Total knee replacement in a resource constrained environment: A preliminary report.

ABSTRACT

INTRODUCTION: Total knee replacement surgery is relatively new in Nigeria and available in few centres only. It has been evolving at a slow pace because of the lack of facilities, structures and adequate surgical expertise alongside patient ignorance and poverty. OBJECTIVE: The aim of this article is to review the cases done in a resource constrained institution in Nigeria and report the short term outcomes. METHODOLOGY: All the patients that were booked for Total knee replacement, using same prosthesis over a 40 month period, were recruited into the study. Using a prepared data tool, information on personal biological information, clinical presentation, peri-operative management, and outcome of management were obtained after an informed verbal consent. All the patients were further followed up for at least one year. RESULTS: 45 knees were replaced in 38 patients. The age range of the patients was 41-85 years with a mean age of 62.6. The male to female ratio was 1 4.4. The indications for surgery were a combination of pain and deformity. All the patients came with varying forms and degrees of angular deformities. Eight knees had bone defects that required bone grafting while 5 knees had tibia extension rods. The commonest complication, which was recorded, was drop foot (8.9%). Knee society pain scores in the patients improved from the average of 21.35 to 83. CONCLUSION: Despite the challenges inherent in health care in developing countries, with proper institutional planning and team work, the short term outcome of arthroplasty in our resource constrained environment is good.