Establishing Arthroplasty Services in a Resource-Limited Setting: A Three-Year Nigerian Experience | ||
| The Egyptian Orthopaedic Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 02 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/eoj.2025.404838.1063 | ||
| Authors | ||
| Adejare Adedire1; Atanda Musiliu Oladosu2; Sunday Olakunle Olarewaju3; Akinwale John Faniyi* 4; Oladayo Emmanuel Folami5; Hezekiah Adebola Akinyemi6; Ayodeji Oluwaseun Ogungbemi7; Olanrewaju Olayemi8; Oluwabukola Ayodele Ala9; Adebimpe Yusuf9; Olaitan Magaret Folayan10; Adewumi Victoria Akinade11; Adebukola Ganiyu Oyeniyi1; Qozeem Opeyemi Asafa12; Tope Olumuyiwa Ajayeoba12; Oluwatoyin Nike Akinyoade12; Thomas Ejim13 | ||
| 1Department of Surgery, Osun State University, Osogbo | ||
| 2Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University Teaching Hospital Complex | ||
| 3Department of Community Medicine, Osun State University, Osogbo | ||
| 4Research Laboratory Department, International Foundation Against Infectious Disease in Nigeria | ||
| 5Department of Anaesthesia/Pain Management /Critical Care | ||
| 6Department of Anatomic Pathology and Forensic Medicine | ||
| 7Department of Family Medicine, Osun State University, Osogbo, Osun State | ||
| 8Department of Medicine, Osun State University | ||
| 9Department of Medicine, Osun State University, Osogbo | ||
| 10Department of Nursing, UNIOSUN Teaching Hospital, Osogbo | ||
| 11Department of Nursing, UNIOSUN Teaching Hospital, Osogbo. | ||
| 12Department of Surgery, Osun State University | ||
| 13Department of Surgery, University College Hospital, Ibadan, Nigeria | ||
| Abstract | ||
| Background Total joint replacement (TJR) offers significant relief for patients with end-stage osteoarthritis and related joint disorders. However, access remains limited in many low-resource settings, including Nigeria. Despite the first hip replacement in Nigeria in 1974, arthroplasty services were scarce until the 2000s. UNIOSUN Teaching Hospital (UTH), Osogbo, established in 1998, lacked an arthroplasty unit until 2022. This study evaluates the early outcomes, challenges, and progress of establishing this subspecialty. Methods Prospective data were collected from February 2022 to January 2025 for patients undergoing total hip and knee replacements. Variables included demographics, diagnosis, joint affected, comorbidities, anesthesia, Oxford scores, and complications. Results A total of 135 procedures (81 hips, 54 knees) were performed on 108 patients. Surgical frequency increased from once every three weeks to 1–2 per week, accompanied by a gradual increase in the number of trained operating surgeons involved. The main indications were osteoarthritis, sickle cell disease, and trauma. Oxford scores improved from 10–20 preoperatively to >40 postoperatively. Two complications were recorded: one periprosthetic joint infection and one dislocation. Financial barriers prevented many eligible patients from receiving care. Conclusion This experience highlights the feasibility and impact of introducing arthroplasty in resource-constrained settings. With improved infrastructure and government support, such services can significantly enhance patient outcomes and address a growing public health need. | ||
| Keywords | ||
| Capacity building; resource-limited setting; total joint replacement; osteoarthritis; arthroplasty | ||
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