Why I put the recovery in writing before we discuss the operation.

In the years I have been doing this, the questions that come up in my consulting room have barely changed. Will I be able to drive? Will I get up the stairs at the office without holding the rail? Will I be on the badminton court next winter, or is that part of my life quietly over? Will I be able to sleep on one side? Will I be able to comb my hair as before? And underneath all of them: is the person telling me to have surgery telling me because I need it, or because that is what they do?

Those are reasonable questions, and they deserve to be answered out loud, in writing, before anyone agrees to anything. So that is where I start. Before we discuss a procedure, we discuss the recovery pathway — not just the operation. What you can expect in the early weeks, when driving may become possible, when stairs should become easier, when strengthening begins, and what it will take to return to your sport or routine.

It is written down, so you can take it home and discuss it with the family.

Why I will sometimes tell you not to operate

A good number of the people who come to see me do not need an operation. Some do not need one yet. Some will never need one. I say so, and I tell them what to do instead — because a practice that only ever says yes is not giving you information, it is giving you a default.

Much of the work I do is focused on preserving a joint rather than replacing it. A meniscus repaired instead of trimmed away. A leg realigned instead of a knee replaced. That is a preference I will argue for, but not one I will apply where it does not fit. If your arthritis is spread across the whole joint, I will tell you an osteotomy is the wrong operation for you, even though preservation is what I generally argue for.

Saying no costs a practice money in the short term. It is also the only thing that makes a yes worth believing.

The operation is only one part of your treatment

Diagnosis, procedure and rehabilitation are one piece of work, not three separate ones handed between people. I read your scan with you rather than handing you a report. I plan the rehabilitation with your physiotherapist, and when a coach or trainer is involved, they belong in the conversation from the start, not at the end.

Training and teaching

Sixteen years in orthopaedics, twelve of them as a specialist. MBBS from Lokmanya Tilak Municipal Medical College — Sion Hospital — in Mumbai, then a DNB in orthopaedic surgery from the National Board of Examinations. After that, ISAKOS-approved arthroscopy fellowships in India, Italy and Germany, with the training focused on complex knee and shoulder work.

My practice is focused on knee and shoulder arthroscopy and sports-related joint problems. Not general orthopaedics with an interest — the two joints, and the operations that belong to them: ACL injuries, meniscus tears, shoulder instability, rotator cuff tears and cartilage injuries. Where the native joint can be preserved, that is what I try to do.

I continue to teach postgraduate orthopaedic surgeons, and teaching has shaped the way I practise. Having to explain a decision clearly to another surgeon is a useful discipline — it forces you to question assumptions, understand the evidence, and be precise about why you are recommending something.

Hospitals and appointments

Operating and consulting appointments have included Pt. Madan Mohan Malaviya Shatabdi Hospital and Niramay Hospital since 2020, and Apollo Spectra Hospital since 2022. Earlier posts were at ESIC Hospital and PGIMER Medical College, Dr. B. A. M. Central Railway Hospital, HBT Trauma Centre, and Deenanath Mangeshkar Hospital.

Member of the Indian Orthopaedic Association, the Indian Arthroscopy Society, the Maharashtra Orthopaedic Association and the Association of Medical Consultants.

Language

Consultations are in English, Marathi or Hindi, whichever you find easier. Nobody makes a good decision in a language they are still translating, and your daughter should not have to interpret your knee for you.

What I want you to leave with

You may come to me because someone has told you that you need surgery. You may come because your MRI has shown something frightening. You may come because your knee has stopped you from running, or your shoulder has stopped you from sleeping. Or you may simply want another opinion before making a decision.

You do not have to arrive knowing what treatment you want.

You come with a problem. My job is to help you understand it, understand your options, and leave knowing what the next step should be.

Come in with a question. Leave with a plan.