The Human Core of the Machine
A conversation with Dr. K. J. Reddy, Chief Joint Replacement Surgeon at Apollo Hospitals, Hyderabad, on rural roots, robotic knees, and what technology will never replace.
As India’s own robotic surgical platforms enter clinical use and artificial intelligence quietly reshapes how operations are planned, Rashmi M of Neo Science Hub sat down with Dr. K. J. Reddy to revisit the arc of a career built between two continents.
His career spans a Chief of Unit posting in joint replacement surgery at Basildon & Thurrock NHS Hospitals in the UK, the presidency of the Indian Arthroplasty Association, and over 7,000 personally performed joint replacement surgeries — alongside a rural hospital built in direct response to his own father’s death. Here, Reddy speaks candidly about the discipline behind the discipline, and the one thing he insists no machine will ever replicate.
Q: You grew up in Aithole village, often on one meal a day, walking barefoot to school. Which single memory from those years surfaces when you’re scrubbing in at 7 am or still teaching at midnight?
The image that comes back to me is of a young boy walking barefoot to school, sometimes having had only one meal that day. We had very little, but there was never a feeling that our circumstances should determine our future — my parents made certain of that. They taught us that hardship is temporary, but knowledge and determination stay with you for life.
Even today, when I scrub in early in the morning or am teaching a young surgeon late at night, I sometimes think of that boy walking to school. It reminds me where I came from and, more importantly, why I continue to work. I have never considered medicine simply a profession — for me it is an opportunity to serve, to teach, and to create opportunities for others that may not have been available to me. That barefoot boy is still a part of me.
Q: Your father died because timely treatment wasn’t available. What is one specific thing — a protocol, a piece of equipment, a rule — at SVS Hospital or in your rural camps that exists directly because of what happened to him?
My father’s death had a profound influence on the way I looked at healthcare. He died at a time when timely medical treatment simply wasn’t available in our area, and for me that was not just a personal tragedy — it demonstrated exactly what happens when people are forced to travel long distances for emergency care, in a region where serious trauma cases were routinely sent all the way to Hyderabad because local facilities didn’t exist.
That experience is precisely why SVS Hospital was built around genuine 24-hour emergency services — the infrastructure, specialists and support required to respond immediately, rather than sending patients elsewhere. My father’s death cannot be undone. But if a family in that same region can now receive timely emergency treatment because we built those facilities, then something positive has come from a very painful experience.
Q: Four joint replacements on one patient in 24 hours is an extraordinary load. Walk us through what that day looked like — where the risk was highest, and what almost went wrong.
The patient was a 35-year-old senior banking professional from Lucknow with severe ankylosing spondylitis involving both hips and both knees — significant deformities, shortened limbs, and severe pain and disability. Replacing just one joint would not have solved the problem; the deformities were interconnected, so we planned a staged approach: both hip replacements on the first day, both knee replacements on the second.
The greatest challenge was managing the physiological stress of such extensive surgery. During recovery he developed an episode of hypotension, which required careful monitoring; we kept him in the ICU for two days, and he recovered very well. What makes the case particularly rewarding is where he is today — back in his professional life in banking, walking without the debilitating pain he had lived with, and extremely happy with the outcome. Cases like this remind me that complex joint replacement is not simply about replacing joints. It is about understanding the patient’s entire functional problem, planning carefully, having an experienced multidisciplinary team, and knowing when to intervene — and when to be cautious.
Q: From your own clinic data — what are the top three orthopaedic injuries you’re now seeing in under-35 patients that you didn’t see ten years ago?
Three categories stand out. The first is motorcycle-related injuries — with more young people on two-wheelers, we see significant knee, ligament and shoulder trauma following road accidents. The second is sports-related injury: more young people are playing football, cricket, badminton and running competitively, a genuinely positive development, but one that has brought more ligament, meniscal and tendon injuries into my practice. The third is overuse and stress injury, from intensive gym workouts and running pursued without adequate conditioning, technique or recovery.
These injuries existed ten years ago too, but I am seeing them far more frequently in younger patients now. The message isn’t to discourage activity — it’s to encourage young people to train intelligently, with proper technique, gradual progression and adequate recovery.
Q: Some doctors say the ‘gym culture is wrecking young joints’ narrative is overstated and mostly anecdotal. Does your data actually support an increase, or does it just feel more visible because these patients post about it?
I would not blame the gym or exercise itself — regular strength training, done correctly, is genuinely beneficial for bone, muscle and joint health. What I have noticed is an increase specifically in injuries tied to inappropriate training: excessive loads, poor technique, inadequate recovery, sudden jumps in intensity, and exercising despite pain.
Social media may make these injuries more visible, but in my clinical practice the real issue was never whether someone goes to the gym — it’s how they train. My message to young people is simple: exercise is medicine when it is done correctly. Build strength progressively, learn the correct technique, listen to your body, and don’t confuse pushing yourself with ignoring an injury.
Q: You’ve said up to 80% of knee problems can improve without surgery if caught early. What’s the single decision a patient makes that turns a manageable knee into a replacement case?
The biggest mistake is not seeking an opinion early enough. Knee pain is often ignored until it becomes severe — people continue with an unhealthy weight, inadequate muscle strength, poor activity patterns and repeated self-medication with painkillers, and by the time they come to us the disease may have progressed considerably.
Not every knee problem needs surgery, and I believe strongly in preserving the natural joint whenever reasonably possible — exercise, weight management, physiotherapy and activity modification can make a tremendous difference. The decision that changes the whole course is simple: don’t ignore persistent knee pain. Get the right diagnosis early, and treat the cause rather than merely suppressing the pain.
Q: For someone lying on the operating table next week: in plain language, what does the robot actually change about their surgery — the cut, the alignment, the pain after, the walk home?
The robot does not replace the surgeon; it helps the surgeon execute the surgical plan with greater precision. Before surgery, we build a detailed three-dimensional plan from the patient’s own anatomy; during the operation, the robotic system assists with positioning, alignment, bone preparation and balancing the knee.
That doesn’t mean every patient automatically has less pain or walks home sooner — recovery still depends on age, fitness, medical condition, surgical technique and rehabilitation. What the robot gives me is greater information and precision in the moment. The surgeon remains responsible for every decision; technology is an additional tool in the surgeon’s hands, not a substitute for surgical judgement.
Q: Robotic systems cost significantly more. Show us the number that justifies that cost — return-to-work time, revision rate, or satisfaction score, robotic vs. conventional.
The short-term results are genuinely promising — patients generally have less pain, recover faster and regain function earlier, and the precision and reproducibility robotic technology offers are real advantages. I would, however, be cautious about claiming robotic surgery delivers better long-term results than conventional knee replacement. We simply do not yet have sufficient 10-, 15-, or 20-year data to prove that conclusively.
What we can say today is that early clinical outcomes are encouraging and at least comparable to conventional surgery; the long-term evidence will determine how significant the advantage really is. For me, the value of robotics isn’t a claim that it’s simply ‘better’ — it’s that it improves precision and personalises the procedure, with recovery potentially made easier as a result.
Q: Between imported platforms — Mako, CORI, CUVIS, VELYS — and India’s own MISSO, how do you actually choose for a given patient, and where do you think Indian-built robotics will be in five years?
I don’t believe the question should simply be, ‘which robot is the best.’ The more important question is which technology is appropriate for this patient, this surgeon, and this clinical situation — weighing accuracy and reliability, the quality of pre-operative planning, intra-operative feedback, integration with the implant system, the surgeon’s experience with the platform, service support, and, importantly, overall cost to the patient.
India developing its own robotic technology matters enormously for the future of Indian healthcare. I want to see Indian robotics become increasingly evidence-based, affordable and accessible — not just in major metropolitan hospitals, but in Tier II and Tier III cities. The real success of Indian robotics, five years from now, will be the day a patient no longer has to compromise on technology simply because of cost.
Q: What AI tool are you actually using right now in your practice — not a pilot, not a press release — and what has it changed in a number you can point to?
At present, I use AI primarily as a support tool in radiology and surgical planning — particularly in young patients with knee deformities who may require corrective osteotomy, where AI-assisted analysis helps us understand the deformity more precisely and plan the correction more accurately. I also use technology-assisted planning in hip and knee replacement, where detailed analysis of the patient’s anatomy supports pre-operative planning and implant positioning.
I see AI as an additional tool for the surgeon, not a replacement for clinical judgement — the decision is still mine, made after weighing the patient’s symptoms, examination, imaging and individual requirements. The biggest change is that we can analyse information more precisely and plan surgery in a far more personalised way. I wouldn’t claim a specific percentage improvement unless it has been formally measured in my own practice, but the technology is developing rapidly, and I expect AI to become an increasingly important part of orthopaedic decision-making.
Q: Describe a realistic day for an orthopaedic surgeon in 2035. What part of that day is still unmistakably human, no matter how good the AI and robotics get?
By 2035, I expect a surgeon’s day to be surrounded by technology — AI analysing scans, identifying patterns, perhaps predicting which treatment suits which patient, with robotics making execution increasingly precise. But the most important part of the day will remain human.
A patient does not come to a surgeon with an X-ray alone. They come with fear, expectations, family concerns and questions about their future. Someone still has to listen, explain the options, take responsibility for the decision, and give the patient confidence. Robots can help me operate more precisely; AI can help me make better-informed decisions. But empathy, judgement, communication and responsibility cannot be outsourced. I hope the surgeon of 2035 will be less burdened by repetitive tasks, and therefore have more time to simply be a doctor.
Q: You and Dr. A.V. Guruva Reddy at KIMS are close friends as well as two of Hyderabad’s leading names in robotic joint replacement — does that friendship ever turn into a professional rivalry, or do you actually compare notes and refer patients to each other?
Dr. Guruva Reddy and I are very good friends, and the relationship goes well beyond our profession — we actually worked at the same place in the UK, and over the years it has grown into a close family friendship; his wife and mine are good friends too. We travel together and spend time together — last year, for instance, we travelled together to Vapi and spent three days there.
Professionally, there is a genuine exchange of ideas. Whenever either of us organises a conference, the other is usually there unless travel prevents it, and we discuss new developments in joint replacement and robotics openly. I don’t see it as a rivalry at all — we are both passionate about improving orthopaedic care, and having a good friend who is also an excellent colleague makes the profession more enjoyable. We can challenge each other and learn from each other and still remain very close. At the end of the day, the friendship matters far more than any professional comparison.
Q: You’ve treated VIPs and film actors alongside patients from your rural camps in the same week. Does treating a high-profile patient change anything about how you operate — the pressure, the precautions — or is a knee a knee regardless of who’s on the table?
The responsibility is the same. A high-profile patient may bring additional attention, and with it greater pressure around confidentiality, logistics and expectations — we have to be particularly careful about privacy, and make sure the entire team understands the importance of discretion.
But once the patient is in the operating theatre, the principles do not change. The assessment is the same, the surgical planning is the same, the safety protocols are the same, and the standard of care has to be the same. I have treated people from very different backgrounds — from public figures to patients who travelled from rural areas after attending our camps — and their circumstances may be entirely different, but when someone lies on that table, they are all patients who have placed their trust in us. So in the operating theatre, a knee is a knee — and every patient deserves the same concentration, care and respect.
