58 yr old lady presented to us with osteoarthritis of left knee joint. The right knee joint also had early changes of osteoarthritis, but was not very troubling. Plan was made to replace only the left knee, with the hope that it would off load the right knee and increase its life too. However, the patient was resident of hilly area with tough terrain. She confessed that there was not road access to her home even. The patient was counseled about surgery and it advantage in prolonging preserving her right knee. These pictures are of the day sutures were removed. Notice the good range of motion and absolutely straight limb. After 7 yr follow-up, the patient now has no pain in left knee and very less discomfort in right knee. She is able to climb uneven hilly areas and carry on with her household work. The only medication given to her is glucosamines for her right knee and absolutely no pain killers.