The pattern of knee pathology seen in an Indian mission hospital following the introduction of knee clinics is described. This paper reports the results of the first 200 consecutive patients seen at these clinics, relating the findings to anticipated treatments. The occurrence of degenerative disease was high. The importance of knee flexion, in order to be able to squat, is highlighted. The necessity to adopt this position materially alters the types of treatment that can be offered to this group of people. It is concluded that treatments common to the West are not always suitable for patients in the Third World.