Total hip replacement for Mseleni joint disease undertaken in a rural hospital: Five-year follow-up

Abstract

Objective: The objective of this project was to ascertain whether it is reasonable to perform specialist surgery for Mseleni Joint Disease (MJD) in a rural hospital by assessing the medium--term outcome of surgery for MJD performed at Mseleni. The study was designed as a review of patients at Mseleni Hospital in rural KwaZulu Natal, five years after the procedure had been performed. The subjects were patients who had undergone hip surgery at the hospital between August 1993 and June 1995. The measures according to which the outcomes were based were: pain, function and mobility, which were scored on a modified Harris hip score both pre-and postoperatively. An X-ray assessment of the prosthesis was also done. The results showed that there had been a significant improvement in all scores after primary. Design: Patient review 5 year follow-up hip replacement surgery, as well as good pain relief for patients with Girdlestones, without any deterioration in function or mobility. The X-ray appearance of loosening was common, although clinical symptoms were not associated with the findings. It was therefore found that hip surgery in this setting is of great benefit to Mseleni Joint Disease patients, although further attention needs to be paid to the problem of aseptic loosening of the hips. Subjects: Patients who had undergone hip surgery between August 93 and June 95 at Mseleni Hospital Main outcome measures: pain, function and mobility were scored on a modified Harris hip score pre and post operatively and an AP X-ray assessment of the prostheses was done. Results: There was a significant improvement in all scores for primary hip replacement surgery and good pain relief for patients with Girdlestones without deterioration in function or mobility. The X-ray appearance of loosening was common though clinical symptoms were not associated with the findings. Conclusions: Hip surgery in this setting is of great benefit to the Mseleni Joint Disease patients but further attention needs to be paid to the problem of aseptic loosening of the hips.