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<p class="abstract"><strong>Background:</strong> The clinical and functional outcome of total knee arthroplasty was studied using low cost Indian knee prosthesis called Destiknee by Maxx Company in government medical hospital. The objectives was to do assessment of pain relief, joint mobility and deformity correction post-operatively, pre-operative and post-operative Knee society score comparison.</p><p class="abstract"><strong>Methods:</strong> Patients included were those who underwent primary total knee arthroplasty in Department of Orthopaedics, GMCH Aurangabad from January 2020 to January 2021. Clinical and functional assessment was done using the Knee society score and x-rays at 3, 6 and 12 months intervals.<strong></strong></p><p class="abstract"><strong>Results:</strong> At 1 year follow up of 28 knees, there was an improvement in the average pre-op Knee society score of 53.92 to average post-op score of 86.25 and in the range of motion from 80.42 degree to 127.32 degrees and knee flexion deformity improved from 15.25 degrees to 2.17 degrees, all of which had a p value&lt;0.05 are significant statistically. One diabetic patient with poor glycemic control had superficial infection and one developed minor pulmonary embolism which recovered with medical management. Patients had good satisfaction both in unilateral and bilateral TKA.</p><p class="abstract"><strong>Conclusions:</strong> TKA resulted in significant reduction in knee pain and improvement in the functional ability of patients. The results of this low cost Indian prosthesis in a government rural setup with no laminar airflow with good efficacy and minimal complications are excellent. It was a boon for the rural population suffering from knee pain.</p>

<p><strong>Background:</strong> Lumbar canal stenosis (LSS) is a source of significant morbidity and economic burden in the Indian population. Spinal canal compression is the sine qua non of lumbar canal stenosis but whether instrumentation should be done or not is the major dilemma. In this study, we aim to compare the functional outcome of instrumented versus non-instrumented fusions for the treatment of lumbar stenosis along with the post-operative complications and cost-effectiveness of both procedures.</p><p><strong>Methods:</strong> This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between May 2016 and May 2018 were included. Patients were assessed using the modified Oswestry disability index (MODI) and visual analogue scale (VAS). These evaluations were done at 3, 6, 12 and 24 months.</p><p><strong>Results:</strong> We found similar pain relief and stabilization in both the groups in the initial post-operative period, but after 2 years, there was a significant difference (p=0.0001) between the two groups in terms of VAS (back) and MODI score. Complication rate was higher in instrumented patients. </p><p><strong>Conclusions:</strong> Patient selection is the most important thing in the management of lumbar canal stenosis. We believe that, with the flowchart on the management of lumbar canal stenosis, it would help choosing patients better as to who would require instrumented fusion. Non-instrumented fusions might cost less and have fewer complications, but the overall outcome of the patient in the future should be kept in mind.</p>