Determination of the Functional Outcomes of Total Hip Replacement,By Using the Harris Hip Score,In Adults Presenting at Hospitals in Lusaka,A Cross Sectional Study

BACKGROUND: Total hip replacement (THR) is one of the most successful orthopaedic procedures performed worldwide (Miller 2008). The number of joint replacements performed in Africa is increasing but outcomes reported in sub-Saharan Africa, excluding South Africa, are sparse (Dossche 2014). Coupled with an anticipated rise in the prevalence of total hip replacements resulting from trauma, infection and the aging population (Elders 2000, Keruly 2001), there has been no corresponding increase in the health facilities offering specialised orthopaedic services. Zambia has not been spared as there is an information gap regarding information on patients that have undergone Total Hip Replacement and their functional outcomes. The aim of this study was to determine the functional outcomes of patients based on the Harris hip score after total hip replacement
MATERIALS AND METHODS: 31 patients were enrolled in the study by using convenient sampling from hospital records. Patients that met the criteria were then invited to join the study. A standardised structured questionnaire was used to obtain the biophysical profile, pre and postoperative co-morbidities. Functional outcome of the patient was then determined by using the HHS and the results obtained tabulated thereafter.
RESULTS: Twenty males and females were enrolled. The minimum age was 19 years, maximum 78 and mean age was 48.8years. Ten patients were found to be hypertensive, 8 HIV positive, 1 Diabetics Mellitus, 5 had Sickle cell trait while the remaining 7 had no pre-existing medical conditions. Pain was the major indication of surgery. Postoperative complications were either wound infection (38.7%) or hip dislocation (3.2%). Twenty three rated the operation a success, 8 said it was a failure. The Harris Hip Score ranged from poor to good.
CONCLUSION: Pain was the main indication for surgery. Functional outcomes using HHS ranged from poor to good. Patients were generally satisfied with the outcome after Total Hip Replacement. No association was found between the HHS and the patients’ biophysical, pre-existing comorbidities, postoperative complications and duration from time from surgery.