Prosthetic HIP replacement: its place in developing countries

During the last 30 year, Prosthetic Total Hip Replacement has become a standard Orthopaedic surgical procedure and one of the commonest practiced in Western communities. This has brought a lot of relief to many patients afflicted with severe hip arthrosis from various causes, making them lead almost a normal life. Although the potential complications following prosthetic total hip replacement are many and may be serious; intra-operative complications like femoral fractures or perforations and post-operative ones like stem or cup loosening and failures; can be overcome by better surgical procedures and better instrument and prosthetic designs. Post-operative infection in the author’s opinion, is the most crippling and disabling complication, limiting the routine prosthetic total Hip Replacement in most developing countries. A sample of 183 patients who underwent prosthetic total hip replacement at Kreiskrankenhaus Dormagen, 7 and 25 who underwent hip arthrodesis and resection (Girdlestone) arthroplsty respectively at Muhimbili Medical Centre are analysed in terms of post-operative functional capabilities. The results show the superiority of total hip replacement may be an expensive undertaking it is an absolute entity in the present set-up of orthopaedic surgery. Infact it is possible to start hip replacement using the present physical facilities at Muhimbili Medical Centre by practicing certain precautions.