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African Journal of Rheumatology

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Hip osteoarthritis in Douala General Hospital: Clinical, radiological patterns and treatment options

B M Doualla, L Longbiforo, P Fokam, C M Taku, A M Chichom, M N Ngowe

Abstract


Background: Hip osteoarthritis is a chronic debilitating disease that is treatable surgically by total hip replacement, sparingly available in developing countries, particularly in Africa. Few data are available on clinical patterns of hip OA in Cameroon.
Objectives: To describe the epidemiological, clinical and radiological profile of hip OA, and also treatment options offered to patients presenting with this condition at the Douala General Hospital, Cameroon.
Methods: After prior ethical clearance, a hospital-based cross sectional descriptive study was carried out, including all patients (one patient = one file) diagnosed with symptomatic hip OA during a 10 year period between January 2004 and December 2013 in Rheumatology and Orthopaedic Units at DGH. The Kellgren-Lawrence classification was used. Data was collected using pretested questionnaires and analyzed using Epi info version 7 and Microsoft excel 2007.
Results: Of the 9615 cases reviewed, 258 (2.7%) had symptomatic hip OA. The mean age was 53.3 ± 16.3 years (16 – 85 years). Females were more affected (56.4%). The mean BMI was 27.0 ± 4.3 (19.7 – 41.9) Kg/m2. The prevalence increased with age over 50 years. The most frequent clinical findings were pain in the inguinal area, morning stiffness, limping, and limited range of internal rotation hip motion. Pain was usually moderate to severe in intensity. The most frequent radiological grade was K-L grade 4 (39.3%). The condition was unilateral in 73.1% of cases; it was unipolar in 65.4% (superior pole most affected); bicompartmental in 14.1%; tricompatmental in 20.5% of cases. There was no association between pain and radiologic grade of symptomatic hip OA. Out of the hundred with indication of hip arthroplasty, only forty-seven patients underwent surgical hip replacement therapy. The main limitation was financial.
Conclusion: Symptomatic hip OA has a female predominance. From the age of 50 years, females are more likely to develop the condition. There is poor correlation between symptoms and radiological findings.

Key words: Hip osteoarthritis; Pain; Joint replacement; Africa



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