Total Hip Arthroplasty in a Resource-Limited Setting: A Retrospective Case Series at Panzi Hospital, Bukavu, Democratic Republic of the Congo.
Article Sidebar
Main Article Content
Abstract
Background: Total hip arthroplasty (THA) is a functional surgery that replaces a damaged joint to reduce pain and improve the patient's quality of life. It is a procedure that requires careful preparation, from consultation to surgical procedure, taking into account patient hygiene conditions, aseptic conditions in the operating room, equipment, and surgical expertise. All these aspects pose challenges for hospitals with limited resources.
Case presentation: We report a case series study of 10 consecutive cases of total hip arthroplasty indicated for coxarthrosis and old femoral neck fractures in the Department of Surgery of Panzi General Referral Hospital in 2022. The etiology of joint destruction included primary and secondary coxarthrosis, osteonecrosis, and fracture sequelae. The mean age of our patients was 38 years. A posterolateral surgical approach according to Moore was used for our patients. Ninety percent of the implanted prostheses were cemented. All patients received prophylactic antibiotic therapy (amoxicillin-clavulanic acid). No major complications or reoperations were noted after a minimum follow-up of 1 year. The results, according to the Merle d'Aubigné scale, are considered good.
Conclusion : In cases of advanced osteocartilaginous destruction of the hip joint with severely impaired function, regardless of age, total hip arthroplasty remains the treatment of choice, even in a resource-limited setting.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Ferguson RJ, Palmer AJ, Taylor A, Porter ML, Malchau H, Glyn-Jones S. Hip replacement. Lancet. 2018; 392(10158):1662 -71.
Elzohairy MM. Concept récent de prise en charge des fractures du col du fémur non consolidé chez l'adulte jeune. Ortho Rheum Open Access J. 2017; 6(4):1-7.
Learmonth ID, Young C, Rorabeck C. L'opération du siècle : l'arthroplastie totale de la hanche. Lancet. 2007; 370(9597):1508-19.
Rivière C, Harman C, Logishetty K, Van Der Straeten C. Le remplacement de la hanche : Son développement et son avenir. Pers Hip Knee Jt Replace. 2020; 23-32.
Pedneault C, George SS, Masri BA. Challenges to Implementing Total Joint Replacement Programs in Developing Countries (Défis de la mise en œuvre des programmes d'arthroplastie totale dans les pays en développement). Orthop Clin. 1 avr 2020; 51(2):131 -9.
D'Augibné RM. Evaluation numérique de la fonction de la hanche. Rev Chir Orthopédique Réparatrice Appar Mot.1970 ; 56(5):481 -6.
Pivec R, Johnson AJ, Mears SC, Mont MA. Arthroplastie de la hanche. Lancet. 2012; 380(9855):1768 -77.
Roshan A, Ram S. The neglected femoral neck fracture in young adults : review of a challenging problem. Clin Med Res. 2008 ; 6(1):33-9.
Davidovitch RI, Jordan CJ, Egol KA, Vrahas MS. Défis dans le traitement des fractures du col du fémur chez l'adulte non âgé. J Trauma Acute Care Surg. 2010; 68(1):236-42.
Polkowski GG, Callaghan JJ, Mont MA, Clohisy JC. L'arthroplastie totale de la hanche chez le très jeune patient. JAAOS-J Am Acad Orthop Surg. 2012; 20(8):487-97.
Davies PS, Graham SM, Maqungo S, Harrison WJ. L'arthroplastie totale en Afrique subsaharienne : une revue systématique. Trop Doct. Avr 2019; 49(2):120 -8.
Hasegawa Y, Amano T. Surgical Skills Training for Primary Total Hip Arthroplasty. Nagoya J Med Sci. févr 2015;77(1 -2):51 -7