Dr. Chandrasekar Chikkamuniyappa – Renowned Joint Replacement Specialist in Bangalore
With more than 25 years of experience in advanced joint replacement operations, Dr. Chandrasekar Chikkamuniyappa stands out as a renowned figure in orthopedics. Serving as both CEO and Senior Joint Replacement Surgeon in DHEE Hospitals Doddakallasandra, Bangalore, he has gained recognition as one of India’s top joint replacement specialists due to his dedication to enhancing mobility and quality of life. Dr. Chandrasekar, an expert in minimally invasive and computer-aided techniques, is highly regarded for his proficiency in hip replacement surgery, revision joint replacement procedures, and other intricate orthopedic interventions.
Extensive Knowledge in Orthopedics and Joint Replacement
The medical practice of Dr. Chandrasekar covers a wide range of orthopedic conditions, with particular emphasis on sophisticated procedures including:
Joint Replacement Surgery
Recognized as a top-tier joint replacement specialist, Dr. Chandrasekar is renowned for his outstanding results in knee and hip replacements, as well as revision operations. He utilizes state-of-the-art technology to enhance accuracy and expedite patient recovery.
Hip Replacement Surgery
Primary and revision hip replacement surgery are among Dr. Chandrasekar’s specialties. Complex cases involving severe arthritis, fractures, and unsuccessful prior surgeries are among his areas of expertise.
Revision Joint Replacement Surgery
Dr. Chandrasekar primary focus is on revision surgeries, where he addresses issues from prior joint replacements. Even in the most difficult situations, he guarantees the best results by drawing on his extensive experience.
Total Hip Replacement Surgery:
Dhee Hospitals provides cutting-edge total hip replacement surgery, giving patients a new lease on life via enhanced mobility, pain alleviation, and restored quality of life.
Revision Joint Replacement Surgery:
With the newest surgical procedures and individualized care service, Dhee Hospitals’ seasoned orthopedic team specializes in revision joint replacement surgery. We help patients to overcome problems and get back to their best.
Award for Excellence in Orthopaedics in 2018.
• India’s Most Promising Orthopaedic Surgeon – 2014
• ROC Fellowship
• Winner “Aryabhata International Award” 2010
• Best Performer Award, SPARSH Hospital 2008
• Fred Heatley Award for best poster presentation, London 2006
• Presented award winning video presentation at the annual conference of Karnataka Orthopaedic Association 2003
• British Council Sponsorship for Higher Training in the United Kingdom, 2003
• Best post graduate trainee M.S Orthopaedics examinations held by the Bangalore University, Bangalore, India, 1998
• National Merit Scholarship for 7 continuous years, Govt. of India, 1986-1993
“Welcome to America. Hope you will enjoy your visit,” greeting by the Visa officer at the JFK Airport, ended all my fears of being sent back home.
“Hi Ramya, I am here at JFK terminal 4,” I told my niece over the phone. “OK, just come out of the arrivals lounge and look to your left at the pick-up and drop-off area. You will see me and Ram.”
Life can never be so easy! You travel 13,400 Kms and there is someone waiting for you with a smile to welcome you! And this gets repeated at every place you go in America! Gods must be sweet!
“Hi there! May I help you?” asked a lovely young lady as I entered the education department.
“Hi, I have an appointment with Ms. Amanda Irene at 9 am. I am here to report as the new Ranawat fellow.” “Oh great! You must be Chikka …….. (Chikkamuniyappa). Sorry, I can’t get the name!”
“Please call me Chandra,” I said.
“Ok Chandra, please follow me,” said the lady.
“But my appointment with Ms Amanda…” I wondered loudly.
“Sorry, my mistake, I am Amanda!”
“Oh OK!” (I was expecting a 50-year-old lady sitting behind a huge desk who would interview me!)
“Please come with me Chandra,” reminded Amanda.
While on our way across the 70th street, Amanda gave me a few items and explained: “This is your bag, this is your ID Badge, you have to wear your badge at all times while you are in the hospital premises. The east elevators are located at the entrance to the main building. As we get out on the 2nd floor, make 3 left turns and you will be in front of the Scrubex machine which dispenses the orange scrub suit meant for all visiting doctors. Please enter 4045, your ID number. Now you enter the passcode I gave you, select your size and press enter.”
A neatly pressed scrub suit came out of the machine. As I was about to say “wow!” …
“Please remember your ID and passcode and do not forget to deposit your dress back when you leave,” instructed Amanda. “Please take the elevator again and go to 6th floor. Go past 3 doors on your left and you will be at Dr Ranawat’s office. You can always get back to me if there is anything I can help. All the best and Happy Learning new things at HSS.”
I just realized my appointment with Ms Amanda was over!
It’s all well-rehearsed at the Hospital for Special Surgery. Daily, several doctors from all over the world visit HSS. Only for me, it was all NEW!
As I reluctantly entered the 6th floor and opened the 3rd door, I saw the Big man himself just coming out of his office. “Good Morning Dr Ranawat, I’m ….”
“Do you know your schedule?” he asked me before I could complete my sentence. “No sir.” “You can call me Dr Ranawat,” he thundered!
“Sarah, could you please take this gentleman to the research office and let them explain the schedule,” he told another beautiful blonde lady standing there with a white coat.
“Every Monday morning at 7 am CSR (Dr Ranawat) has a teaching session for all the fellows, Tuesday morning is the Research meeting, Wednesday there may be Optional Undergraduate teaching, Thursday is Arthroplasty Grand Rounds and Friday is the General HSS Grand rounds at 7.15 am. Coming to clinical sessions, Tuesday and Wednesday we have full-day operating and the remaining days we have outpatient clinics (Mon, Thu & Fri). Monday and Tuesday the meeting is in Dr Ranawat’s Office and the remaining days at the 2nd floor conference room. This is your desk and your computer. Because of patient confidentiality, I can’t give you the username and password, but I will log you in whenever you need. By the way, my name is Matin and I am from Mumbai. If you do not have any questions, you can join back Dr Ranawat in his Clinic.”
Oh! I met a desi, I realized.
So within 30 minutes of me reporting to Ms Amanda, I was in business – My fellowship had started!
With 150 years of history and as a home to many innovators, designers, great teachers, eminent researchers and super specialists, Hospital for Special Surgery (HSS) stands tall and spreads across 3 streets, with a beautiful east river view in the upper east side of Manhattan. Probably the first hospital to propagate Orthopaedics as a separate sub-specialty, HSS initially had general surgeons as well but later shifted as orthopedic surgeons became dominant. Today, there are over 100 orthopedic surgeons from all super specialties practicing at HSS. There are 28 Arthroplasty surgeons in total, doing replacements alone.
Every day they do, on average, 150 orthopedic surgeries (yes! one hundred and fifty cases), out of which usually 50–60 are joint replacements. There are 20 major operating rooms, 8 ambulatory surgery units (day care surgeries like arthroscopies, etc.), and a couple of special procedure rooms. There is an in-house cadaver workshop for training residents and fellows. There is also a separate bio-engineering department doing basic research. HSS believes in being a front runner in cutting-edge research. In addition, many practices like the Ranawats’ have their own research wings.
HSS has been ranked #1 for Orthopedics for almost a decade in a row by various news agencies. Everyone in the organization is very proud of this fact, and HSS has never been shy of displaying it. One can see it in all their communications, billboards, signages, stationeries, etc. Any visitor or patient will never miss hearing about two things from almost everyone in the hospital: that they are #1 and their infection rate is less than 0.5% – the best in the nation!
Hospital for Special Surgery is not a charitable Trust, but they do a good amount of charity by raising funds through various events.
ROC is a totally independent private practice at HSS. This means that ROC rents space, equipment, theatres, etc. from HSS and has established a very successful practice. It has 3 surgeons – the senior Dr Chitranjan Ranawat and the two juniors, Amar and Anil Ranawat.
Dr Ranawat has also established the Ranawat Orthopedic Research Foundation (RORF) which is primarily responsible for all the research happening at ROC, for the Ranawat Orthopedic Conference held every year in India, and also for giving scholarships to 4 practicing arthroplasty surgeons in India for the Ranawat fellowship (I was one of them this year).
Just before I completed my fellowship, I wrote a letter to Dr Ranawat – I thought it is worth reproducing the way it is, as it retains the personal touch and sounds very dear.
Dear Dr Ranawat
The other day (in the uptown lounge) you wanted me to articulate what I am learning here in my fellowship and how it is going to affect my practice when I go back. Somehow, we did not get time to complete that conversation; hence I thought I will put it down so that you can read it when you are free. I am also adding a bit about why I chose to come here for this fellowship, and what inspires me!
Let us consider these under the following headings;Probably, this is going to be the area of major change to my practice. Blame it on my brief stint in England, I have been doing THRs through the antero-lateral (modified Hardinge) approach all these days. Although I am quite comfortable and getting reasonable and reproducible results, somewhere I felt posterior approach may be a more versatile approach for all hip surgeries. And you have consistently echoed this whenever there was an opportunity. (I know people like me take refuge in quoting less dislocation rate for continuing to use antero-lateral approach).
Books, videos, pictures could not convince me enough to change my practice from antero-lateral to postero-lateral.
After assisting you here, I feel I have reason enough to change my practice. I am amazed at how consistently you can find the landmarks and make every surgery look so easy. Only a few people can do that. I told you the story of a sculptor who, when asked about how he could produce such beautiful statues out of almost useless stones, answered: “The beautiful statues are already hidden there in all these stones; I just remove the unnecessary parts.” When I see your surgeries, I feel it is the same way – as if the road is crystal clear – and every time you find the landmarks in the same consistent manner.
I want to reach that stage, where, every time the surgery is as predictable.
Reproducing leg length and offset has been a big problem for me – now that you have showed me a way, I just can’t wait to go back and start practicing this. I just do not know if I can find the infra cotyloid groove every time. Of course, you have trained your eyes, hands and mind for so many years to perfect everything you are doing today. The least I can do is to start now!
Positioning the implants – trusting your own eyes and physical landmarks rather than feelings – is another learning point for me. For the femoral reaming, the starter reamer kept posterior and lateral in line with the medullary canal is probably easier through the posterior approach – this also might help me to get the lateral alignment of the femoral component.
The importance of closing the wound is another reinforced learning point for me. Even after so many years you wouldn’t leave it for others – I do not think this is without a reason.
Capsular repair by making two drill holes in the trochanter is a fantastic way of ensuring good closure – I had not seen this before but I want to practice this as well.
Injection of the ROC cocktail pain killer – which I have been resisting all these days – is probably another change. I see a pattern in your injection technique – and every time it is the same – every time you inject the same amount in the same area – unlike others who inject around the joint. Probably you should describe that as well! (Sorry for asking ready-made answers for everything).
Mostly, I have been following your techniques – including tibial sizing, finding the postero-lateral corner, matching the lateral side, dialing the tibia for correct rotation, stopping at the true antero-medial border, removing excess tibia (reduction osteotomy), pie-crusting of the medial collateral ligament for varus, inside-out technique for valgus, posterior release at the level of the tibial cut with cautery, etc.
New things, I am learning now / made me thoughtful:
I had no idea about your philosophy and practice prior to coming here. The first line I heard from you was: “Eyes first and most, Hands second and less, Tongue last and least!” I find this a fantastic philosophy. I was relying on my findings more than what the patient is saying or my assistant is feeling, but this line summarizes the order of priority.
When the patient is not yet mentally ready for surgery but has findings enough to warrant a surgery — you just boldly ask them to go back, revisit their lifestyle and come back later after 6–12 months! (People in private practice like me are not bold enough to say it so boldly – because after 6 months they may not come back to you, or someone else would have operated on them after a month!) But I feel for someone who is not prepared, this is great advice. Next time when they are back, they will ‘buy’ the surgery from you.
Asking your assistant or nurse to speak to the patient prior to you going in is one of the best strategies for outpatient practice. It prepares the patient, gives them time and opportunity to rehearse their complaints, and express freely. Often patients forget their lines when they go to see the ‘Big doctor’. For you, this gives an insight into the patient’s world – you already know their name, complaints, and needs before meeting them.
I have seen your patient examination techniques – every time it is thorough and intentional, and of course well documented. I feel like taking a video and watching it over and over again. Patient confidentiality comes in the way, but I am making a mental note of everything. Probably there is a case for you to make a video document of orthopedic examination of hip and knee (we can put it on YouTube so that people can see and learn). What impresses me is the consistency – if you are so consistent, you can’t miss a finding.
What I may not be able to reproduce is your charm – your ability to connect with the patient instantly and read their minds – understanding their needs and making a decision for them – preparing the patient for the worst but not denying them hope. I like your way of handling a difficult and unhappy patient – no confrontation, be consistent in what you are saying, and if everything fails, offer them a second opinion. I feel even such an unhappy patient will come back after visiting a few others. That’s a philosophy too.
Your ability to disconnect from one patient and reconnect with the next quickly is another quality I would want to reproduce.
I am amazed at how you have kept yourself ahead through research – what I see here is a parallel life. I see a structure which cannot fail! I want to understand this a bit more so that I can reproduce it (I know it’s not easy at all). Many of us get bright ideas, but most fail to execute them – we fail to put a structure so that it can reach a logical conclusion. Many projects die before they take off, and many others do not reach the conclusion stage.
Your undiluted enthusiasm for teaching is exemplary. As I see, your tribe is becoming less and less. Probably the need has grown exponentially, distractions have multiplied, and commercialization has taken over.
Getting up early in the morning and coming to your class is an ethereal experience for every fellow/resident at HSS. Lucky are those (many may not even realize this, but I am sure they will treasure these moments forever).
You have been exceptional as a human being, doctor, professor, educator/teacher, academician/scientist, designer, entrepreneur, mentor/guide, father, citizen (as I know), and also husband, grandfather (as I presume), and perhaps so many other responsibilities I may not even comprehend.
You have handled all kinds of pressure and responsibility with ease and eloquence. You never lost your ground despite the greatness achieved.
You have kept your standards very high and probably believed in what you keep saying: “Everything in life can be improved” – and you went on improving. Today you have reached a place where no one else can dream. I know your mantra is very simple: “Whatever you do, do your best.” This is very powerful, because you have proved it beyond doubt.
I was born in a small village with no connectivity of any sort. My parents never went to school but were small-time agriculturists. By God’s grace, my parents’ & teachers’ blessings, my brother’s support, and magical turns of events and scholarships, I happened to land in a medical college, then in orthopedics (all in state-run hospitals), and later in England, and now as a Ranawat fellow at Ranawat Orthopedic Center HSS!
I could have stopped at any stage, but I was unable to – I am unable to. I feel incomplete and restless after some time. After I learnt about you, I felt I have a role model to look up to. This was what made me choose this fellowship rather than any industry-sponsored and so-called training opportunities.
You have also proved what Narayana Murthy of Infosys keeps saying: “A plausible impossibility is better than a convincing possibility.” I would like to take this route. Of course life is not as simple as we wish, but like I said earlier, intention is important before execution. I want to aim for the sky so that I might reach at least the treetop!
In this regard, I would say you inspire millions; I am one of them too. If you ever write an autobiography, I will be the first one to read it – and be inspired by it.
I guess I have articulated enough for this time! The letter has already become too long – I will wait for my next opportunity to pick your brains.
Thanks a million for your time.