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Foot and Ankle Surgery in India

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Foot and ankle orthopaedics has come a long way in India. In spite of a huge foot and ankle problems suffering population, till the twentieth century, India neither had a qualified foot and ankle surgeon nor had a centre of excellence for foot and ankle care! No opportunity to learn modern methodologies in the subject ever existed in India. Orthopaedic surgeons were not keen on practising foot and ankle orthopaedics. An association to study modern foot and ankle medicine The Indian Foot and ankle Society (IFAS) was established by Professor Sureshwer Pandey in 1987, however, it was officially registered in 2010 [1]. It initially had a membership base of 200 generalists. IFAS, at that time had a focus mainly on paediatric foot and ankle problems.

It was in the year 2006 that India’s first centre of excellence for foot and ankle care was established at Vadodara, Gujarat by three fellowship-trained generalists, Dr. Rajiv Shah, Dr. Malhar Dave and Dr. Nikesh Shah. Thereafter, the journey to establish foot and ankle orthopaedics as ‘The Specialty of Orthopaedics’ in India was on. It indeed was a big challenge! Foot and ankle problems in India were characterised with delayed presentations, lack of awareness and sheer neglect on the part of patients. Those on the part of the medical fraternity were also the same, lack of awareness and neglect! With no in house opportunity to get educated on the subject, orthopaedic surgeons had to look towards the western world for getting trained and educated; a costly mode. Implants, instruments and equipment were not available. Even India’s first centre of excellence for foot and ankle care was closed down at the end of 2 years because of financial losses.

The scenario slowly started changing. Indian origin foot and ankle surgeons based in UK and USA wilfully came forward to train and educate Indian colleagues. More and more orthopaedic surgeons got interested in the subject and got trained in the subject. Dr. Kartik Hariharan, Dr. Selene Parekh, Dr. Ashish Shah and Dr. Vinod Panchbhavi with their strong desire to give back to the home country provided mentorship to one and all. IFAS took rebirth as a comprehensive society for study and analysis of modern foot and ankle methodologies with a membership base of 600 orthopods. Annual meeting of IFAS is now receiving a huge response and is packed with quality deliberations and discussions of international standards [2]. IFAS is one of the key members of the Asian Federation of Foot and Ankle Surgeons (AFFAS) [3] and International Federation of Foot and Ankle Societies (IFFAS) [4]. The interest also aroused amongst the general orthopaedic surgeons to learn recent advancements in the subject of foot and ankle orthopaedics. State associations addressed this desire and association’s meetings gave a platform to the subject. Make in India, implants and instruments have gradually become available. So are the centres of excellence in foot and ankle care run by qualified foot and ankle surgeons all across the country. Foot and ankle orthopaedics is now on track to get established as ‘The Specialty’ of Orthopaedics in India.

Though the journey is towards a positive mode, a lot remains to be done. More and more youngsters need to shape their career in the subject of foot and ankle orthopaedics. At medical colleges, undergraduate curriculum needs a revamp to give wider coverage to this subject. More and more training opportunities require to be created at the doorstep. Education of society at large with respect to foot and ankle ailments is the need of the day. This is more so for the diabetic and sports population of India. The government needs to take a proactive role for this. While on part of foot and ankle surgeons of India, an obligation is to maintain records out of a huge database. Research is the tune of today and attitude of research must prevail amongst all. We, Indians have a lot to give to the world in the field of foot and ankle orthopaedics. The world is keen to learn about innovative Indian methodologies to effectively treat delayed presenting and neglected mangled cases. How we, Indians produce great results in spite of limited resources and financial constraints, is what world is also eager to learn. This can only happen through research and publication. Indeed we are very poor in this area. Let the research and publishing be our habit, our honest attitude! Tomorrow belongs to us, Indians!

References

  1. 1.

    Ifas.in. (2020). IFAS - Indian Foot And Ankle Society - Home - ifas.in. http://ifas.in/#/abouthis. Accessed 20 Jan 2020.

  2. 2.

    Ifascon2019.com. (2020). IFASCON 2019. 32nd annual conference of the Indian Foot & Ankle Society. http://ifascon2019.com/. Accessed 20 Jan 2020.

  3. 3.

    Affas.org. (2020). Asian Federation of Foot & Ankle Surgeons - Membership. https://www.affas.org/membership.html. Accessed 20 Jan 2020.

  4. 4.

    Aofas.org. (2020). Home, IFFAS. International Federation of Foot & Ankle Societies. https://www.aofas.org/iffas. Accessed 20 Jan 2020.

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Correspondence to Rajiv Shah.

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Shah, R. Foot and Ankle Surgery in India. JOIO 54, 1–2 (2020). https://doi.org/10.1007/s43465-020-00043-4

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