The clinical profile and progression of patients presenting for total joint arthroplasty at a central Johannesburg hospital – A cross-sectional study.

Rumbidzaiishe Munyanduri; Nkodiseni  Sikhauli; Mithasha  Gayaparsad; Sithandiwe  Dingezweni

doi:10.51168/sjhrafrica.v7i3.2372

Authors

Dr. Rumbidzaiishe Munyanduri Registrar, Department of Anaesthesia at Witwatersrand University, Charlotte Maxeke Johannesburg Academic Hospital, RSA
Dr. Nkodiseni Sikhauli MBChB, FC Orthopaedics (SA)
Dr. Mithasha Gayaparsad MBChB, DA(SA), FCA (SA), MMED (Anaes)
Dr. Sithandiwe Dingezweni MBChB, DA(SA), FCA (SA),Cert critical care (SA), MSC (Med)

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2372

Keywords:

Total joint arthroplasty, Regional anaesthesia, General anaesthesia, complications, Length of hospital stay

Abstract

Background

This study aimed to describe the clinical profile and immediate postoperative course of patients presenting for total hip and total knee arthroplasty at Charlotte Maxeke Johannesburg Academic Hospital, and explore associations between anaesthetic techniques and postoperative destination and length of hospital stay.

Methods

A retrospective, cross-sectional review was conducted using convenience sampling. Adult patients presenting for primary hip or knee arthroplasty surgery were included in the study, and various statistical methods were used to analyse the data.

Results

The study population included 187 patients, the majority of whom were female. The median age was 67 (IQR 60 to 73). The median BMI was 31.1 kg/m² (IQR 26.5 to 34.5), and 59% of the patients were obese. Hypertension was the most common comorbidity (61%), and ASA I and II patients were the most prevalent. Regional anaesthesia (RA) was more frequent (69.5%) than general anaesthesia (GA) (30.5% ). Most patients (94.1% ) were discharged to a ward. Patients who received GA had a more extended hospital stay, a median stay of nine days (IQR 6 to 14 days), than those who received RA. Late discharge was more common among males with a median duration stay of nine days (IQR 6 to 14 days) (p = 0.029). The complication rate was 9.6%, with an in-hospital mortality rate of 1.1%.

Conclusion

In this single-centre cohort, the case-mix was older patients, comorbidity-burdened, and regional anaesthesia was used predominantly. Crude associations were observed between anaesthetic technique and immediate postoperative disposition and/or length of hospital stay. These hypothesis-generating findings require adjusted analyses and external validation.

Recommendation

Further multicentre, prospective studies are recommended to evaluate postoperative outcomes and long-term progression following TJA. The current findings may assist in improving preoperative assessment and healthcare planning in resource-limited settings.

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