I am pleased to submit this report on the ISKSAA Columbia, USA Travelling Fellowship, which I attended in April 2025 at the Missouri Orthopaedic Institute, University of Missouri under the expert mentorship of Dr. Ajay Aggarwal. I am deeply grateful to ISKSAA, especially Dr. Pushpinder Bajaj Sir and Dr. Lalit Maini Sir for this valuable opportunity.

Surgical Exposure

During the fellowship, I was exposed to 82 surgical cases, with a b focus on hip and knee arthroplasty. This included:

• Primary Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA)
• Direct Anterior Approach (DAA) THA
• Complex and revision joint replacements
• Robotic-assisted arthroplasty using the MAKO and VELYS systems

I had the privilege of scrubbing in for the majority of these procedures, gaining valuable insights into the surgical strategies employed by Dr. Ajay Aggarwal and Dr. Ellis Ghanem, particularly in complex hip revisions and advanced robotic-assisted cases.

Additionally, I participated in a Hands-on Cadaveric Robotic Arthroplasty Workshop at the Stryker Lab in St. Louis, where I trained with the MAKO 4.0 system for both hip and knee replacements, further enhancing my understanding of robotic workflows and precision techniques.

Hip Arthroscopy and Preservation Surgery

Under Dr. Ajay Aggarwal, I observed several hip arthroscopy procedures addressing FAI and labral tears, which were further reinforced by a Hands-on Cadaveric Hip Arthroscopy workshop at the MU Bioskills Lab. This session helped strengthen my anatomical and technical understanding of hip preservation surgery.

Shoulder & Knee Arthroscopy

I also had the opportunity to observe advanced arthroscopic surgeries under Dr. Matt Smith, Dr. Steve Defroda, and Dr. Nuelle Clayton, including:

• Primary and Revision Rotator cuff repair with augmentation
• Bankart Repair
• Meniscal repair, ACL & PCL reconstructions with Auto & Allografts
• Osteochondral Allograft transplants

These sessions offered valuable learning in technique and decision-making in sports medicine.

Academic Culture

Alongside operating room exposure, I attended outpatient clinics twice a week, gaining valuable insights into clinical evaluation, surgical planning, and patient communication. The team at the Missouri Orthopaedic Institute (MOI) fostered a warm, vibrant academic environment that encouraged curiosity, discussion, and collaborative learning.

A highlight of the academic culture was the weekly Arthroplasty Conference at MOI, where the entire arthroplasty team convened to audit recent cases, discuss complications, and review surgical outcomes. These sessions were followed by structured academic discussions and case presentations, enhancing evidence-based learning and clinical decision-making.

Dr. Ajay Aggarwal’s mentorship stood out as especially generous—he was consistently approachable, thorough in his teaching, and genuinely invested in the growth of each fellow.

Conclusion

This fellowship has enriched my surgical understanding and sharpened my vision for future practice. I am sincerely thankful to ISKSAA, Dr. Ajay Aggarwal, and the entire MOI faculty for this life-changing experience. I bly recommend this program to young orthopaedic surgeons aiming for global excellence in arthroplasty and arthroscopy.

Warm regards,