Abstract
Joint replacement therapy (JRT) commonly performed in advanced countries is being introduced in some developing countries. The objective of this study was to assess anaesthesia used and the outcome of the first 17 cases performed at a young teaching hospital in Nigeria. This was a cross-sectional descriptive study of patients for JRT at Benue State University Teaching Hospital, Makurdi, Nigeria from 23/6/2014 to 31/8/2016. Data analyzed from the anaesthetic/surgical records included age, sex, ethnicity, ASA classification, Ficat and Arlet classification of avascular necrosis, Gardens classification of fracture neck of femur, indication/type of surgery, packed cell volume (PCV), anaesthesia type, estimated blood loss, transfusions, duration of surgery and hospital stay, post-operative PCV, pain management, complications and surgical outcome. Results were summarised as means, median and percentages using SPSS version 21.0 for Windows®. One-way test of ANOVA was used for statistical significance (p= 0.05). Seventeen patients aged 27-90 years (mean 54.71±19.69). Indications were femoral neck fracture (47%), chronic osteoarthritis (35%), avascular necrosis (18%). The commonest procedure was hemiarthroplasty (41%), total hip replacement (35%), and total knee (24%). All were under regional anaesthesia with spinal (53%) and combined spinal-epidural (47%). Multimodal post-operative analgesia was used. There was no significant difference between pre and post-operative PCV (t = 0.708, p=0.05). Mean duration of hospital stay was 19.44±9.61 days. The outcome was good in all. JRT can be established in a new center with proper planning. Regional anaesthesia with multimodal analgesia is recommended. With relevant surgical skill, patient outcome is good.
Highlights
Total joint replacement therapy is one of the advanced surgical techniques offered in modern day surgery
The objective of this study was to assess anaesthesia used and the outcome of the first 17 cases performed at a young teaching hospital in Nigeria
Seventeen cases of joint replacement surgeries were done during the period under review
Summary
Total joint replacement therapy is one of the advanced surgical techniques offered in modern day surgery. 2018 Journal Impact Factor: 1.10 Print ISSN: 2636-7378 | Online ISSN: 2651-5865 performing over 600,000 annually,[3] many centres in the less developed parts of the world are yet to resume this service to patients. This is due to reasons bordering on developmental challenges. Salihu et al,[4] reported early efforts at total joint replacement therapy in Dala Kano involving 10 cases with severe osteoarthritis of the hip in 2008, but three of the patients had severe adverse outcome that necessitated revision surgery. Ekere et al,[5] in 2008 reported two cases of total hip
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