{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:44:19Z","timestamp":1790754259111,"version":"4.1.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,1,12]],"date-time":"2019-01-12T00:00:00Z","timestamp":1547251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Outcomes of arthroplasty in sub-Saharan Africa are not widely reported. To our knowledge, this systematic review is the first to explore this topic. Scopus, EMBASE, Medline and PubMed databases were searched, utilising MeSH headings and Boolean search strategies. All papers from South Africa were excluded. Twelve papers reporting 606 total hip replacements (THRs) and 763 total knee replacements (TKRs) were included. Avascular necrosis was the most common indication for THR, whereas osteoarthritis was the main indication for TKR. HIV prevalence of up to 33% was seen. Improvements were seen in patient-reported outcome measures in both THR and TKR. The dislocation rate in THR was 1.6%. The deep infection rate was 1.6% for TKRs and 0.5% for THRs. Positive results were reported, with comparable complications to high-income countries. However, there is likely to be significant reporting bias and the introduction of mandatory registries would enable more accurate monitoring across the region.<\/jats:p>","DOI":"10.1177\/0049475518822239","type":"journal-article","created":{"date-parts":[[2019,1,12]],"date-time":"2019-01-12T08:46:52Z","timestamp":1547282812000},"page":"120-128","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["Total joint replacement in sub-Saharan Africa: a systematic review"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-7439","authenticated-orcid":false,"given":"Peter SE","family":"Davies","sequence":"first","affiliation":[{"name":"Registrar, Department of Trauma and Orthopaedics, Ninewells Hospital and Medical School, Dundee, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon M","family":"Graham","sequence":"additional","affiliation":[{"name":"Limb Reconstruction and Orthopaedic Trauma Fellow, Orthopaedic Research Unit, Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa"},{"name":"Welcome Trust Clinical Research Fellow, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sithombo","family":"Maqungo","sequence":"additional","affiliation":[{"name":"Consultant Surgeon and Professor, Orthopaedic Research Unit, Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J","family":"Harrison","sequence":"additional","affiliation":[{"name":"Consultant Surgeon and Professor, Department of Trauma and Orthopaedics, Countess of Chester Hospital, Chester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,12]]},"reference":[{"key":"bibr1-0049475518822239","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0133858"},{"key":"bibr2-0049475518822239","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-017-1540-2"},{"key":"bibr3-0049475518822239","unstructured":"UNAIDS.\n                      The Gap report\n                      . Geneva: UNAIDS. Available at: http:\/\/www.unaids.org\/en\/resources\/campaigns\/2014gapreport (accessed 14 October 2017)."},{"key":"bibr4-0049475518822239","unstructured":"National Joint Registry.\n                      NJR 14th Annual Report 2017\n                      . Hemel Hempstead: The NJR Centre. Available at: http:\/\/www.njrreports.org.uk\/Portals\/0\/PDFdownloads\/NJR%2014th%20Annual%20Report%202017.pdf (accessed 14 October 2017)."},{"key":"bibr5-0049475518822239","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B3.21706"},{"key":"bibr6-0049475518822239","unstructured":"Blue Cross Blue Shield.\n                      A study of cost variations for knee and hip replacement surgeries in the U.S\n                      . Chicago, IL: BCBS. Available at: https:\/\/www.bcbs.com\/the-health-of-america\/reports\/study-cost-variations-knee-and-hip-replacement-surgeries-us (accessed 14 October 2017)."},{"key":"bibr7-0049475518822239","unstructured":"NHS Improvement. 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Available at: https:\/\/ec.europa.eu\/europeaid\/countries\/south-africa_en (accessed 17 September 2018)."},{"key":"bibr10-0049475518822239","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-016-3280-6"},{"key":"bibr11-0049475518822239","first-page":"2016","volume":"82","author":"Lisenda L","year":"2016","journal-title":"Acta Orthop Belg"},{"key":"bibr12-0049475518822239","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.96B4.33213"},{"key":"bibr13-0049475518822239","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.OA.17.00029"},{"key":"bibr14-0049475518822239","doi-asserted-by":"publisher","DOI":"10.4103\/1119-3077.196117"},{"key":"bibr15-0049475518822239","first-page":"70","volume":"12","author":"Kigera JWM","year":"2015","journal-title":"Ann Afr Surg"},{"key":"bibr16-0049475518822239","doi-asserted-by":"publisher","DOI":"10.1258\/td.2008.080139"},{"key":"bibr17-0049475518822239","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.96B2.31304"},{"key":"bibr18-0049475518822239","first-page":"44","volume":"4","author":"Kingori J","year":"2010","journal-title":"East Afr Orthop J"},{"key":"bibr19-0049475518822239","first-page":"153","volume":"37","author":"Mulla Y","year":"2010","journal-title":"Med J Zambia"},{"key":"bibr20-0049475518822239","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.4103\/njcp.njcp_179_18","volume":"21","author":"Katchy AU","year":"2018","journal-title":"Niger J Clin Pract"},{"key":"bibr21-0049475518822239","volume-title":"Health Insurance Coverage","author":"Centers for Disease Control and Prevention"},{"key":"bibr22-0049475518822239","volume-title":"Gross national income per capita 2015, Atlas method and PPP","author":"World Bank"},{"key":"bibr23-0049475518822239","unstructured":"GOV>UK.\n                      HMT Public Expenditure Statistical Analyses (PESA)\n                      . 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