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A joint replacement register for Africa: the Malawi
National Joint Registry Project Abstract: In developed countries there are a number of joint replacement registries. These registries, have led to a wealth of evidence to guide best practice. In Africa, the volume of joint replacement surgery is increasing. However, the indications for surgery and the age of patient are considerably different to those in the developed world, as is the demand placed upon the prosthesis (e.g. toileting). It is therefore vital that we aim towards a hip registry for Africa. In Malawi, we have started a pioneer registry that includes all joint replacements that have been performed in the country. Data gathered includes: age, sex, tribe, indication, prosthesis, approach, bone graft requirements cement types, pressurizing systems and thromboprophylaxis. In addition, preoperative and post-operative clinical scores for all patients at 3 months, 6 months and 12 months after surgery. Unique to the Malawi National Joint Register, all patients are counseled and tested for HIV, allowing analysis of the effect of HIV on successful joint replacement. Currently, the joint register has 2 knee replacements and 22 hip replacements. 4 different surgeons performed the hip replacements. The indications for hip surgery were OA (7/22, 32%), osteonecrosis (9/22,41%) and other (6/22.28%) including one case of TB hip and one of Giant cell tumour of the hip. We report a wealth of data from the total unselected Malawi joint replacement experience, and report the process for setting up a national joint registry for other African countries performing joint replacement to utilize. Were other countries to follow suit, a united African registry may become a reality. |
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