20-year-old sickle cell patient, other five benefits from hip, knee joint replacement at UCH

A 20-year-old sickle cell patient was among six patients that had their knee and hip replaced at the University College Hospital, as part of efforts by the hospital to improve their quality of life and train orthopaedic surgeons on hip and knee joint replacement surgery.

The hospital, which revived its knee and hip joint replacement surgery, had carried out over 12 of such surgeries in the past two years on individuals with sickle cell patients.

Head, Department of Orthopaedics and Trauma, Dr Michael Okunola, said the surgeries were incorporated into a five-day training on knee and hip arthroplasty workshop, at the hospital, to build capacity for Nigerians that require knee and hip joint replacement.

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Dr Okunola said the hospital had done over 120 cases of hip and knee joint replacement in the last three years to restore quality of life to people with arthritis.

The hospital, the flagship of teaching hospitals in Nigeria and leading training centre for hip and knee joint replacement, he said had embarked on the surgeries to curb medical tourism and positively impact the lives of Nigerians living in pain and with disability due to bad joints.

According to him, about 40 per cent of people above 60 years of age will have arthritis in one joint or the other, adding that the commonest joints that are affected are the hip and knee joints, been weight-bearing joints.

He said: “Usually these patients present with symptoms such as pain, difficulty in walking and deformity and a reduction in their everyday activities.

“Some patients have been going abroad to have this procedure done, but many of our patients do not have the financial capability to travel abroad to have the procedure. So we have a lot of patients in Nigeria that will benefit from this procedure.”

Dr Okunola, who noted it was more cost effective to have a hip or knee joint replacement done at the hospital, declared that doing so will also afford such patients the required follow up care after the treatment.

He also assured that the surgery was safe even in elderly people, as long as they do not have any serious medical conditions.

The lead trainer and visiting consultant arthroplasty surgeon to UCH, Ibadan, Dr Charles Ayekoloye said replacing the hip of the 20-year-old sickle patient was significant considering the disease’s crippling effect when the joints of the hip go bad.

Dr Ayekoloye, remarking that sickle cell disease was prevalent in the African region, said “the problem is that they have a hip problem at an early age, usually in their 20s. These are people in the prime of the lives, who want to get going but this because of this creeping problem affect their work, relationships and so on.”

Although, hip and knee joint replacement surgeries were designed for much older people with diseases such as arthritis, he stated because sickle cell patients end up with bad hip at a younger age, “we have to do it in such a way that it lasts the patient as long as possible.”

He added, “So not only is the operation important for the wellbeing of a patient with sickle cell disease, both in terms of their quality of life, it has implications in terms of how long the replaced hip will last. That is why it requires a multidisciplinary treatment to manage, such as is available at UCH, Ibadan.

“We have done about 12 hip replacements in patients with sickle cell disease and we have not had any significant complications with any of them over the last two years.”

Dr Ayekoloye, however, said the worst knee or hip joints occurs as a result of an injury to the joint from accident, old age and diseases like arthritis and sickle cell disease.

He stated: “As we all get older, the joints wear. Just as our hair turns grey, the same thing the joints will not last forever.”

The UK-based arthroplasty surgeon said the training on knee and hip joint replacement surgeries at the hospital had also raised the profile of the arthroplasty community.

He said an algorithm for hip and knee joint replacement was also developed and published in the Nigerian Medical Journal to guide surgeons doing these surgeries to reduce the risk of infection.