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Global Corporate Priorities For 2007 - Doing Business With China And India

In developed markets, executives point to high labour costs and saturated markets as the critical challenges with innovation being a key priority. In emerging markets the challenges are quite different: labour costs are low and markets are largely untapped. Whilst 2007 promises to deliver much, executives need to be realistic about the complexity of the task ahead.

Optimism delivers investment

Top line growth will be a higher priority than cost control for most executives throughout 2007. Spending will be targeted at the front office first and foremost: sales and marketing are the areas of the business to receive the greatest share of the investment.

Globally, China and India continue to grab headlines and attract the largest share of investment. Within the next 3 years more than half of the executives surveyed expect to get more than half of their revenue from abroad.

Huge Growth

Demand and supply issues dominate the CEO?s agenda: by 2010 India alone is expected to have some 500 million middle class people. Supplying the increased demand is a huge opportunity and a challenge and many firms are struggling to keep pace with demand.

In addition, rising volume of trade within emerging markets (rather than merely between developed and developing markets) is putting added pressure on infrastructure. The notoriously poor transport networks within developing countries remain a major challenge and transport providers need to invest in putting domestic transport solutions inside China and India to allow these economics to develop and to allow consumers to consume.

Increasing Competition

Executives recognize that emerging markets such as India and China not only provide today?s new customers, but also tomorrow?s new rivals. A small but significant minority of firms point to the threat of rising competition from domestic companies based in emerging markets

Shortage of Talent

One of the biggest challenges facing Chief Executives during 2007 is a shortage of talent. This is especially true in emerging markets where one in two respondents identify a lack of available talent as the primary barrier to growth.

Competition for the best talent is an international game with some of the world?s major banks traveling to India to recruit for their offices in London, New York, Hong Kong and Singapore.

With the increased pressure on talent comes issues around turnover and wage costs. Wage inflation in the Indian information technology sector is about 20% and staff turnover is double that as highly skilled workers switch jobs to boost their salaries. It is a similar story in China with most multinational operations contending with a 20-30% annual turnover rate.

Global Corporate Strategies for 2007:

Nearly 60% of executives surveyed for this report believe that they will invest more time and money in emerging markets than developed markets. China vies with the US and UK as the overseas market that executives expect to visit most frequently in 2007.

Managing an enterprise that sprawls across several continents and many more countries may be good for the air miles account but poses huge challenges.

To succeed, firms must localize their products and services, differentiate themselves appropriately in a range of markets and have the right people in place around the world

Localise Products and Services - Market leading companies recognize the need to develop products that are tuned to local needs, cultural preferences and demands A tube of toothpaste or soap in Western packaging won?t sell in India, for instance, unless it?s packaged in smaller containers more easily transported and sold within smaller retailers

Differentiate ? three quarters of respondents will differentiate themselves on quality in future rather than cost as consumers become more discerning

Fight for talent ? executives are putting more effort into building successful training and development programmes and placing greater emphasis on performance based compensation

Pam Kennett is a business consultant with more than 20 years' experience working with organisations to help them understand the talent of their staff through the implementation of competency models. She has an MBA from City University Business School (London), is a Member of the Chartered Institute of Personnel and Development and is a registered member of the British Psychological Society. She also manages a property portfolio worth over ?2 million and is in the process of launching a wealth creation coaching business.

She is the founder and Director of Chiswick Consulting Limited and can be contacted at +44 208747 1886 or chiswickconsulting

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If You Have Rheumatoid Arthritis You May Want To Start Going To Indian Restaurants!

Folk and herbal remedies for arthritis are often found, after scientific scrutiny, to have beneficial effects. A recent study seems to support the role of turmeric as a spice that could help alleviate the pain and inflammation of rheumatoid arthritis.

Turmeric is the spice that flavors and gives yellow color to curries and other foods. It has been used for centuries by practitioners of Ayurvedic medicine to treat inflammatory diseases. Turmeric extract containing the ingredient curcumin is marketed widely as a dietary supplement for the treatment and prevention of a variety of disorders, including arthritis.

Janet L. Funk, MD and Barbara N. Timmermann, PhD, researchers at the University of Arizona, Center for Phytomedicine Research, set up a series of experiments to determine whether (and how) turmeric works as an anti-arthritic. They began by preparing their own extracts from the root of the plant and compared them with commercially available products.

Dr. Funk and her colleagues then tested in animal models a whole extract of turmeric root, only the essential oils, and an oil-depleted extract containing the three major curcuminoids found in the plant root.

Of the three extracts, the one containing the major curcuminoids was most similar in chemical composition to commercially available turmeric dietary supplements. It also was the most effective, completely inhibiting the onset of rheumatoid arthritis.

Dr. Funk states that, ?This was the first study that has examined turmeric with the researchers' own prepared, well-defined extracts? the study represents the first documentation of the chemical composition of a curcumin-containing extract tested in a living organism? for anti-arthritic efficacy. It also provides the first evidence of anti-arthritic efficacy of a complex turmeric extract that is analogous in composition to turmeric dietary supplements.?

The significance, she explains, is that ?translating the results of trials such as these to clinical use depends on accurate information about the chemical content and biological activity of the botanical supplements available for use. This work paves the way for the preclinical and clinical trials needed before turmeric supplements can be recommended for medicinal use in preventing or suppressing rheumatoid arthritis.?

Dr. Funk and her colleagues add, ?This study also provides the first in vivo documentation of a mechanism of action -- how curcumin-containing extracts protect against arthritis.?

?We found that the curcuminoid extract inhibits a transcription factor called NF-KB from being activated in the joint. A transcription factor is a protein that controls when genes are switched on or off. Once the transcription factor NF-KB is activated, or turned on, it binds to genes and enhances production of inflammatory proteins, destructive to the joint.

The finding that curcuminoid extract inhibits activation of NF-KB suggests that turmeric dietary supplements share the same mechanism of action as anti-arthritic pharmaceuticals under development that target NF-KB. It also suggests that turmeric may have a use in other inflammatory disorders, such as asthma, multiple sclerosis and inflammatory bowel disease.?

In addition to preventing joint inflammation, Dr. Funk's study shows that the curcuminoid extract blocked the pathway that affects bone resorption. Bone loss associated with osteoporosis in women typically begins before the onset of menopause. Bone loss is also a feature of rheumatoid arthritis.

(Funk JL, Frye JB, Oyarzo JN, Kuscuoglu N, Wilson J, McCaffrey G, Stafford G, Chen G, Lantz RC, Jolad SD, Solyom AM, Kiela PR, Timmerman BN. Efficacy and mechanism of action of turmeric supplements in the treatment of experimental arthritis. Arthritis Rheum. 2006: 54 (11): 3452-3464).

Note: This story has been adapted from a news release issued by University of Arizona Health Sciences Center.

Author?s note: This study is interesting from at least three points of view. First, it confirms the effectiveness of an herbal supplement for adjunctive treatment of rheumatoid arthritis and provides information on a possible mode of action. Second, it gives credence to the use of turmeric in standard dietary supplement form for arthritis. Third, the bone loss inhibiting effect of turmeric is an important one given the magnitude of osteoporosis as a public health issue.

I, for one, am making reservations to my favorite Indian restaurant as soon as I can.

Nathan Wei, MD, FACP, FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland (aocm.org). He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and consultant to the National Institutes of Health. For more info: hArthritis Treatment

Retail Expansion spills over to Tier II and III cities in India

The Indian organised retailing story is no longer limited to Tier I cities. The retail vehemence has entered Tier II and III cities in the country according to real estate services firm Jones Lang LaSalle (JLL). The firm also expects retail supply to be created in SEZs as well as for mall developers to adopt a revenue sharing moderl with retailers.

The spectacular growth in the major metros has infused confidence in developers and occupiers to expand into smaller cities. JLL estimates a total of 58 million sq ft of mall space to be developed across Tier I, II and III cities by end-2007. About 45% of this will be in Tier II and III cities such as Ahmedabad, Pune, Kolkata, Hyderabad, Chandigarh, Ludhiana, Kochi, Jaipur, Lucknow, Kanpur, Coimbatore, Agra and Amritsar.

The share of Tier II and III cities is expected to further increase in the next two to three years as more and more players express interest in these cities. Most of these Tier II and III cities are state capitals, educational hubs or satellite cities with population size of more than a million.

Retail players are primarily focusing on value-added offerings such as modernised retail formats and luxury malls in Tier I cities. On the other hand, Tier II and III cities are untapped markets where players are looking at gaining the first-mover advantage. Majority of the retail developments in Tier III cities are expected to be part of large mixed-use projects that include residential, entertainment and hospitality developments.

Quality retail supply is also expected to be developed in the special economic zones (SEZ) across the country. As per the government SEZ guidelines, up to 65-75% of the total approved SEZ area can be utilised for support infrastructure such as residential units, schools, retail establishments and hospitals.

For more information on Real Estate Agents, MLS visit Propertiesmls

Source: IndiaRealEstateblog

About the Author

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Travel to India for your Laparoscopic Pyeloplasty Surgery

Medical tourism can be generally defined as provision of 'cost effective' personal health care in association with the tourism industry for patients needing surgical healthcare and other forms of dedicated treatment. This process is being facilitated by the corporate sector concerned in health care as well as the tourism industry - both personal and public. Medical or Health treatment package tourism has become a recurrent form of vacationing, and covers a broad range of medical services. It mingles free time, amusing and recreation together with wellness and healthcare packages.

What is a laparoscopic pyeloplasty Surgery?

A laparoscopic pyeloplasty is a minimally invasive surgical procedure for correcting a kidney ureteropelvic junction obstruction.

Procedure of laparoscopic pyeloplasty Surgery:

The evening before surgery, patient will not be permitted to eat or drink after midnight. This ensures that no food is in patient's stomach prior to induction of anesthesia. Before procedure, an anesthesiologist will see patient. Patient will be given medication, which will decrease anxiety and induce relaxation and, once patient is in the operating room, patient will then be given general anesthesia. This medication is given by the anesthesiologist who will be at the head of the table. This medication will prevent patient from feeling any pain during surgery and make patient unaware of what is going on around patient at this time. The procedure is then performed by the surgical team.

It will be necessary for patient to have a bladder catheter inserted to facilitate measurement of urine output during the operative and postoperative periods. The operative position will be a modified lateral position with patient's affected site elevated. Three 0.5 to 1cm small skin incisions will be created as shown in the following figure. The entire surgery will be performed through these incisions.
During the operation, the stenotic (narrowed) portion of patient's ureteropelvic junction will be excised and then the ureter reconnected back to the kidney. A double-J ureteral stent will be placed to allow healing and drainage of urine from the kidney down to the bladder. The scar tissue will be removed completely and a drain left afterwards temporarily. The incisions will be closed and covered by tapes.

What are the advantages of laparoscopic pyeloplasty Surgery?

* Reduced hospital stay and faster healing

* Less postoperative pain and less need for pain medication

* Quicker return to normal activity and work

* Smaller incisions and less scarring

What to Expect after laparoscopic pyeloplasty Surgery:

Hospital stay
The typical stay is 2 days.

Diet
Patients resume normal eating as they recover in the first day after surgery or soon thereafter.

Postoperative pain
Pain is managed immediately with an intravenous patient controlled analgesia pump, which is removed and replaced by pills the day after surgery. Upon discharge, pain pills are given for several days, after which over-the-counter acetaminophen or ibuprofen is usually all that is needed.

Urinary catheter
A urinary catheter is left in place for one or two days following the surgery and then removed.

Abdominal drain
A small drain placed in the area of the kidney is usually removed the second day after surgery.

Recovery
Time to complete recovery is typically 3-4 weeks compared with 8 weeks for open pyeloplasty.

Follow-up
Patients will follow-up with their surgeon 1 month after the operation for a routine visit, then at 3, 12 and 24 months with nuclear renal imaging and ultrasounds of the kidney.
Why should one go for laparoscopic pyeloplasty Surgery in India?
Most Important Reason to do so is that the cost of the laparoscopic pyeloplasty Surgery is very low in India-almost 20% of the cost of what one would pay in USA, Canada or UK.

Today's India offers World Class Medical Facilities, comparable with any of the western countries. India has state of the art Hospitals and the best-qualified doctors. With the best infrastructure, the best possible Medical facilities, accompanied with the most competitive prices, you can get the treatment done in India at the lowest charges.

Patients from around the globe are beginning to realize the enormous potential of modern and traditional Indian medicine. Indian hospitals, medical establishments and the government of India have also realized the potential of this niche segment and have begun to tailor their services for foreign visitors. International marketing divisions have been set up by most of the top India Hospitals. Some top medical tourism providers are helping the hospitals in this task.

Visitors, especially from the United States of America, United Kingdom and the Middle East find Indian hospitals a very affordable and viable option to coping with insurance and National medical systems in their respective countries. Travelers prefer to combine their medical treatments with a visit to the 'exotic east' with their families, visiting places like the Taj Mahal in Agra, the palaces in Rajasthan, the serene beaches in Goa and the mountains of Kashmir and the backwaters of Kerala among others. The total price of an overseas treatment with airfare, hotel accommodation and even a few days of vacation is often far less than just the procedure cost back in the US or UK.

To know more about Hospitals in India and the Laparoscopic pyeloplasty Surgery packages available in Hospitals,
Please visit- fly2india4health

Important Details:

Medical Tourism to India -fly2india4health

International Patient Experiences-fly2india4health/international.php

Email -enquiry@fly2india4health

Contact Number- 0091-98607-55000.

About the Author

Dr Arjun Bhojwani is the Director of fly2india4health Consultants.
An Internal Medicine Physician by profession, he has been into practice for more than 25 years. He is an authority in the field of Medical Tourism to India having helped more than 400 patients.

Indian Sleepwear Market

There is a huge untouched potential in non-metros

Producers of women's pajama sets are increasing R&D capability to raise the range and functions of designs. Companies are also making efforts to enhance product quality and decrease operating costs through vertical integration. With the elimination of export taxes and import limitations on China-made sleepwear to the EU and the US, suppliers from China and India find themselves in a strong competition for market share. In the Indian market, the sleepwear and lingerie market is emerging quickly as a fashion segment, and has, over the last decade, observed the existence of organised players such as Juliet, Sleep-ins, etc

What was Kashmira Nightwear Company started with a single standalone store in Pune many years ago is today the Sleep-ins brand of complete nighrwear solutions possessing a chain of many exclusive Sleep-ins stores and existence in many of the country's major retail chains. This change has been promising on account of the single-handed effort by only one person, Kishor Chhabria, who is managing director of the Pune-based Kashmira Nighrwear Company -? Sleep-ins today is a brand with a national manifestation. Chhabria experienced that Indian consumers have awareness of about selecting of occasion-wear and sleeping dresses were as important as office, casual, party or sports wear, and commence to offer consumers what they required.

Sleep-ins is among the leading players in the segment, and has been beholding considerable growth in its market share over the last few years. This market even today is largely in the unorganised sector where price is the only its consideration. Organised players are not contending with products that are being traded on the streets. The growth in retailing, the rising level of fashion consciousness has supported sleepwear and lingerie move into a higher market step.

Sleep-ins has increased by almost 150 per cent over the two-three decades, they were highly focused in the western market, but this year the brand performed well locally. They have appointed distributors in Chennai, Bangalore, Hyderabad, Kolkata, UP, MP, Punjab, etc. and possessed more than 20 exclusive outlets in the country, and will add to this by another six. Besides the exclusive outlets, the brand retails from a many large departmental stores too.

This increasing in retail space is encouraged by the remarkable response the brand has gained in various parts of the country. Many of their garments are in the range of Rs 2000-4000. When introducing these, they believed that sales in this price segment would be optimum in Delhi and Mumbai, and they were staged to see sales growth gained in Punjab. This just set to observe that fashion awareness is high in every part of the country, and there is still a lot of unexploited potential in cities other than the metros. And this is where the fashion aspect plays an important role. The company finds the finest of fabrics from within the country, imports the satins from Korea, and makes the prints in-house.

Sleep-ins is possibly the only far-reaching sleepwear brand for whole family. It satisfies a hidden demand for quality sleepwear which the Sleep-ins exclusive brand stores offer - the whole range for women, men and kids. Within a lesser time from its establishment, the chain stores have registered a good growth all over India. As of now, women in the 18-50 years age group comprise the major buyers though men too make significant purchases. There is a large segment of consumers who wish to wear high quality nighrwear with features that match international standards.

Chhabria himself is a designer and thinks not just making, but real pieces of art. The Sleep-ins variety covers sleepwear and loungewear. The matchless and marvelously confined ensembles in cottons and cotton blended satin and Lycra are all made in-house. Nightshirts are offered in satins and georgettes and animal prints; Robes in soft fabrics; and Chemise in shimmering soft and tender pastel silhouettes. They also offer nighties with spaghetti straps, provoking teddy suits, stylish shorts with bikini tops, pajamas, Capri, etc. For men, Sleep-ins provides an elegant and sophisticated variety of night suits in pure cottons and imported polyesters and robes in soft suede and satins with pajamas.

They believe that men and women of today look at wearability, affordability and comfort; hence, the pricing factor cannot be unnoticed. The brand has helps to match the budget as well as the premium class of customers. Sleep-ins in Pune, which is possibly the biggest sleepwear stores in the country with 1500sq.ft of floor area holding a rich collection of more than 4000 garment pieces at a time. Their exclusive franchisees stores are situated in cities like Mumbai, Delhi, Hyderabad, Surat, Ludhiana, Kolkata, Baroda and Gurgaon. The brand is also offered at leasing retail chains like Globus, Shopper's Stop, Piramyd and Pantaloons.

The speed at which the brand is growing its market reach states that there is huge experience that gives a solid foundation of self-belief. He started retailing business with a little investment of rupees one crore," "and today aimed at setting up Sleep-ins as a standalone brand, which needs a healthy investment for brand imaging.

Sleep-ins is very well known to the existing competitors and is arranged to take on the new entrants. And they do not bother about stiff competition, as they have a complete range of nightwear and loungewear for women, men and kids. Its close competitor is "Sweat Dreams", but Sweet Dreams has so far not made any branding effort and is currently in all types of stores in the country whereas Sleep-ins is offered at exclusive stores only that placed on a firm territory.

Sleep-ins' immediate object is to go through the premium malls setting up in major cities. But that's not all, the company is foreseeing to setting up Sleep-ins nightwear and loungewear as a quality brand in the international market. They are aimed at identifying the product to the brand, which customers should ask for Sleep-ins rather than any night dress product.

Sleep-ins is now planning to set its product range into the quite lower range of the market too, where the price points would be about Rs 200-400. They could perhaps be retailing these from stores like Big Bazaar.
The company has a production capacity of 15,000 garments per month, and is planning to enhance the same by another 25 per cent. They are bringing in 30 more machines, making the total to 130. They are setting in place IT systems for good quality control and monitoring.

Sleep-ins has started business jointly with Disney for supply of 5,000 garments per month, and the enhanced production would mostly go to Disney. The company has also been gaining a plenty of export enquiries from Europe and the Gulf, but is taking time to go in this segment.

Another India supplier, Poppy's Knitwear (P) Ltd, can functions from spinning, weaving and knitting to sewing and finishing, at its factory. The plant is set with Rieter spinners, Vanguard and Orizio knitting machines and Tubetex dyeing units. In India, women's pajamas from Poppy's are ranges in between $3.50 and $8.50 per set. Low-end models are produced by lightweight single-jersey cotton. Midrange designs normally have overall printing and more garment features such as pockets and collars. High-end versions are largely used for winter and produced by heavier fabric such as polar fleece and cotton interlock.

Clifton provides designs priced between $3 and $7. The midsize company makes women's pajama sets for OEM customers like Ethel Austin and Littlewoods of the UK, Carrefour of France and Canada's Teenscene India's Sentinel Clothing Co. engaged in manufacturing of nightwear, kids-wear etc possessed with Taitexma circular rib and interlock knitting machines as well as equipment for making single and flat knitted fabric. Apart from these, the company has machines for silk-screening and embossing.

At Sentinel, women's pajama prices range between for $2.50 to $6.50. Models are normally produced by single-jersey cotton. New entrants have lace trims, ruffles and bows on necklines and sleeve openings. The company possesses three factories in India making more than 3 million women's pajama sets per year. Its 10-member R&D team makes 20 innovative models a month. Leeds' nighwear product ranges from $3.25 to $8. Models are produced by pure cotton or polyester-cotton blends. The company also makes T-shirts, shorts, bathrobes, tank tops and children's wear.

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Indian Recipes And Indian Spices: History, Present And Benefits

For centuries south asian region has been rich. Rich with it?s spices and food recipes. For years, the region lured various different crusaders to invade the region over centuries. Beginning from the 14th century, the moghuls invaded and ruled, what is today the Indian subcontinent, for over three centuries. And then came the marvelous voyages of Christopher Columbus taking upon the arduous long voyage and Vasco De Gama of Portugal, all because of the lure of rich and vast variety of spices in the sub-continent.

Vast fortunes have been made and squandered, powerful rulers seduced, ailments cured and nations have been discovered. All in the name of spices. Spices have always cast a spell on our imaginations. Spices flatter our senses; our sight with their vibrant colors, our smell with their enticing fragrances and our taste with their distinct unique flavors.

Today, India is one of the largest exporting nation of spices in the world. Vast variety of spices grow due to natural conditions available in various parts of India. The major western, south-west, south and south-east is tropical in weather conditions, north-west, north are dry with less humidity and north-east and east have pre-dominantly high-rainy seasons.

Due to the abundance in availability of spices in India, Indian food is never bland. Most of the recipies originating from the Indian sub-continent contains spices in the list of ingredients. Spices in Indian food are not heavy and although Indian food is not bland, most Indian dishes are delicately spiced to enhance the flavor of the main cooking ingredient. Curry powder sitting on the grocers shelf may be like saw dust when one compares it to the fine spices roasted, combined and dry ground or wet ground in the traditional Indian traditions. Today one of the most famous entr?e in the west consists of curry ? a blend created mixing various different ground spices in right proportions with the water. However there are many delicacies in Indian recipes due to the inclusion of variety of spices.

Fresh ground spices are the order of the day in an Indian home and will be chosen according to the nature of the dish, season, individual and family. Some of the common Indian spices available are red chilli pepper, turmeric, black pepper, nutmegs, cloves and many more.

Other then the usage of spices in culinary, they are also used as medicine. Ancient Ayurvedic texts prescribe the herbs and spices for curative and therapeutic functions. Ayurvedic scripts dating back to 3000 years, list the preventive and curative properties of various spices. Looking at curative properties of some of the spices - Ginger prevents dyspepsia, garlic reduces cholesterol and hypertension and fenugreek is a good resistance builder and with pepper often serve as antihistamines, turmeric is used for stomach ulcers and for glow of the skin.

Spices have been used to make the food last longer in the days when refrigeration was absent. And even today in some remote parts of India where electricity is not available, spices are used in food for preservation.

In India the western after dinner mint is substituted by the fragrant spices such as fennel, cardamom or cloves. Effective mouth fresheners, they aid digestion, prevent heartburn and curb nausea. Others such as asafoetida and ginger root, have been known to counteract flatulence and colic, and are added to lentils, a must with every Indian meal.

About the Author:

Learn more about Indian Spices and Indian Recipes visit spicesandrecipes. Sekhar Kodaipati is renowned for his ability to perform indepth research and compose detailed articles.

Knee Replacement Surgery in India - Benefits, Costs, Function

Total knee replacement surgery is a permanent solution to the aged patient suffering from Osteoarthritis in India. The elderly become pain free and the quality of life improves. However there has been a universal feeling amongst south Indians that the majority of implants available in India do not allow more than 100 degrees of knee bending. There is a high degree of dissatisfaction with standard knee replacements. The patients say that they are unable to squat on the floor or climb stairs easily with the operated leg. Even computer assisted surgery cannot achieve deep knee bend unless the prosthesis is designed to provide this extra bend. They may have difficulty in climbing stairs, using Indian toilet and squatting on the floor. This is a great disadvantage to majority of South Indians who prefer to squat on the floor for prayer, social activities and meals.

So, many people refrain from undergoing a knee replacement surgery and suffer in silence. Now with the advent of a new type of prosthesis, patients in South India undergoing a knee replacement need not be functionally impaired. A new design of prosthesis allows knee bending up to 155 degrees. The patient has to be motivated to regain high knee flexion and participate in early and aggressive physiotherapy. They should not be obese and the pre operative knee bend should be above 90 degrees. This prosthesis is implanted by special instrumentation which is minimally invasive and does not damage the tissues. Hence post operative pain is less and rehabilitation is faster.

This prosthesis is different to the many claims of rotating platform prosthesis.

Preoperative considerations for a High flexion knee replacement

Not all patients can get a high degree of flexion after a knee replacement. To qualify for this procedure, the patients must not be obese, have a thigh calf index of > 90 degrees and should be motivated to participate in physiotherapy in the early days after surgery, bearing post op pain. The wound is likely to weep slightly more as it would be subject to stretching. Cycling is an activity that promotes the building of hamstrings and quadriceps.

High flexion knee prosthesis

Special knee implants are now available which provide more flexion or bending at the knee to suit Indian, and South Asian habits of kneeling for prayer, or sitting cross legged on the ground for meals or social purposes. Muslims in particular need this to offer prayers. Japanese customs also require high knee flexion. Even westerners have begun to appreciate the benefits of high flexion knee prosthesis as they can pursue hobbies like gardening and are also gratified for the ability to do recreational activities. The prosthesis used allows high flexion from 130 degrees to 155 degrees. Rotating platform prosthesis alone does not allow high flexion as claimed by many centers. These centers are monopolizing a particular brand which does not allow high flexion.

Minimally invasive technique

Traditionally knee replacements have been done through incisions in the skin about 14- 20 cm long. Special instrumentation allows the operation to be performed through a modified new surgical approach without dividing the thigh muscles (Quadriceps). By down sizing the incision to 9 cm (3 inches), the amount of postoperative pain is less, hospital stay is shorter (5 days) and return to function is faster.

As post op pain is less the patient will cooperate with the physiotherapist to do the required exercises regularly.

Recent advances in knee replacement have occurred in the lat one year driven by higher patient expectations. The introduction of the High flex prosthesis in the market will spur many more people who have suffered in the last decade from knee arthritis to undergo a Total Knee replacement in Chennai.

The author is a knee surgeon in Chennai and has performed the first High flexion knee replacement with the Nex gen prosthesis from Zimmer. Please visit kneeindiablogspot for videos and photos of patients with unilateral and bilateral High flex knee replacements.

Dr. A.K. Venkatachalam

MD,MS, DNB,FRCS,MCh orth

Consultant Orthopaedic surgeon

Knee & Shoulder Clinic, Chennai

27,1st aveue, Besant nagar,Chennai

Tel 00 91 44 24912905.

Bharathi raja hospital Chennai

Tel 00 91 44 28345301

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