BENGALURU: With an increasing number of people requiring Total Knee Replacement(TKR) and Total Hip Replacement (THR) surgeries due to conditions like severe arthritis and ageing, the state government has issued an order to strengthen its health institutions for performing TKR and THR surgeries under the ‘Ayushman Bharat Arogya Karnataka (ABArK) scheme’.
The initiative comes in response to growing demand for these critical procedures and aims to reduce the current dependence on private healthcare facilities.
Currently, only 35% of TKR and THR surgeries are carried out in government hospitals. To address this gap, the government has designated the Sanjay Gandhi Institute of Trauma and Orthopaedics in Bengaluru, as the ‘Centre of Excellence’ (CoE) for TKR and THR surgeries which will provide comprehensive care, handle complex cases, and serve as the primary hub for training and technical support.
The government has also reconstituted a committee responsible for scrutinising pre-authorisations for TKR and THR procedures under the ABArK scheme. This committee, which now includes three to four additional orthopaedic surgeons, will ensure that only necessary and appropriate surgeries are performed, while also overseeing referrals to private hospitals. This will be the sole authority for authorising any such referrals and no government hospital will be allowed to authorise TKR or THR referrals to private hospitals without approval from this committee.
The committee will also assess why certain procedures are not being done in public institutions. If specific equipment is required, the committee will notify the concerned hospital authorities and the health department, ensuring that necessary provisions are made.
In cases where a government hospital lacks the expertise to perform TKR or THR surgeries, the committee will deploy trained orthopaedic surgeons from a pool of mentor surgeons associated with the CoE. These mentor surgeons will not only perform the surgeries but will also mentor the local medical staff and will be entitled to receive incentives as outlined under the ABArK scheme.
Under the new directive, the ABArK scheme will revise the package rates for TKR and THR surgeries, including the cost of implants. The Karnataka State Medical Supplies Corporation Limited (KSMSCL) will manage the centralised procurement of surgical implants to ensure cost efficiency and uniformity in quality across all government hospitals.
The Health Department, along with the Suvarna Aarogya Suraksha Trust (SAST), will monitor the implementation of this government order on a regular basis. The committee will offer free second opinions on the need for TKR and THR surgeries and SAST will establish a dedicated helpline to provide this service.