Total hip replacements at Kikuyu Hospital, Kenya
Background: Total joint arthroplasty is a highly effective procedure that is frequently performed in elderly patients. This is not so in the third world and is not frequently performed. Total hip replacement (THR) relieves the pain and functional disability experienced by patients with moderate to severe arthritis of the hip, improving their quality of life. It is a highly cost-effective procedure. Many patients deserving this operation cannot afford it in this part of the world and hence do not have it done. Objective: To analyse total hip replacement surgical procedures done in a mission orthopaedic hospital in Kenya with emphasis on early complications. Design: A retrospective hospital based study Setting: Kikuyu hospital Methods: Medical records of patients who underwent primary total hip arthroplasty between June 2006 and January 2008 in a sample of 97 patients done surgery at Kikuyu hospital. The patient’s medical records were looked at from the time a patient is first seen at the clinic by an orthopaedic surgeon and is recommended for a total hip arthroplasty and is followed up until 6 months after the operation. The difficulties encountered either by the surgeon or the patient during this period were recorded and analysed. Results: Of the 97 patients seen 99 operations were done and there were, two dislocations, two superficial and one deep wound infections, one upper gastro intestinal bleeding, two Deep Vein Thrombosis, one sciatic nerve neuropraxia, one haematoma formation and one intraoperative femoral fracture. Out of the 97 patients 40 of them had the surgery performed more than six months after a proper diagnosis was made and hip arthroplasty recommended. This is mainly due to lack of finances. At operation two cases were really difficult and took longer than the usual timing. Conclusion: Total hip arthroplasty is a safe operation even in the third world with satisfactory results. Just like in any other surgical procedure difficulties and complications are bound to occur.