From Disability to Arthroplasty: Prevalence of Osteoarthritis and Utilization of Joint Replacement in Pakistan’s Elderly Population.

Abstract

Background:Osteoarthritis is one of the most common degenerative joint diseases in elderly people and contributes to a significant proportion of chronic pain, disability, and diminished mobility in Pakistan. At the advanced stage, the condition may need surgical intervention, such as joint replacement, to regain function and quality of life.

Objectives:To assess the prevalence of OA in the elderly Pakistani population and the outcome of JRS in terms of pain relief, mobility improvement, complications, and satisfaction of patients.

Methodology:The was a cross-sectional study and was carried out in the Department of Orthopedic MTI lady reading hospital Peshawar  from 25 April 2019 to 25 October  2022. Patients older than 60 years who were diagnosed as having advanced osteoarthritis and were to undergo total knee replacement (TKA) or total hip replacement (THA) were recruited by consecutive sampling for a total of 100 patients. The following data were collected: demographic parameters, involved joints, co-morbidities, pain, postoperative mobility, and complications. The statistical analysis was carried out using SPSS version 20, and a p-value < 0.05 was used as significant.

Results:The 100 patients, 68% were females and 32% were males, with a mean age of 66.8 ± 5.9 years. Knee osteoarthritis was present in 78% of cases, while hip osteoarthritis accounted for 22%. Total knee replacement was performed in 74% of patients and total hip replacement in 26%. Mean pain scores significantly improved from 8.1 ± 1.2 preoperatively to 2.4 ± 0.9 postoperatively (p=0.001). Functional mobility improved in 84% of patients. Postoperative complications occurred in 11% of cases, including wound infection, joint stiffness, and deep vein thrombosis. Female patients showed significantly higher osteoarthritis prevalence (p=0.032).

Conclusion:Osteoarthritis is very common in older adults in Pakistan, especially females, and THR surgery can significantly reduce the pain and increase mobility, while also having relatively low complication rates.