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East African Orthopaedic Journal
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ISSN (Print) 1994-1072
Published by African Journals Online

[260 journals]

Reducing the risks of nuclear war—the role of health professionals
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  Authors: Chris Zielinski
  Pages: 69 - 70
  Abstract: No Abstract
  PubDate: 2023-11-02
  Issue No: Vol. 17, No. 2 (2023)
Diagnostic implications of a cold hip on isotope bone scanning in the
paediatric patient
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  Authors: A. Horn, W. Hansen, S.M. Venter, A. Brink
  Pages: 71 - 76
  Abstract: Background: Diagnosing a child with hip pain or limping is challenging. Isotope bone scanning is often utilised to diagnose or exclude septic arthritis where diagnostic difficulty is encountered. Objectives: The aim of this study was to determine the diagnostic implications of a cold hip on bone scan, as well as the overall accuracy of bone scans in the setting of septic arthritis of the hip. Methods: A retrospective review of all patients who underwent bone scans for suspected septic arthritis of the hip, over a 10-year period, was performed. All patients that demonstrated a cold hip were included. Demographic and clinical data were extracted from medical records. Patients with septic arthritis and a cold hip were compared to those who had different diagnoses to determine indications for surgical intervention. Sensitivity and specificity data analyses of all patients that underwent a bone scan to diagnose or exclude hip septic arthritis were performed. Results: We included 59 patients of whom 29 demonstrated a cold hip on bone scan. Septic arthritis was present in 17 (58%) of patients who had a cold hip. There was a significant difference in clinical and haematological variables between patients with septic arthritis and those with other diagnoses. The sensitivity and specificity of a cold hip on bone scan for the diagnosis of septic arthritis were 81% and 68% respectively. The positive predictive value was 59% and the negative predictive value 87%. The overall sensitivity and specificity of bone scan to diagnose hip septic arthritis was 95% and 66% respectively. Conclusion: A cold hip on bone scan is diagnostic of septic arthritis of the hip in the presence of typical clinical and haematological features of infection. The strength of this investigation lies in its high sensitivity and negative predictive value and its ability to exclude the diagnosis of septic arthritis.
  PubDate: 2023-11-02
  Issue No: Vol. 17, No. 2 (2023)
Short-term functional outcomes of partial meniscectomy among middle-aged
patients in Tanzania
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  Authors: A. Hussein, C. Mcharo, J. Mwanga, F. Mrita, J. Sabas, J. Zakariyya, F. Fabian, M. Muhamedhussein
  Pages: 77 - 84
  Abstract: Background: Arthroscopic partial meniscectomy for middle-aged patients with meniscal tear is an effective procedure in relieving knee pain and improving functional outcome. The functional outcome depends on gender, body size and type of meniscal tear. Objective: The aim of this study was to assess the short-term functional outcome after arthroscopic partial meniscectomy in-middle aged patients with a meniscal tear treated at Muhimbili Orthopaedic Institute. Methods: This descriptive cross-sectional study was conducted at Muhimbili Orthopaedic Institute. A total 53 patients were enrolled. Visual Analogue Scale score was used to assess pain and Lysholm Knee Functional Score was used to assess the functional outcome of the patients three months after arthroscopic partial meniscectomy. Data were analyzed using descriptive statistical methods to determine the short-term functional outcomes. Results: There was a significant pain reduction between preoperative (VAS Score 7.26±1.17) and 12th week postoperative (VAS score 2.32±1.34). Functional outcomes improved at the 12th week postoperative (Lysholm knee scoring scale 80.04±11.63) compared to preoperative period (Lysholm knee scoring scale 48.88±11.08). The functional outcome score at 12th week was graded as excellent to good (62%), fair (28%) and poor (10%). Male had significant improvement than female in terms of functional outcome (P=0.008) at the 12th week postoperative. Conclusion: Arthroscopic partial meniscectomy improved knee pain and functional outcome in the short-term postoperative period. Males showed to have better improvement in functional outcome compared to females.
  PubDate: 2023-11-02
  Issue No: Vol. 17, No. 2 (2023)
Assessment of pain severity and functional status in patients with knee
osteoarthritis at the Kenyatta National Hospital , Nairobi, Kenya
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  Authors: S.Y. Dino, G.O. Oyoo, C.S. Ilovi
  Pages: 85 - 91
  Abstract: Background: Chronic pain in knee osteoarthritis influences the quality of life and functional status of these patients. Despite numerous treatment modalities, pain may be inadequately controlled and affect a patient’s functional status. This may be more evident in our local setup as patients tend to present later in the disease. This study was designed to understand the burden of pain in knee osteoarthritis. Objective: To assess pain severity and the level of function in patients with knee osteoarthritis at the Orthopedic and Rheumatology clinics at the Kenyatta National Hospital (KNH). Methods: A cross-sectional descriptive study that assessed patients above the age of 18 years with a diagnosis of knee osteoarthritis on follow-up who fit the inclusion criteria. The pain was assessed by the Brief Pain Inventory- Short Form (BPI-SF) and the functional status was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain severity was analyzed and presented as a proportion of patients having either mild, moderate, or severe pain. Any patient reporting a pain score >4 in question 5 of BPI-SF indicating moderate (4-7) or severe pain (>8) was classified as having inadequate pain control. Functional impairment was assessed using the WOMAC score (0-96). A higher score indicated poorer function. Pain severity was associated with functional status using the ANOVA test. The chi-squared test was used to associate patient-related factors with pain control. A 5% level of significance was used to interpret all the statistical tests (p-value less or equal to 0.05). Results: A total of 270 patients were recruited into the study of whom 139 (51.5%) were females and 131 (48.5%) were males, The mean age of the study population was 55.1 years. The majority of the patients were overweight (n= 134, 49.6%) with a smaller number (n=27, 10%) being obese. The median duration of osteoarthritis diagnosis was 48 months. Bilateral knee osteoarthritis (n= 172, 63.7%) was more prevalent than unilateral disease (n= 98, 36.3%). Knee pain was inadequately controlled in 265 (98.1%) participants with these patients scoring >4 (moderate to severe pain) in Question no 5 (pain on average) of the BPI-SF. The majority of participants (n=259, 95.9%) also had functional impairment/disability. Participants with inadequate pain control (moderate pain or higher) had a worse functional status p-0.026 (<0.05). Older patients had higher pain severity p-0.029 (<0.05). Conclusion: Pain severity is mostly moderate or severe indicating poor pain control in patients with knee osteoarthritis. Higher pain severity is more common in older patients and is associated with worse functional status. This limits their daily activities and enjoyment of life.
  PubDate: 2023-11-02
  Issue No: Vol. 17, No. 2 (2023)
Short-term outcomes in obese patients undergoing anterior minimally
invasive total hip arthroplasty
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  Authors: N. Goga, J.R.T. Pietrzak, I. Cassimjee, S.K. Magobotha, J.N. Cakic
  Pages: 92 - 104
  Abstract: Background: Obesity affects over 774 million individuals worldwide. It is associated with an accelerated onset and progression of osteoarthritis, resulting in an increased need for Total Hip Arthroplasty (THA). Obese patients have a higher risk of perioperative complications. The Direct Anterior Approach (DAA) for THA is gaining popularity globally, however, there are concerns over its suitability for obese individuals. Objective: This study compares short-term clinical, functional, and radiological outcomes of obese and non-obese patients undergoing THA via the DAA. Methods: We conducted a retrospective study of 356 consecutive patients who underwent elective primary THA via the DAA using a specialised leg positioner (Medacta International, Switzerland) and intraoperative fluoroscopy. Obese patients (BMI ≥ 30 kg/m2 ) were compared to the control group using baseline patient information, perioperative data and postoperative outcomes at minimum one-year follow-up. Results: The study included 107 (30%) obese patients. Cohorts were well-matched for age, sex, preoperative diagnosis and baseline PROMs. In the obese cohort, surgical time and blood loss increased by a mean of 8.32 ± 6.9 minutes (p = 0.03) and 58.19 ± 25.37 ml (p = 0.0003) respectively. There were no significant differences in intraoperative radiation (mGys), time to discharge and discharge destination between the groups. Obese patients had a higher incidence of wound-related complications (5.6% versus 2.4%), however overall complication rates were similar (9.3% versus 6.8%, p = 0.67). Functional outcomes were equivalent with a mean postoperative mHHS of 97.57 ± 4.86 and 98.05 ± 5.59 in the obese and non-obese cohorts respectively (p = 0.54). PROMs including the Forgotten Joint Score (p = 0.34), patient joint perception score (p = 0.2) and patient satisfaction rates (p = 0.085) were comparable. Conclusion: The AMIS® DAA is a safe and effective approach for obese patients with excellent shortterm outcomes, however an increased risk of wound-related complications remains.
  PubDate: 2023-11-02
  Issue No: Vol. 17, No. 2 (2023)
Outcome of ankle arthrodesis for post-traumatic ankle arthritis
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  Authors: H.O. Obiegbu, M.O. Ikeotuonye
  Pages: 105 - 112
  Abstract: Background: Post traumatic osteoarthritis of the ankle joint is characterized by debilitating joint pain, dysfunction and instability of the ankle joint, posing a significant morbidity on affected patients. Additional soft tissue loss often further complicates management and also affects prognosis. Arthrodesis is an effective salvage procedure for these patients. Objective: The aim of this study was to determine outcome of patients who had ankle arthrodesis for post traumatic ankle osteoarthritis Methods: This was a retrospective study undertaken from April 2018 to May 2022 on all patients who had ankle arthrodesis for post traumatic arthritis of the ankle joint. Results: A total of 20 patients were recruited into this study, with a mean age of 40.7, with a male: female ratio of 1:1. Although all patients had open arthrodesis of the ankle joint, fourteen patients had trans-articular screw fixation, while two patients had ankle arthrodesis using Charnley’s clamp, vertical transtalar Steinman’s pin fixation, and a locking plate respectively. Using the AOFAS Ankle- Hind foot scale, 75% of patients had excellent outcomes, 15% had good outcomes while 5% each had fair and poor outcomes respectively. Conclusion: Arthrodesis of the ankle joint is an effective tool in the management of post traumatic arthritis of the ankle joint.
  PubDate: 2023-11-02
  Issue No: Vol. 17, No. 2 (2023)
Scope of papers published in the East African Orthopaedic Journal
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  Authors: K.C. Lakati, W.J. Nyachoti, P.W. Mutua, B.M. Ndeleva
  Pages: 113 - 118
  Abstract: Background: The East African Orthopaedic Journal since inception in 2007 has received and published papers in all specialties of trauma and orthopaedic surgery. Objective: To determine the specialty distribution and source of papers published in the journal. Methods: A retrospective bibliographic review of original clinical and experimental studies published in the journal. Results: A total of 185 papers met the inclusion criteria. Adult trauma and spine constituted the majority of papers published at 18.9% and 17.3% respectively, while the least were in hand and wrist, foot and ankle and pelvis and acetabulum at 2.7%, 2.7% and 1.6% respectively. Most of the papers were from Kenyan public university teaching hospitals and public universities. Conclusion: Most of the articles published in the journal were in adult trauma, spine and basic sciences, with most of them being from public university teaching hospitals and articles from Kenya formed the majority of the articles.
  PubDate: 2023-11-02
  Issue No: Vol. 17, No. 2 (2023)