Nigerian Journal of Orthopaedics and Trauma

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Total Knee Replacement: a Preliminary Report Thirteen (13) Cases at Nohl

ME Ugbeye, OO Odunubi


Background: Total Knee Arthroplasty (TKA) is a major technical procedure. Since its introduction it has become a successful procedure for treating various forms of pathologies in the knee associated with severe pain and disabling deformities such as severe osteoarthritis. Although various systems exist, they are broadly classified into 2 main types, the posterior stabilized (or cruciate substituting) and the cruciate retaining. The procedure is not routinely done in Nigeria. This is due to lack of technical expertise and facilities.
Objectives: The goal of this report is to highlight the results of 13 cases done at the National Orthopaedic Hospital, Lagos.
Methods: This is a prospective report of 13 cases of primary Total Knee Replacement (TKR) at the National Orthopaedic Hospital Lagos between August, 2001 and September, 2005. There were a total of 13 knee replacement surgeries in 11 patients. Ten were females while 1 was male. Consecutive patients with severe osteoarthritis, uncontrolled with non-operative treatment, and who could afford the procedure were selected. All were operated through the standard anterior approach using the PFC knee system by Johnson and Johnson and all had cruciate substituting and cement fixation. The indication for surgery was pain in all of them (100%). There were angular deformities in 10 0f the knees. The
pre-operative diagnosis was severe osteoarthritis with an average
of 18 years duration (range of 12 to 30 years). The follow-up duration range between 2 to 49 months. There was no formal preoperative
knee scoring done.
Results: A total of 13 knees in 11 patients (two had bilateral surgeries) were replaced within the period under review by 3 Surgeons at the National Orthopaedic Hospital Lagos. There were 10 female and 1 male with male to female ratio of 10:1. The age range was between 50 to 80 years. All the patients had severe pain preoperatively with scores of 9 to 10 on the Visual Analogue Scale and the corresponding postoperative pain score was 0 to 2.Preoperative limitation of knee joint movement improved from
an average of 860 to 980 postoperatvely. Patients commenced ambulation between the 5th and the 14th postoperative day and the average duration of hospital stay was 2.1 weeks. There were superficial wound infectiosn in 3 patients while all had excellent functional ability and subjective contentment postoperatively.
Conclusion: TKR is possible in Nigeria and preliminary short term result is encouraging and comparable to those of other center
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