Bhubaneswar: Adding another feather to its cap, AIIMS Bhubaneswar has conducted successful Quadruple Join replacement surgery in a crippled patient.

A 37- year female from Aul Block of Kendrapara district was admitted to AIIMS Bhubaneswar with severely painful arthritic knee and hip joints of both sides. She was suffering from rheumatoid arthritis and was on numerous medications. Unfortunately, she was crippled because of severe arthritic involvements of the hips and knees. She was able to walk to her toilet with the help of walking aids and that to with extreme difficulty. There were no movements in the hip joints and she had very little movement in both the knees. She needed replacement surgeries of all four joints.


The patient was evaluated by a team of doctors and planned for surgeries of both the hip and knee joints in one setting. Four joint replacements at one setting incur numerous challenges to the patient and surgeon. The bleeding and surgical stress on the patient was evaluated during the surgery with blood parameters. The replacements of the hips were performed first followed by the knees. The surgery could be completed in three hours. The patient was managed in ICU for two days and adequate pain relief was provided. She started walking on third day and happy with the outcomes. Because of a perfect team management, young age and no comorbidities, the patient could be operated successfully.

The cost of the implants and surgery were provided by the government through BSKY scheme.


Dr. Sujit Kumar Tripathy and Dr Mantu Jain were the chief orthopedic surgeons and the anesthesia team was led by Dr. Sritam Swarup Jena. Previously only one case has been reported from AIIMS Delhi in which an Odia patient was operated with all four joints replacement in one setting. This is the second case to be reported globally and first of its kind in Odisha where all four joints were replaced in one setting.
AIIMS Bhubaneswar Executive director Prof (Dr) Ashutosh Biswas meeting the patient asked about her recovery progress. Dr. Biswas congratulated the team for managing such a complex case and providing mobility to the patient. Such surgeries are rare and must be carried out with extreme caution, said Dr. Biswas.
Medical Superintendent Dr. Dillip Parida also congratulated the Doctors for such a successful feat.
Notable, for such a cripple patient, it is essential to consider about multiple joint replacement at same setting as one or two joint replacements cannot let the patient walk. It is possible in expert hands and in a good set up.