Joint replacement surgery in Ghana (West Africa)—an observational study

Abstract

Introduction With the continued and effective transfer of orthopaedic knowledge and skills across continents, the incidence of hip and knee replacement surgery has increased in the developing world. More patients are having these procedures done locally rather than having to travel over to the more developed western countries at great financial costs for those who cannot really afford it. We report the data collected by an orthopaedic charity MOTEC LIFE UK which has been offering hip and knee arthroplasty procedures to patients who require them. The time period of the procedures was February 2013–October 2017. Methods The data was collated prospectively and this included age, sex, indication for procedure, and side of procedure (including if bilateral). The information on hip implants used were also collected—implant type (cemented or uncemented), type of bearing surface, size of acetabular cup, liner, femoral head size, and stem size and including if screws were used to augment the fixation of the femoral cup. For the knee implants used, information on the type of implant (semi-constrained, cruciate retaining, or Stanmore hinge knee prosthesis), femoral and tibia stem size, insert type (fixed bearing or mobile bearing), and size; patella button size (whether patella replacement or circumcision) were collected. The surgical approach used in both knee and hip arthroplasty cases was noted. Results It is seen from the data collected that a total of 113 hip arthroplasty procedures from 109 patients were carried out and for total knee replacements, 82 knee arthroplasty procedures from 76 patients were carried out. The above procedures were carried out in two separate hospitals. Degenerative osteoarthritis still remains the main indication for hip and knee arthroplasty surgery in our study and this is similar to other joint registries around the world. It was noted that the incidence of avascular necrosis as an indication hip surgery was higher than that seen in registries for developed countries. The mean age for the hip and knee replacement patient in our data was much lower than that what is obtained in the developed world. Furthermore, it was observed that there was increased use of semi-constrained knee prosthesis due to the severe osteoarthritic deformities noted in the patients seen when compared to rate of use of similar implants in the developed world. Conclusion This observational study could serve as a springboard for establishment of arthroplasty registries for countries in the sub-region as a whole.

Epidemiology and medical costs of orthopedic conditions in a tertiary hospital in Kenya; A five-year analysis of admission data

“…The median length of stay observed in this study was longer compared to literature from the developed world 26 but consistent with data from the developing world 22,24,27 . A possible explanation based on our experience could be due to little emphasis on cost effective care and resources miss match resulting in prolonged hospital stay and delay in accessing supporting services such as radiology, physiotherapy and laboratory.…”

“…In regards to arthroplasty, the median age and gender ratios are comparable to that recorded in other studies 22,23 but differs slightly from finding from a study from Malawi and Ghana 24,25 . The study however, points to an increased importance of fragility fractures or neck of femur fracture in total hip arthroplasty and posttraumatic arthritis in both total hip and knee arthroplasty.…”

Functional, Radiological Results and Quality of Life after Primary Total Hip Arthroplasty

“…In sub-Saharan Africa, the indications are multiple and varied, including tropical infectious pathologies, notably infections and post-traumatic hip osteoarthritis [2]. Access to this surgery remains limited in these countries with limited resources due to difficulties linked in particular to lack of equipment, insufficient qualified personnel, the absence of universal health insurance and the expensive cost for patients [3,4].…”

General and specialized Orthopaedics

“…Our aim is to compose the Journal according to the trends matching the current practice and research; however we know that the access to science is not even on our planet. We acknowledge in the general orthopaedics section efforts made by developing economies to provide quality orthopaedics in specific geographic locations and this stirs debate and comments [9,10]. We provide literature on general emergency principles, war and life threatening injuries [11,12].…”