Frequently Asked Questions

No referral is necessary. You can book a consultation directly through Aster MIMS Kannur by calling 91-497 353 8000, messaging on WhatsApp, or using the online booking portal. If you are coming for a second opinion, bring your existing reports and imaging — I review everything independently before forming my own assessment.

Bring any existing X-rays, MRI or CT scans (DICOM files on CD are ideal), previous surgical reports, blood investigations, and a list of current medications. If another surgeon has recommended surgery, bring that opinion too. The more complete your records, the more precise my assessment. If you do not have records, we will arrange the necessary imaging at Aster MIMS.

Never. I trained at PGIMER Chandigarh, where the culture is thorough clinical examination before ordering any test. That approach stays with me. Your appointment is a dedicated time slot — I take a complete history, perform a detailed physical examination, review your imaging personally, and explain the diagnosis and options until you are fully satisfied. I do not believe in five-minute consultations or ordering unnecessary investigations.

Absolutely. A significant proportion of my practice involves patients seeking a second opinion before major surgery. Bring your reports, imaging, and the surgical plan you have been given. I will review everything independently and give you an honest assessment — including whether I agree with the recommendation, whether I would approach it differently, or whether surgery is even necessary. There is no obligation to proceed. Learn more about our second opinion service.

Yes. I use the CORI Surgical System by Smith+Nephew for total knee replacements at Aster MIMS Kannur. CORI uses real-time 3D bone mapping during surgery — it creates a digital model of your knee anatomy and guides implant positioning with sub-millimetre precision. Published studies demonstrate that robotic-assisted TKR achieves more consistent mechanical alignment and reduces outliers compared to conventional manual techniques. The robot does not replace the surgeon — it is a precision tool that I control at every step. The result is a knee replacement positioned exactly where it should be, tailored to your individual anatomy.

A total knee replacement typically takes 60 to 90 minutes of surgical time. With CORI robotic assistance, the planning is more precise but does not add significant time to the procedure. You will be in the operating theatre for approximately two hours including anaesthesia preparation. I use spinal anaesthesia combined with an adductor canal nerve block and a periarticular infiltration cocktail — this multimodal approach means most patients experience minimal pain immediately after surgery and require very little opioid medication.

I use internationally established implant systems with long-term published survivorship data — from manufacturers like Smith+Nephew, DePuy Synthes, Zimmer Biomet, and Stryker. The majority of my knee replacements use cemented fixation, which remains the gold standard with the most extensive long-term evidence. Modern implants have published survivorship rates exceeding 95% at 15 to 20 years. The specific implant is selected based on your anatomy, bone quality, and activity level — I discuss the choice and the evidence behind it with you before surgery.

Most patients undergoing total knee or hip replacement at Aster MIMS are discharged within 3 to 5 days. With our enhanced recovery protocol — which includes the adductor canal block, periarticular infiltration, and early mobilisation — you will begin walking with support on the day of surgery itself. Discharge timing depends on your pain control, mobility milestones, and home support. I do not rush discharge, but I also do not keep patients in hospital longer than necessary.

Pain management is one of the most important aspects of joint replacement, and I take it seriously. My protocol uses a multimodal, opioid-sparing approach: spinal anaesthesia for the surgery, an adductor canal nerve block that selectively numbs pain fibres while preserving muscle strength (so you can walk sooner), and a periarticular infiltration cocktail injected directly around the joint during surgery. After surgery, oral analgesics and ice therapy are usually sufficient. Most patients are surprised by how manageable the pain is compared to what they expected.

You will stand and take your first steps on the same day as surgery, with physiotherapist support. By Day 2 you should be walking short distances with a walker. Most patients transition to a walking stick by 3 to 4 weeks and walk unaided by 6 to 8 weeks. The pace depends on your pre-operative fitness, pain tolerance, and commitment to physiotherapy. The adductor canal block helps here — because it preserves quadriceps strength, you can mobilise earlier and with more confidence.

This is one of the most common questions I get, and the honest answer is: it depends. Many patients achieve enough flexion (120 degrees or more) to sit cross-legged comfortably after a well-done knee replacement with dedicated physiotherapy. However, the outcome depends on your pre-operative range of motion, body habitus, and commitment to rehabilitation. Deep squatting and using a floor-level Indian toilet place high stress on the implant — I generally recommend a Western-style commode or a raised seat attachment for the long term. For sitting on the floor during prayer or social occasions, most patients find a comfortable way to adapt within 3 to 6 months.

Yes — physiotherapy is not optional, it is fundamental to your outcome. A structured rehabilitation programme begins on the day of surgery and continues for 8 to 12 weeks. The physiotherapy team at Aster MIMS works closely with me to ensure your rehab protocol matches your surgical procedure. At discharge, you receive a detailed exercise plan that you can follow at home or with a local physiotherapist. I monitor your progress at follow-up visits and adjust the programme as needed.

Temple visits involving steps and uneven terrain are generally comfortable by 6 to 8 weeks, depending on the temple. For air travel, short domestic flights are usually fine after 3 to 4 weeks — the main concern is prolonged immobility increasing clot risk, so I recommend aisle seats, regular ankle exercises, and compression stockings for longer flights. Long-distance train or car journeys (4+ hours) should be approached with planned stops for stretching. I provide specific guidance based on your travel plans.

I treat the full spectrum of sports injuries at Aster MIMS Kannur — ACL and other ligament injuries of the knee, meniscus tears, rotator cuff tears and shoulder instability, ankle ligament injuries, and cartilage damage. We have a full arthroscopy setup, so most sports injuries are treated using minimally invasive keyhole techniques. This means smaller incisions, less pain, and faster return to activity compared to traditional open surgery.

ACL reconstruction is performed arthroscopically — through two or three small incisions around the knee. A new ligament is reconstructed using a tendon graft. The choice of graft — hamstring, bone-patellar tendon-bone, or quadriceps tendon — depends on your sport, anatomy, and activity demands, and I discuss this with you beforehand. The surgery takes approximately 60 to 90 minutes. Return to sport follows a structured rehabilitation protocol: light jogging by 3 to 4 months, sport-specific training by 6 months, and full competitive return by 9 to 12 months. I clear patients for return based on objective strength testing, not just time elapsed.

Read Dr. Vishnu's complete month-by-month recovery guide

Yes. I perform arthroscopic rotator cuff repair, treatment for shoulder instability (recurrent dislocations), frozen shoulder release, and other shoulder procedures. Not every rotator cuff tear needs surgery — small tears and partial tears often respond well to structured physiotherapy. For tears that do require repair, arthroscopic surgery offers excellent results with less post-operative pain and faster rehabilitation compared to open techniques. I assess each case individually and recommend surgery only when it will genuinely improve your outcome.

Not necessarily. Many meniscus tears — particularly degenerative tears in patients over 40 — can be managed effectively with physiotherapy, activity modification, and anti-inflammatory medication. Surgery is recommended when a tear is causing mechanical symptoms like locking or giving way, or when conservative treatment has failed after an adequate trial. When surgery is needed, I perform arthroscopic meniscus repair (preserving the meniscus) wherever possible, or partial meniscectomy (removing only the damaged portion) when repair is not feasible. The evidence strongly supports preserving meniscal tissue whenever we can.

Aster MIMS Kannur has a 24/7 trauma and emergency department. I manage the full range of orthopaedic trauma — from simple fractures to complex periarticular injuries, pelvic and acetabular fractures, and polytrauma (multiple injuries from road accidents or falls from height). Complex fractures often require urgent surgical stabilisation, and having an experienced trauma surgeon available makes a significant difference to outcomes. My training at PGIMER Chandigarh included high-volume trauma exposure across every major fracture pattern.

A non-union is a fracture that has failed to heal — typically after 6 months without signs of progress. A malunion is a fracture that has healed, but in a poor position causing deformity or functional problems. Both are complex but treatable. I manage these with revision fixation, bone grafting, deformity correction osteotomies, or a combination depending on the specific problem. If you have been told your fracture has not healed or has healed crooked, bring your X-rays and previous operative notes — these cases benefit from a detailed surgical plan.

Yes. Revision joint replacement — replacing a previously implanted knee or hip that has failed — is among the most complex procedures in orthopaedics. Causes include implant loosening, infection, instability, fracture around the implant, or wear. I manage revision TKR and THR cases, including infected implants requiring staged procedures. These cases require specialised implants, careful pre-operative planning, and experience managing bone loss. If your previous joint replacement is causing problems, I am happy to assess the situation and discuss options honestly.

Yes. Aster MIMS Kannur is empanelled with most major insurance providers and Third Party Administrators (TPAs) in India. Cashless hospitalisation is available for eligible policies. Our billing team can verify your coverage before admission and handle the pre-authorisation process. For patients without insurance, we provide transparent cost estimates upfront so there are no surprises.

Yes, for follow-up reviews and second opinion cases. Initial consultations for surgical planning should ideally be in person, as a proper clinical examination cannot be replicated on a screen. However, if you are travelling from outside Kannur or from abroad, I can conduct a preliminary assessment via video call after reviewing your imaging — and confirm the surgical plan when you arrive. This is particularly useful for international patients planning their trip.

You can book directly through Aster MIMS Kannur by calling 91-497 353 8000 or messaging on WhatsApp. Online booking is also available through the Aster Hospitals portal. If you are seeking a second opinion for complex trauma, revision surgery, or a non-union, please mention this when booking so we can schedule adequate consultation time.