Vimhans Nayati performs rare Bilateral TKR on 65-year-old Iraqi woman

Single-session surgery significant due to patient’s intrinsic complications, including obesity

Recognized for delivering exceptional patient care, Vimhans Nayati Super Specialty Hospital today announced a rare bilateral total knee replacement surgery performed in a single session on a 65-year-old lady from Baghdad, Iraq. Zainab Salen Mohammed Hasan – a morbidly-obese lady with a BMI (body mass index) of 44.5, weighing 100 kg – had difficulty in walking, eventually suffering severe back pain. She was diagnosed with advanced osteoarthritis (Stage 4), wherein patients experience pain and discomfort in moving their joints, preventing or hampering daily activities.

Speaking about her life-changing experience, Zainab said, “I had consulted many doctors in seeking relief from severe pain. Finally, after consulting Dr Rajeev Sharma at Vimhans Nayati Super Specialty Hospital, I consented to Bilateral Total Knee Replacement. I am extremely grateful to Vimhans Nayati for putting me back on my feet so quickly through its first-class treatment. Now, I perform daily activities without pain and I’m leading a normal, healthy life.”


Being overweight or obese is a risk factor for progression of knee osteoarthritis. Since Zainab was in the Class 3 (high-risk) obese category, her obesity made it a rare case. With each BMI unit increase, the chances of rapid cartilage loss rise by 11%. Moreover, she had comorbid symptoms such as diabetes and hypertension. As the high BMI makes the procedure strenuous for anaesthesia and surgery, it is done in multiple sessions.

Commenting on the demanding single-session surgery, Dr Rajeev Kumar Sharma, Chairman – Institute of Orthopaedics, Sports Medicine & Arthroplasty at Vimhans Nayati Super Specialty, said, “Due to the bad deformity of both knee joints, joint laxity and weak bones, Zainab was suffering painful knees for the past 15-20 years. The pain became so severe, she faced difficulty in walking and remained mostly bedridden. In the past, we have observed that osteoarthritis worsens if rising obesity, past injuries and lack of muscle strength are not addressed. The alignment of limbs and quality of cartilage also affect the knee joints.”

“In Zainab’s case, excess weight exerted extra pressure on her hips and knees, causing faster deterioration of the joint cartilage. Excess fat tissue in any part of the body also produce chemicals that inflame and damage joints. As the intolerable pain was limiting her range of movement in both knees, she could not walk or stand for more than five minutes. With such high BMI, total knee arthroplasty is taxing – making it almost impossible for the patient to endure any safe surgical procedure in routine circumstances. Besides, weak bones made the fixation of implants unmanageable. To ensure the benefits of this surgery last longer, backed by an improved range of motion, we used a mobile-bearing joint that can last up to 20-25 years. Furthermore, her badly-stretched knee joint ligaments needed a special technique for fixing them and balancing the knee joints. We have restored the joint anatomy and limb alignment. Now, both her legs are straight with full movement of knee joints, ensuring she walks easily.”

Given the expanding need, Vimhans Nayati Super Specialty Hospital has a special Pain Management Programme for such cases, involving minimally-invasive surgery, including techniques such as careful handling of tissues, small cuts, special surgical techniques, injections and other select medical treatment for making the patient comfortable after surgery.

Considering the country’s growing need for Total Knee Replacement, Niira Radia, Chairperson – Nayati Healthcare & Research Pvt. Ltd, stated, “When it comes to providing good healthcare, there are no borders. Hence whether it is at Vimhans Nayati Delhi or Nayati Medicity Mathura or at any of our hospitals our endeavour is to provide world class healthcare to our patients to ease their suffering that too in the most humane way. In our hospitals, be it in big cities or small towns, we make sure that they are built around the finest medical team; the most advanced equipment; and, of course, around patients.”

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