Development of a lower limb arthroplasty service in a developing country : Lessons learned after the first 100 cases (joints).

There is emerging evidence that total hip arthroplasty (THR) can be safely practiced in developing countries but scant evidence of safety of total knee replacement (TKR). The purpose of this study is to evaluate the outcomes of these procedures focusing on procedure related complications. This is a retrospective study of the first 100 arthroplasties (92 patients) consisting of 58 TKR and 42 THR with a minimum follow-up of 26 months (range of 26 to 47 months). Major complications included deep infection in one TKR and dislocation of one THR and one TKR. Two patients died in the second post-operative week from cardiac events following TKR. Blood transfusion rate for hips and knees was 13.7% and 5.6% respectively. THR can be safely performed in less than ideal circumstances in developing countries in carefully selected patients. More importantly this study demonstrates that TKR can be safely practiced under the same circum-stances.