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Inpatient mortality after elective primary total hip and knee joint arthroplasty in Botswana

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Abstract

Purpose

Total hip and knee joint arthroplasty (TJA) rank among the most successful orthopaedic operations. Several developing countries in Africa have started to perform these procedures that are routine in developed countries. The aims of this study were to measure the incidence and assess the determinants of in-hospital mortality after elective primary TJA in our unit and compare it with published data.

Methods

This was a retrospective study of the first consecutive cohort of patients who underwent elective primary TJA in Princess Marina Hospital, Botswana between March 2009 and October 2015 (6.5 years).

Results

346 elective joint replacements were performed comprising 153 total hip arthroplasties (THA) and 193 total knee arthroplasties (TKA); 36 % of the THA were in female patients and 82 % of TKA were in females. The mean age was 64.5 years (range 26–86). Three patients died giving an inpatient mortality rate of 0.86 %. These three mortalities represent 1.55 % (three out of 193) of all the TKA. There were no deaths after THA. The cause of mortality in two patients was an adverse cardiac event while the third mortality was due to pulmonary embolism.

Conclusion

The inpatient mortality rate of 0.86 % following TJA is higher than the reported rates in the developed countries but comparable with data from other developing countries. The inpatient mortality rate following TKA was higher than that following THA and cardiovascular events proved to be the main cause of death. We recommend formal cardiology assessment and close peri-operative monitoring of all patients with a history of cardiovascular disease undergoing TJA.

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Authors and Affiliations

  1. Department of Orthopaedics, Princess Marina Referral Hospital, PO Box 258, Gaborone, Botswana

    Laughter Lisenda

  2. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa

    Laughter Lisenda, Lipalo Mokete & Mkhululi Lukhele

  3. Department of Anaesthesia, Princess Marina Referral Hospital, Gaborone, Botswana

    Joseph Mkubwa

Authors
  1. Laughter Lisenda
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  2. Lipalo Mokete
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  3. Joseph Mkubwa
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  4. Mkhululi Lukhele
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Correspondence to Laughter Lisenda.

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The content of this article is the sole work of the authors. No benefits or funds were received in support of this study.

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Lisenda, L., Mokete, L., Mkubwa, J. et al. Inpatient mortality after elective primary total hip and knee joint arthroplasty in Botswana. International Orthopaedics (SICOT) 40, 2453–2458 (2016). https://doi.org/10.1007/s00264-016-3280-6

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  • DOI: https://doi.org/10.1007/s00264-016-3280-6

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