Bengaluru, March 24, 2026: Karnataka’s first NitrX Medial Pivot total knee replacement surgery using the Kinematic Alignment Instrument Set was conducted at KIMS Hospitals, Mahadevapura. The procedure was carried out by a team of doctors led by Dr. Kumardev Arvind Rajamaniya as part of the hospital’s orthopaedic services.

The procedure was carried out on a 65-year-old female patient who had Grade 4 osteoarthritis of the knee. This is the most advanced stage of arthritis and is accompanied by a lot of pain, deformity, and instability in walking. However, despite her condition, the patient was very active and climbed stairs regularly, looking for a solution that would enable her to maintain her mobility.

The procedure represents a major milestone in the development of knee arthroplasty in the state, as it brings with it a new-age technique of knee replacement that aims to accurately mimic the natural motion of the knee. The surgery was completed successfully, and just within 3 days, the patient was fit to be discharged.

The Medial Pivot design differs from traditional knee implants by closely mimicking the natural biomechanics of the knee. The new knee replacement offers greater stability on the inner (medial) aspect of the knee, as in a ball-and-socket joint, yet permits more normal movement from front to back on the outer (lateral) aspect of the knee. In addition, the NitrX implant has a titanium niobium nitride coating, providing a low metal reactivity profile, which can be advantageous in patients with metal sensitivities. The device is also bone-conserving and has a single-radius design, which helps maintain constant ligament tension throughout the range of motion.

Commenting on this, Dr. Kumardev Arvind Rajamanya, Director & Lead Consultant - Orthopaedic Surgery & Complex Trauma, Robotic Joint Reconstruction / Replacement, Sports Medicine & Arthroscopy, said, “This patient had severe Grade 4 osteoarthritis with deformity and instability, but was very active and wanted to be able to climb stairs easily. Given her age and desire to remain active, we opted for a procedure designed to restore knee function in a way that closely replicates her natural anatomy. The Medial Pivot allows for stability on the medial side with controlled lateral translation, which is as close to a natural knee as possible. With kinematic alignment, we are effectively recreating her natural pre-arthritic knee, not just aligning it like every other knee.”

Dr. Nitish Shetty, Managing Director, KIMS Hospitals (Krishna Institute of Medical Sciences), Bengaluru, said, “At KIMS Hospitals, we are dedicated to facilitating the implementation of evidence-based and patient-centric surgical practices. This initiative is a part of our continued endeavour to enhance the advanced orthopaedic care services offered at our hospitals.”

This development reflects the growing adoption of highly advanced, bone-conserving, and anatomically correct knee replacement procedures in India, which further emphasises the need for precision-based and result-oriented orthopaedic practices.