65-Year-Old Woman Undergoes Rare TKR with 32 Loose Bodies Removed at Fortis Shalimar Bagh

New Delhi: In a rare surgical achievement, doctors at Fortis Hospital, Shalimar Bag, successfully performed a Total Knee Replacement (TKR) surgery on a 65-year-old woman while simultaneously removing 32 intra-articular loose bodies weighing 250 grams — a combination seldom reported in global orthopaedic practice.

The complex procedure was led by Dr. (Prof.) Amite Pankaj Aggarwal, Principal Director and Head of Department at the Fortis Bone and Joint Institute, Fortis Shalimar Bagh. The patient was discharged in stable condition within six days.

The patient had been suffering from progressively worsening knee pain and joint deformity for several years. Performing basic activities had become near impossible for her due to the severe stiffness and instability in the joint.

Upon admission at Fortis Shalimar Bagh, pre-operative X-rays revealed widespread calcified loose bodies filling the joint. Intra-operative images confirmed 32 lumpy growths, some nearly 4 cm in size, with the combined specimen weighing an unprecedented 250 grams.

This condition was identified as secondary synovial chondromatosis – a rare disorder in which cartilage nodules form inside the joint due to an earlier issue, progressively restricting movement and damaging the joint. All loose bodies were removed before the knee replacement, ensuring successful reconstruction.

The sheer volume, 32 bodies weighing 250 grams, marks this as an exceptionally rare occurrence in medical literature.

Giving details of the case, Dr. (Prof.) Amite Pankaj Aggarwal, Principal Director and Head of Department at the Fortis Bone and Joint Institute, Shalimar Bagh, said, “This was an extremely advanced and rare reported case. The joint cavity was packed with 32 loose bodies, some nearly the size of walnuts.

The total weights exceeding 250 grams are very rare and, combined with a complex reconstruction, make it even rarer. Performing a knee replacement in such a compromised joint required meticulous planning and advanced surgical techniques.

The patient responded well to early mobilisation and reported substantial pain relief and improved joint mobility within days. Post-operative physiotherapy is ongoing, leading to good recovery.

Cases like these are rare not just in number or weight, but in the surgical challenges they pose. However, we were able to restore the total joint function with significant improvement in the quality of life for the patient who had been suffering for years, and that’s the real happiness for a doctor”

Mahipal Singh Bhanot, Business Head, Fortis Memorial Research Institute, Gurugram, said, “This case is a testament to the clinical excellence, advanced surgical capabilities and compassionate care that define Fortis hospitals.

Successfully managing such a rare and complex presentation — involving one of the heaviest documented intra-articular burdens during a knee replacement — reflects the expertise of our medical team and the high standards of care we uphold. Our focus remains on delivering world-class outcomes that not only treat the condition but also restore dignity and mobility to our patients.”