Chennai hospitals and doctors find favor in the UK & USA, for orthopedic surgery. Treatments like Hip & Knee replacements, Shoulder surgery, and Knee & Shoulder arthroscopy are available. Sea side spas and resorts nearby allow recuperation following orthopaedic surgery. Patients from the UK, USA, Australia and Canada with orthopedic problems are now attracted to this south Indian city.

Absence of hidden costs and agents, transparent dealings, skilled surgery, nursing, physiotherapy, clean hospitals are factors responsible for increasing medical tourism. Emerging collapse of Medicare in the US and the NHS in the UK are forcing ordinary folk without medical insurance to seek orthopedic treatment in India. Elderly people with chronic orthopaedic problems like Hip and knee osteoarthritis, shoulder and spine problems are unable to withstand their pain and cannot afford private treatment in their own countries.

They discover well qualified and trained Indian doctors performing these operations in India at affordable costs. Having worked in the West earlier enables doctors to understand the requirements of their patients in terms of comfort, standard of care, communication, food habits of the patients etc. Westerners find themselves comfortable in the presence of UK qualified doctors. The common operations like total knee & hip replacements, hip resurfacing, arthroscopic surgery of shoulder and knee are much in demand amongst these medical tourists. While emergency care is excellent in the UK's NHS, patients are faced with long waiting lists of up to a year for elective orthopedic surgery. Having paid up their tax contributions they become frustrated when they cannot get timely surgical treatment for chronic joint problems.

Unlike patients with heart disease, people with orthopaedic problems can travel safely and are doing exactly that, flying half way around the world to India for orthopedic surgery. Mark Carr, an outdoor sports expert from Wales who underwent shoulder surgery in Chennai six months ago, says "When recently faced with a further 12 months of shoulder pain and the resultant inactivity, I decided to look for a solution outside the NHS. Of course there is private surgery in the UK. I asked the cost and was told £4500. This was more than I could afford. Back to search the web and reults lead me to Chennai. My operation was skillfully performed, I know that because I have seen the photographs and am now enjoying the results.

After ten days the constant nagging pain that had been with me for more than a year had gone and I enjoyed my first full night's sleep for that same period.” The same kind of frustration and inability to earn income and lay off from work due to pain arising from Knee osteo-arthritis also drove Mr. Brian Toughton, a 66 year old luxury coach driver from Stratford upon Avon to seek a knee replacement in Chennai. He came to have only one knee replaced, but when he realized that he couldn't afford another trip for surgery to his other knee which was also

in the same diseased state; he decided to have bilateral knee replacements done. He

did not regret it and was able to enjoy a fortnight's holiday in a seaside resort. Concerns amongst patients about cleanliness of hospitals, skills of surgeons, and familiarity of latest techniques are put to rest easily as Mr. Cliff Arkley, a marine consultant from Sussex found out recently by his experience. This gentleman underwent bilateral partial knee replacements. The prosthesis inserted was Unicondylar prosthesis with a mobile bearing. The surgery was performed through 3 inch long incisions called minimally invasive surgery or MIS. Advantages of minimally invasive surgery are decreased blood loss, lesser operating time and morbidity, less pain, quick rehabilitation and return of function. MIS, high flexion knee replacements ( allowing more natural bending of the knee to 155 degrees) are some of the latest advances in knee surgery available in the west and foreigners are delighted to have the same performed in India for a fraction of the cost. Affordable Costs - A total hip replacement in the US costs $39000, whereas one in Chennai costs only $6000 along with the cost of the implant.

A TKR in the UK costs 9500 pounds whereas the same can be done here for 3000 pounds. Patients find it easier to pay out of pocket than claim insurance. These surgical options are attractive . An added attraction at the successful conclusion of their surgery is recuperation in nearby resorts and spas. This added comfort mitigates to some extent the absence of loved ones by their side during recovery. The increase in numbers of foreign patients would boost the economy of the country. The standard of Indian hospitals would go up as institutions would be obliged to get JCI accreditation. Although costs are important in the short term, quality of care, research inputs, efficient management and long term results will fuel the industry of medical tourism. Governments should take note and should make available all incentives to doctors and hospitals to promote medical tourism like reduction in duties of imported equipment, reduction in visa processing times airport formalities and infra structure improvement. The trend in medical tourism to India will be then there to stay.

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