Total Hip Arthroplasty in a Low-Income Country: Ten-Year Outcomes from the National Joint Registry of the Malawi Orthopaedic Association.

Graham, Simon Matthew ORCID: 0000-0002-4091-7548, Howard, Nicholas, Moffat, Chipiliro, Lubega, Nicholas, Mkandawire, Nyengo and Harrison, William J ORCID: 0000-0001-7229-0041 (2019) Total Hip Arthroplasty in a Low-Income Country: Ten-Year Outcomes from the National Joint Registry of the Malawi Orthopaedic Association. JB & JS open access, 4 (4). e0027.1-e0027.5.

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Abstract

We describe our 10-year experience performing total hip arthroplasty (THA) in patients enrolled in the National Joint Registry of the Malawi Orthopaedic Association.<h4>Methods</h4>Eighty-three THAs were performed in 70 patients (40 male and 30 female) with a mean age of 52 years (range, 18 to 77 years). The cohort included 24 patients (14 male and 10 female; mean age, 52 years [range, 35 to 78 years]) who were human immunodeficiency virus (HIV)-positive.<h4>Results</h4>The main indications for surgery were osteonecrosis (n = 41 hips) and osteoarthritis (n = 26 hips). There were no deaths perioperatively and no early complications at 6 weeks. Forty-six patients (59 THAs) were seen at 10 years postoperatively, with a mean Harris hip score (HHS) of 88 (range, 41 to 91) and a mean Oxford Hip Score (OHS) of 46 (range, 25 to 48). Five hips (8% of 59) were revised due to loosening (n = 4) and fracture (n = 1). There were no infections or dislocations. Fourteen patients died, including 4 HIV-positive patients, of unknown causes in the follow-up period, and 10 patients were lost to follow-up. In the group of 24 HIV-positive patients, there were no early complications, and the mean HHS was 88 (range, 76 to 91) at >10 years.<h4>Conclusions</h4>Our 10-year experience and long-term outcomes after primary THA in a low-income setting show that good results can be achieved within a controlled hospital environment, thereby establishing a benchmark against which other hospitals and registries in similar low-income countries can compare their results.<h4>Level of evidence</h4>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Item Type:	Article
Uncontrolled Keywords:	HIV/AIDS, Prevention, Clinical Research, Arthritis, Musculoskeletal, Infection
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	16 Apr 2021 07:16
Last Modified:	17 Mar 2024 08:40
DOI:	10.2106/jbjs.oa.19.00027
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3119392