joint replacement surgeon at Rishabh Multispecialty Hospital. Tell us about your journey and what inspired you to enter this field.
Answer: My journey in medicine began in 2002, when I joined the MBBS programme, which I completed in 2008. Since 2011, I have been actively involved in clinical medicine and continued to develop my expertise in orthopaedics. I pursued my postgraduate education at SMS Medical College and then completed my MS in Orthopaedics.
I subsequently specialised in joint replacement through an FNB in Arthroplasty from Sakra World Hospital, Bangalore and also undertook an international fellowship in Robotic Joint Replacement and Hip Arthroscopy from Bumin Hopsital, Seoul in South Korea. Previously, I have worked in places like Jhunjhunu and Bhilwara. I recently joined Rishabh Multi-Specialty hospital.
As far as my inspiration is concerned, joint-related problems are increasingly common, particularly among the elderly. Many people experience pain and restricted mobility that can significantly affect their quality of life. For me, the opportunity to help a patient become pain-free, regain mobility and return to a more active life is immensely satisfying. That has been one of my biggest motivations for being in this field.
Question: How do you see the evolution of orthopaedics, particularly with regard to technological developments?
Answer: Orthopaedics has witnessed tremendous technological advancement in recent years. There have been significant improvements in implants, including their design, performance and longevity. Surgical procedures and techniques have also evolved considerably.
Technologies such as artificial intelligence, computer navigation and robotic assistance are increasingly becoming part of modern orthopaedic practice. They can help surgeons achieve greater accuracy and precision in diagnosis, planning and surgery.
Technology has essentially become a helping hand for the surgeon. It can improve surgical precision, streamline procedures and contribute to better outcomes. With advancements in surgical techniques and infection-control practices, joint replacement has also become increasingly predictable and result-oriented.
Question: What factors do you consider before recommending an implant to a patient?
Answer: There are several types of implants available, and the choice depends on multiple factors. One important consideration is affordability. Patients should know the cost of the implant and understand the options available to them.
We also explain the expected longevity of the implant and educate patients about their condition. Implant cost can vary depending on factors such as its design and the material or metal used. I believe patients should be given complete information about the available options, their advantages, expected longevity and cost before a decision is made.
Question: What is the most common myth surrounding joint replacement?
Answer: One of the most common concerns is an inherent fear of joint replacement surgery. Many patients believe that undergoing surgery itself may create problems or that recovery will be extremely difficult.
Patient education plays a very important role in addressing this fear. We first explain the disease, its severity and the available treatment options. The intensity of the problem determines what kind of treatment may be appropriate.
I also believe that the doctor should not be the sole decision-maker. The patient is an important stakeholder in the treatment process. Their comfort, preferences, expectations and lifestyle requirements should also be considered. When patients understand their condition and the proposed treatment properly, they gain confidence and are better prepared to make an informed decision.
Question: What advice would you give patients to increase the longevity of an artificial joint?
Answer: First and foremost, patients should understand that there is no complete substitute for a natural joint. Therefore, once an artificial joint has been placed, it is important to take proper care of it.
Maintaining an appropriate body weight is particularly important because excess weight increases the load on the artificial joint. Patients should also avoid putting unnecessary stress on the joint and should follow the activity and exercise recommendations provided by their doctor.
Certain strenuous activities and movements that place excessive pressure on the operated joint may need to be avoided. Following rehabilitation and maintaining a healthy lifestyle are important for preserving joint function over the long term.
Question: Knee and joint problems are increasingly being seen in younger people as well. What could be the reasons?
Answer: Joint problems in older people are often associated with age-related changes and degeneration. However, younger people can develop orthopaedic problems for different reasons.
Sports injuries and road accidents are significant contributors. Such injuries can damage cartilage, ligaments and other soft tissues around a joint. Certain bone and joint disorders can also progress during younger years.
Therefore, joint problems should not automatically be considered an issue associated only with old age. Injuries, lifestyle factors and specific medical conditions can affect people across different age groups.
Question: Why are bone-related problems increasingly common among women?
Answer: One important factor is menopause. After menopause, significant hormonal changes occur in a woman’s body, which can increase the risk of osteoporosis and bone-related problems.
Reduced bone density can make bones more vulnerable and can contribute to pain and fractures. Women therefore need to pay particular attention to bone health as they age. Early evaluation, appropriate nutrition, physical activity and medical guidance can play an important role in maintaining bone health.
Question: How do you see cities such as Jaipur and other metropolitan centres in terms of access to advanced joint replacement facilities?
Answer: Cities such as Jaipur have witnessed considerable advancement in healthcare infrastructure. Technologies such as robotic assistance, navigation systems and AI-supported tools are increasingly available for orthopaedic procedures.
This means that patients in cities like Jaipur can access sophisticated joint replacement facilities without necessarily having to travel to other major healthcare destinations. The availability of advanced technology, combined with experienced surgeons and appropriate infrastructure, is helping strengthen the quality of orthopaedic care.
Question: What precautions should be taken before performing joint replacement surgery in a patient aged 50 to 60?
Answer: A detailed medical evaluation is extremely important before surgery, particularly in this age group. We need to assess conditions such as diabetes, high blood pressure and thyroid disorders and ensure that they are adequately controlled before the procedure.
The patient’s complete medical history should also be reviewed. For example, if a patient is taking blood-thinning medication, that needs to be carefully considered before surgery. Depending on the patient’s condition, consultation with the relevant specialist may also be required.
Potential risks and complications should be discussed with the patient beforehand. Proper pre-operative assessment and optimisation of existing medical conditions can help make surgery safer.
Question: What is the importance of personalised treatment in orthopaedics?
Answer: Personalised treatment is extremely important because every orthopaedic patient is different. Even if two people present with knee pain, the underlying causes may be completely different.
A proper clinical examination, detailed medical history and assessment of symptoms are therefore essential. We also need to consider the patient’s age, lifestyle, activity levels and associated medical conditions.
Not every patient with knee or joint pain requires surgery. Depending on the condition, conservative treatment, medication, lifestyle modification or physiotherapy may be sufficient. If symptoms such as persistent pain, swelling or restricted movement continue, further investigations such as MRI or CT scans may be recommended where clinically appropriate.
Surgery should generally be considered when other appropriate treatments have not provided sufficient relief or when the patient’s condition warrants an operative intervention. The treatment plan should be based on the individual patient rather than a one-size-fits-all approach.
Question: How do you see orthopaedics evolving in the coming years?
Answer: I believe technology will continue to play an increasingly important role in orthopaedics. We are likely to see more advanced tools, improved procedures and greater integration of technologies that can make surgery more accurate and effective.
However, it is important to understand that technology will remain a helping hand for the surgeon rather than a replacement for the doctor. Clinical judgement, experience and understanding the individual patient will continue to be at the heart of good medical care.
Question: Finally, what message would you like to give readers who are experiencing orthopaedic problems?
Answer: My message is simple: do not ignore persistent joint pain. If you are experiencing pain, swelling, stiffness or difficulty in movement, seek timely advice from an orthopaedic specialist.
Early evaluation can help identify the underlying problem and determine the appropriate treatment. In many cases, timely conservative treatment can help manage the condition and may prevent it from progressing.
Patients should also follow the treatment plan recommended by their doctor and avoid self-treatment or unnecessarily delaying consultation. The earlier a problem is properly evaluated, the better the chances of choosing an appropriate treatment and maintaining mobility and quality of life.
