BENGALURU: The share of total knee replacement (TKR) and total hip replacement (THR) surgeries conducted in government hospitals has risen sharply to nearly 99% following a series of reforms introduced in 2024 to strengthen public healthcare facilities.
Until recently, a majority of these surgeries were being referred to private hospitals. In 2022-23, government hospitals performed 645 procedures, while 901 were referred to private facilities. The trend continued in 2023-24, with 633 surgeries in government hospitals compared to 1,038 in private institutions. In 2024-25 (till October), 537 surgeries were conducted in government facilities and 651 in private hospitals.
To reverse this dependence, the state government issued an order in September 2024 focusing on infrastructure upgrades, improving in-house surgical capacity and reducing referrals. A revised governance structure with senior and junior expert committees, along with mentor surgeons, was introduced.
A key intervention was the modification of the Online Referral System (ORS) in October 2024, ensuring clinical scrutiny before surgeries are approved and helping curb unnecessary procedures. A mentorship programme has also enabled senior orthopaedic surgeons to perform surgeries in government hospitals while training in-house doctors, building long-term capacity. Additionally, package reimbursement for government hospitals was increased from 75% to 100%, improving resource availability.
“As we examined why many cases were being referred to private hospitals, we realised the need to strengthen infrastructure and build confidence among our surgeons. Training and mentorship have helped reduce unnecessary referrals, while changes to the ORS have ensured more rational decision-making,” Health Minister Dinesh Gundu Rao said on Thursday.
“In 2025-26, we performed 1,119 TKR and THR surgeries in government hospitals, with only 14 cases referred to private facilities,” he added.
The number of government facilities offering these procedures has also expanded from 17 to 39, including district hospitals, government medical colleges and taluka hospitals, improving access across the state.
Officials said the reforms have also strengthened implant procurement, infrastructure and quality of care, supported by follow-up systems such as physiotherapy, call centre monitoring and district-level tracking.
Minister urges citizens to make use of second opinion helpline
The health department launched a free 24x7 second-opinion helpline (1800 425 8330) under the Suvarna Arogya Suraksha Trust (SAST) in 2024, through which patients who undergo joint replacement surgeries can consult specialists to understand alternatives and make informed decisions.
Rao said that while the helpline got 99 calls in the initial three months of its launch, it has since received a poor response. He urged citizens to make use of the helpline to avoid unnecessary surgeries and be aware of their treatment options.
