Background: Despite the large volume of knee replacements carried out the world over, three very pertinent questions regarding the basic act of sitting & its relevance to Knee Arthroplasty have not yet been given adequate thought. Objectives: 1). whether sitting cross legged is healthier than chair sitting, 2). does sitting cross legged impact quality and longevity of life, 3.) Does it affect durability of the Arthoplasty implant whether total or partial knee Arthoplasty. This Pilot Analysis may lead to change in the habitual practice of doing total knee replacements without considering a more functional, less invasive & more cost friendly option. Methods: This study was conducted in accordance with the MOOSE (meta-analysis of observational studies in epidemiology) and PRISMA (preferred reporting items for systematic reviews and Meta analyses) guidelines. Results 1. Sitting cross legged is scientifically proven healthier way to sit compared to chair sitting on all counts…Body &Mind as reported by studies from Yoga, Sports medicine & human physiology. It increases fitness & enhances longevity of life too. 2. Only Unicondylar knee Arthroplasty gives the ability to sit cross legged (most Total knees are not allowed to sit cross legged for fear of exaggerated wear and those that are have a unacceptable percentage of spin offs or dislocation of polyethylene inserts) 3. In almost all lab studies, the mean wear rate of the medial & lateral bearings combined as a Total knee Replacement are significantly lower than a comparable fixed bearing as TKR under the same kinematic conditions. Unicondylar knees last longer too. Conclusions: Sitting cross legged is an important function for health & longevity. It is culturally an unalienable part of Indian/Asian lifestyle. UKA provides these advantages and lasts longer in In vitro studies.

<p class="abstract"><strong>Background:</strong> There are many studies to show comparative cartilage wear of medial and lateral compartment of knee. However, there are no studies in Indians that compare relative cartilage loss between femur and tibia.</p><p class="abstract"><strong>Methods:</strong> 44 patients with osteoarthritic knee at our center were posted for operative intervention in the form of partial or total knee arthroplasty and included in this study. Each patient had an magnetic resonance imaging (MRI) (cartogram) and weight bearing X-rays of the same knee. Intraoperative qualitative cartilage loss both femoral and tibial surfaces was observed and confirmed with preop findings of cartilage loss on X-ray or MRI.<strong></strong></p><p class="abstract"><strong>Results:</strong> The wear/loss of cartilage in 44 patients in femur is approximately twice that of tibia.</p><p class="abstract"><strong>Conclusions:</strong> Femoral cartilage loss is significantly more than tibia in Indians. These findings carry significance of not waiting for bone on bone arthritis to consider active treatment for Indian osteoarthritis patients. Bone on bone arthritis has so far been considered the litmus test for any intervention for osteoarthritis, even in India. Specific attention should rather be given to the femoral condyle clinically and radiologically. The authors have already described “The Dervan RIM sign” for the same purpose. The wear pattern is different from Caucasians and focus cannot be on joint space narrowing which is only with equally prevalent tibial and femoral cartilage wear.</p><p class="abstract"> </p>