Survival of primary cemented total hip arthroplasties in east Africa

Abstract

Introduction: Total Hip Arthroplasties (THA) have been carried out in East Africa for over two decades. Data from European and American centres suggests that cemented implants have survivorship of over 80% at 25 years. There is a paucity of data concerning survivorship of implants in Africa. This study was conducted as a follow up study to determine the survival of primary cemented THA implants at the PCEA Kikuyu Hospital.

Methods: A retrospective cohort study was conducted of all patients undergoing primary THA at the centre since 1998. Patients were followed up in the outpatient clinic. In addition, patients who had not returned for follow-up in the last 12 months were contacted by phone and/or mail. A wide variety of cemented and noncemented implants were used. End points of the implant were revision or removal for any reason. Survival was analysed by the use of Kaplan Meir tables. The study was approved by the institution ethics committee.

Results: There were 655 patients with a mean follow up of 31.4 months (10.2 – 146.9). The overall complication rate was 7.5%. The most common indications for the THRA were osteoarthritis (81.7%), fracture of the neck of femur (9.8%) and osteonecrosis of the femoral head (3.8%). Twenty nine implants were revised or removed with aseptic loosening being the commonest indication. The overall survival was 75% at 12 years.

Conclusion: The twelve year survivorship of cemented implants in our region is lower than other reported studies. This data can be useful in preoperative counselling of patients. We recommend the establishment of specialised centres and improving in cementing techniques so as to improve patient outcomes.

Keywords: Survival, Total hip, Hip arthroplasty, Cemented, East Africa