~ 719 ~ International Journal of Orthopaedics Sciences 2018; 4(4): 719-723 ISSN: 2395-1958 IJOS 2018; 4(4): 719-723 © 2018 IJOS www.orthopaper.com Received: 14-08-2018 Accepted: 18-09-2018 Pavankumar Kohli Professor, Department of Orthopaedics BKL Walavalkar Rural Hospital and Research Center, Derwan, Chiplun, Ratnagiri, Maharashtra, India Sushant Chavan Fellow In Joint Replacement, Department Of Orthopaedics BKL Walavalkar Rural Hospital And Research Center, Derwan, Chiplun, Ratnagiri, Maharashtra, India Ankush Nawale Junior Resident, Department of Orthopaedics BKL Walavalkar Rural Hospital and Research Center, Derwan, Chiplun, Ratnagiri, Maharashtra, India Siddharth Hardikar Junior Resident, Department of Orthopaedics BKL Walavalkar Rural Hospital and Research Center, Derwan, Chiplun, Ratnagiri, Maharashtra, India Sunil Nadkarni Professor Emeritus and Trustee, Department Of Orthopaedics BKL Walavalkar Rural Hospital and Research Center, Derwan, Chiplun, Ratnagiri, Maharashtra, India Correspondence Sushant Chavan Fellow in joint replacement, Department of orthopaedics BKL Walavalkar Rural Hospital and Research Center, Derwan, Chiplun, Ratnagiri, Maharashtra, India A nature friendly knee arthroplasty for prayer and meditation in Asiatic lifestyle Pavankumar Kohli, Sushant Chavan, Ankush Nawale, Siddharth Hardikar and Sunil Nadkarni DOI: https://doi.org/10.22271/ortho.2018.v4.i4i.86 Abstract Introduction: India is a country where many religions coexist together. Prayer & meditation form an integral part of Indian lifestyle. Also 90% of India’s population lives in the rural areas. Medial compartment osteoarthritis is the most common type of arthritis in India. Total knee replacement has longer rehabilitation time, morbidity and cost. In addition, it doesn’t allow squatting and sitting cross legged. With rise in unicondylar knee replacements for medial compartment osteoarthritis, patient’s satisfaction is much higher. Hypothesis of this paper was to investigate whether sitting cross-legged easily on floor for prayer and meditation, contributed to higher levels of patients satisfaction in unicondylar knee replacement significantly. Material & Methods: this retrospective study was done with study population of 36 patients of which, 33 knees of unicondylar knee replacement (mean age 61.7) and 25 knees of total knee replacement (mean age 63.5). We used modified Oxford knee score to compare the functional outcome and Likert scale for grading the patient’s satisfaction level. Results: study outcome after unicondylar knee replacement was extremely satisfactory for all patients measured with modified Oxford knee score and is better than total knee replacement. The mean Oxford score for 33 knees with unicondylar knee replacement is 47.18 and for 25 knees with total knee replacements is 46.35. But viewing by satisfaction index point of view, patients are highly satisfied with unicondylar knee replacement because of ability to squat and sit cross-legged used for praying and meditation and other social habits. Keywords: osteoarthritis, unicondylar, total knee replacement, asiatic lifestyle Introduction Osteoarthritis is the most common form of arthritis in knee. It is a degenerative arthritis that occurs most often in people 50 years or older. Common symptoms include pain, swelling, deformity,decreased walking and exercises which affects all the systems finally affecting the life expectancy [1] . “Sitting on the floor is active sitting” – for centuries people in India sat on floors either cross- legged or in a squatting position. In yoga poses like as in “Vajrasana”, “Sukhasana”, it provides a subtle stretch to the spinal roots and nerves and keeps them healthy. You actually engage many of your muscles as opposed to when you sit on a chair. When you sit cross- legged on the floor where your heart receives the benefit of better circulation! [2] . By sitting on the floor, we strengthen the lumbar region of the body, reducing back pain and discomfort. The hips open, making our pelvis and legs more flexible. Core muscles are strengthened, and the ankles also get gently stretched. Floor sitting also helps promote mental calmness, soothes frazzled nerves and is said to aid one’s creative imagination [3] . Total knee replacement was a common choice for relief and instability correction in properly selected patients. This recommendation is often superfluous, training oriented, a hand me down from the dinner table culture of the west. It is certainly not a culture & Indian lifestyle friendly surgery. Many studies have found higher range of motion & functional result along with increased longevity with unicondylar knee surgery [4-8] irrespective of stage of arthritis and