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Published on: March 19, 2019
Developing a sustainable hip service in Cambodia
Jacquelyn A Holt1, James J Aird, James G Gollogly
1Children's Surgical Centre, Phnom Penh - Cambodia.
Summary
Establishing a hip service in Cambodia led to 116 total hip replacements (THRs) in 5 years. Avascular necrosis was the main reason for THR, with an 85% implant survival rate at three years.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Global Health
Background:
- The Children's Surgical Centre in Phnom Penh, Cambodia, initiated a hip service.
- This report details the establishment and initial outcomes of this service.
Purpose of the Study:
- To describe the indications for total hip replacement (THR) in Cambodia.
- To report the initial results and complications of THR at the Children's Surgical Centre.
Main Methods:
- A database was created to collect patient data, including diagnosis, implants, and post-operative complications.
- Pre- and post-operative Harris hip scores were incorporated as the service evolved.
- Patient data was tracked for follow-up.
Main Results:
- Avascular necrosis (AVN) was the most frequent diagnosis necessitating THR.
- Over five years, 116 THRs were performed on 95 patients, including revisions and bilateral procedures.
- Implant survival was 85% at three years, with complications including femoral neck fractures, aseptic loosening, and infections.
Conclusions:
- Developing an affordable hip arthroplasty service in Cambodia presents challenges.
- A local patient registry proved instrumental in identifying complications and refining surgical techniques.
- Improvements in implant selection, surgical training, and infection control measures are ongoing.
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