Indian bones are conventionally weaker, deformed and more osteoporosis-prone compared to Americans or Britons, say leading knee replacement surgeons who participated in a knowledge-sharing exercise here on replacement surgeries. The exercise also threw up insights about how Africa could also emerge as a major resource pool for tapping patients in India's quest for medical tourism. Speaking to IANS on the sidelines of the event, Erik Zeegan, a leading Las Vegas-based orthopaedic surgeon, said that knee replacement surgeries in India tended to be a lot different from those in the US owing to the more deformities of the bones found in the sub-continent. "The deformities here are significant. The knees are more worn out. We do not see such deformities in the US," Zeegan said, adding that knee sizes of patients in the US also tended to be larger than those found here. One of the reasons for this, according to Ameya Velingker, a Goa-based specialist, is that Indian patients tend to take their osteo-arthritic knees to the very terminal stages before choosing the surgical option to overcome a bad knee situation. One of the reasons why over 700,000 knee replacement surgeries are conducted in the US every year as compared to 70,000 in India, is because the procedure is considered a natural extension of knee treatment there, Velingkar said. "In India, a lot of people still give it a lot of thought because of a few failed cases of knee replacement surgeries which have happened because of bad medical advice," Velingker said, adding that there were instances in the past when knee replacement surgery was relatively new and doctors in some cases recommended the surgery even when it was not required.