What inspired your journey into orthopedics, and how has your passion for the field developed over time?
Dr. Manit Arora: When I was in my third year of medical school, I had a strong desire to leave orthopedics and pursue a career in investment banking. I was feeling despondent and uncertain about whether I should continue my MBBS. It was during this challenging period that I had the opportunity to meet a prominent professor in orthopedics at Sydney, where I was studying.
The Professor had a profound impact on me. He was one of the leading experts in Australia, and simply observing his dedication and expertise reignited my passion for both medicine and, more specifically, orthopedics. I sometimes look back on that moment in my career when he encouraged me.
From that point on, my interest in orthopedics continued to grow. I consider myself fortunate to be among the relatively small number of orthopedic surgeons in the world, given that there are over 6 billion people globally and only a limited number of us in this specialized field.
My interest in sports was kindled by my own athletic background. I was a skilled cricket player and even earned a spot on the New South Wales Juniors team during my time in Australia. Additionally, I played rugby for my school. I have cultivated strong relationships within the realm of sports.
Once my passion for orthopedics was rekindled, it was only natural for me to gravitate towards the field of sports medicine.
What prompted your return to India from Australia, given your success there, and how has your transition and adjustment to life in India been?
Dr. Manit Arora: So, I did my MSO in Mumbai, so adjustment wasn't really ever such a big issue for me. The reason I moved back was because of my parents. My parents are in Chandigarh. I always wanted to come back. I felt that there's more potential for me to achieve more here as compared to there. If I was there, I would just be, you know, one of many, many sports legends.
I've had the opportunity to build my own departments also become one of the leading sports surgeons in the North. And I've had the opportunity to work with elite players at quite a young stage in my career. These are probably chances that I wouldn't have achieved if I was there. So, from an opportunistic standpoint, that and from a familial standpoint with my parents being here, those were probably the two driving forces for me to come back.
Do you collaborate with surgeons outside of your team, or is your team sufficient for your surgical collaborations?
Dr. Manit Arora: We have good relations with everyone, and I am of the mindset, which is the Australian mindset, that everyone does good work. I really don't believe you need to pull other people down. I think everyone is doing good work, and you just need to encourage them. The same goes for my team. You know, there are blips, ups and downs always, but as a net, we always move positively.
Same with the community that we're in and the region that we're in. There are a lot of orthopedic surgeons here who are doing very good work. We're really thankful to them for one, you know, referring their complex cases to us, and for two, for overall building up the sports medicine framework in the North. I think over the next 10 years, sports surgery is probably going to be the dominant arm of orthopedics like it is in the West. And we're in a place where we have the opportunity, and we have the skill set to make that happen.
How do you, with years of experience in orthopedic surgery, observe and adapt to changes in the field, including new treatment protocols and guidelines?
Dr. Manit Arora: I think orthopedics is a rapidly advancing field. If you just look back, you know, in the 1980s, there was hardly any sales surgery that was done. They've done open surgery. So, orthopedics came in the eighties and the nineties. The field I'm in is a very new field, only about 30 or 40 years old. Because of that, there are rapid technological advances happening in it. Things continue to evolve and get better with time."
We get more advanced in our techniques. We learn new things and incorporate them into our practice. Technology continues to drive our transformation, ultimately improving patient outcomes. I think this is probably the most exciting subspecialty of orthopedics there is, and it probably has the brightest future going forward because it's such a young field. It will only continue to develop, remodel, and get better as time goes by.
We learn from our past mistakes, things that have gone wrong and how we can improve them. We look forward to tomorrow where technology will take us. Yes, technology is going all over the place, with robotic surgeries, AI, and scanning for cancer cells and all that. I think it's going to continue advancing, and we are going to be outnumbered by the machines and the robots. It is going to happen. That is the future, like Terminator, Judgment Day. So, they're going to take over. I was talking to a robotic surgeon the other day, and she was telling me that the robots, because they're programmed with this machine learning software, when the surgeon puts in their initials and, they basically map each step. So before you know it, they get a sequence for your steps. They know what you're going to do next, so it automatically orients its arm there. What happens with time is that one day, I think not in the near future but in the distant future, once the machines learn all the complications and your movements, they can pretty much do the surgery for you. Yes, they can."
How do you stay updated on new evidence-based information and apply it in your surgical practice?
Dr. Manit Arora: Well, luckily, you know, I've got a very niche practice. I only do shoulder and ligament work.
Even in that, there's a lot of new things that come. I'm on the editorial board for a few journals. So, thanks to that, I get to see a lot of the new work that comes in. Plus, every morning I wake up around 4:35 and I do a lot of reading. That way, I'm abreast of what's happening, both from a new thing coming into the picture's point of view, as well as being apprised of what we've been doing and how that's tracking with how things are moving globally. Because I think it is a little different for other orthopedic surgeons. And being in the sports field is really good. It's always, you know, something new happening, and you're really busy.
I think there are two parts to that. One is your hospital challenges, and one is your community challenges, the community that you're in. So when I joined this hospital, there was a lot of internal challenges. There was a lot of internal resistance among the other orthopedic surgeons, among my fraternity members here. Because the sort of mindset and the sort of approach to patients that we were bringing, secondary training in Australia for all those years, was very different from what everyone had been accustomed to. So whenever something new comes, it's human nature that you're afraid of it. And you sort of, the way that you deal with that fear is you demonize it, right? The initial couple of years were very difficult in terms of dealing with the intra-hospital challenges, trying to educate.
And here, with time, what we've noticed is that those changes have come, people do understand now, right? And we're seeing that move out of our hospital into the community that we're in.
Both into our fraternity members in the community as well as the general public. So five years ago, very few patients in our region came to me saying I've got an ACO ligament tear and I need surgery. Now we've got everyone that says this is my MRI showing an ACO tear. So there's been a drastic shift in the last five years in our region. I would say we're still behind other bigger cities in terms of community development and patient awareness as compared to say, you know, bigger places like Delhi or Mumbai."
But I think that we're on the right path and the right trajectory, and it's just a matter of time. So time heals all wounds. Time will slowly, slowly invigorate people. And we've seen that the amount of arthroscopy that's happening has increased fivefold in the last five years in my region. So people are getting abreast of new technology and new techniques. People are, and those surgeons are now doing the work that we wanted to do, which is educate people in their region, patients as well as other surgeons. And you'll see it's a positive trend, which will reflect not immediately, but over the next five to 10 years.
Stay tuned for the third part of this interview!