Lagos closes gap in knee replacement surgery

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By CHIOMA OBINNA

Rafatu Arowolo, a 62 year – old petty trader used to have great difficulty walking as a result of pain in her left knee.   She could no longer cope with challenges of her trade. Her illness denied her family the crucial support she provided in the home.

But when Rafatu could not move again, it became her clear to her husband and family that her health required major intervention.

“At this point, we began to seek treatment in other hospitals but  to no avail,” said her husband, Arowolo.”When we came to the Lagos State University Teaching Hospital, we were told she need required a total knee replacement surgery.   But we were scared because we were told that the treatment could only be done in abroad and the money required was huge.

“Where do I get such amount of money?  I am a civil servant, how much is my salary? I only manage on what I earn to feed my children and manage the home.”

There and then, it was cleared that I needed help because I cannot imagine my wife being crippled all of a sudden.  Finally, we were directed to the Lagos State Coordinator, Free Health Programme.” The rest is history

The story of  Rafatu Oyelakin is just as pathetic.  The 52 year – old woman was   diagnosed with Osteoarthritis of the knee.

Her case began like with pain but progressively worsened to the deformity of her right knee (K- leg) making it extremely difficult for her to walk.

Rafatu visited LASUTH for three years as an out- patient without a solution.

“My condition did not respond to non operative treatment using medications and physiotherapy.  I was also offered total knee replacement broad but  was unable to afford the cost of the prosthesis.

“My husband and children did all they could but we were not able to afford it until we were directed to partake in the Lagos State free knee replacement surgery.”

Experts say Nigerians with knee problems is on the increase.  A community based study on Prevalence and Pattern of Symptomatic Knee Osteoarthritis in Nigeria published by the Internet Journal of Allied Health Sciences and Practice showed that osteoarthritis is a leading cause of disability, affecting 60-70 percent of people aged 60 years in Nigeria.   Researchers from the study concluded that one out of every five adult Nigerians aged 40 years in rural community has symptomatic knee osteoarthritis, with a female preponderance in the ratio of 1.2:1.

Corroborating this view, Consultant orthopaediatric Surgeon, Ladipo Adewole explained that osteoarthritis is the most common form of arthritis, often called wear-and-tear arthritis.

Osteoarthritis occurs when the protective cartilage on the ends of the bones wears down over time. It can damage any joint in the body.

Adewole who spoke on the official presentation of two beneficiaries of the Lagos State Free Total Knee Replacement programme last week in Lagos noted that even though, some form of surgeries like the knee replacement surgeries exist only a few hospitals have  capacity to do so and most times patients cannot afford cost of treatment put at not less than  Lagos State Commissioner for Health, Dr Jide Idris, regretted that most hospitals including government – owned hospitals in Nigeria lack capacity for knee replacement surgeries.

“The State Government started free knee replacement surgeries in realisation of the high numbers of patients who applied to the state government for financial assistance to travel abroad usually India to have the knee replacement surgery procedure done at high cost.

“As a government we thought it wise to discontinue the trend of taking our resources abroad for surgical exercise that can be done in the country. We felt by starting this exercise, we would not only discourage patronage of overseas treatment, but we would build local capacity for surgical procedures like this.

“It is also an avenue for training resident doctors aspiring to become certified specialists as well as nursing staff and physiotherapists who will be responsible for patients’ nursing and rehabilitation management.”

According to the Commissioner, so far, 12 people have benefitted. “This way, the surgeons, nurses and physiotherapists get to manage such cases frequently and therefore become more proficient.

“Also, less fortunate Lagosians, who would otherwise have been unable to afford this treatment would be the ultimate beneficiaries of this exercise”, Idris said.

“Both patients had severe osteoarthritis of the knees, a condition characterized by worn-out cartilage at the ends of the bones that come together to form a joint. The worn-out cartilage and some of the underling bone is surgically removed and replaced with prostheses during total joint replacement.”

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