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Introduction <p>Hip pathologies, such as traumatic injuries, osteoarthritis, and avascular necrosis, are a significant and expanding global public health concern, with a disproportionately high burden in Africa. The gold standard for end-stage illness is total hip arthroplasty (THA), which significantly improves quality of life, mobility, and pain. However, institutional disparities, financial obstacles, and inconsistent data continue to hinder the assessment of healthcare access and outcomes in Africa. The objectives of this systematic review were to summarize the body of research on hip replacement results in African contexts, pinpoint care-related obstacles, and indicate potential improvement methods.</p> Methodology <p>In compliance with PRISMA guidelines (<b>CRD420251207458</b>), a thorough search of PubMed, Science Direct, AJOL, the Cochrane Library, and Google Scholar was carried out. A total of 17 papers, including cross-sectional analyses and prospective and retrospective cohort studies, from nine African nations satisfied the inclusion criteria. The majority of the patient cohorts were younger (40–50 years old), typically male, and had avascular necrosis, osteoarthritis, and femoral neck fractures as the main reasons. These conditions were often linked to comorbidities such as sickle cell disease and HIV, among others.</p> Results <p>Across studies, THA consistently produced significant functional improvement, with Harris Hip and Oxford Hip Scores averaging between 81 and 93, high rates of independent ambulation, and marked pain reduction. Although revision rates varied from 4 to 8% in prolonged follow-up, implant survival at five years was above 95% at sites with strong support. As a result of inadequate infrastructure and personnel, complications such as infection, dislocation, aseptic loosening, and periprosthetic fractures were more common in environments with fewer resources. Exorbitant out-of-pocket expenses, difficulties obtaining implants, protracted wait periods, and regional disparities brought on by a lack of surgeons were among the obstacles to care.</p> Conclusion <p>Novel approaches have shown promise in increasing access and enhancing results, including public-private partnerships, specialized mission hospitals, regional high-volume centers, and cost-effective implant utilization. However, significant gaps remain in standards, equal access, and registration data. To expand sustainable hip replacement services throughout Africa, it will be crucial to fortify surgical training, implant supply networks, and health funding systems.</p>

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Hip Arthroplasty in Africa: A Systematic Review of Treatment Outcomes and Strategies for Future Improvement

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Chidera Stanley Anthony,
  • Ikponmwosa Jude Ogieuhi,
  • Alexander Idu Entonu,
  • Victor Oluwatomiwa Ajekiigbe,
  • Prince Ngozichukwu Nwachukwu,
  • Chimaobi Nwevo,
  • Victor Olamiposi Olaiya,
  • Emmanuel Oyedeji Oyetola,
  • Thomas Oyediran,
  • Adeshola Pedetin Okunade-Osiki,
  • Kenechukwu Clinton Agudosi,
  • Olufemi Akinmeji,
  • David Olaoluwa Babalola

摘要

Introduction

Hip pathologies, such as traumatic injuries, osteoarthritis, and avascular necrosis, are a significant and expanding global public health concern, with a disproportionately high burden in Africa. The gold standard for end-stage illness is total hip arthroplasty (THA), which significantly improves quality of life, mobility, and pain. However, institutional disparities, financial obstacles, and inconsistent data continue to hinder the assessment of healthcare access and outcomes in Africa. The objectives of this systematic review were to summarize the body of research on hip replacement results in African contexts, pinpoint care-related obstacles, and indicate potential improvement methods.

Methodology

In compliance with PRISMA guidelines (CRD420251207458), a thorough search of PubMed, Science Direct, AJOL, the Cochrane Library, and Google Scholar was carried out. A total of 17 papers, including cross-sectional analyses and prospective and retrospective cohort studies, from nine African nations satisfied the inclusion criteria. The majority of the patient cohorts were younger (40–50 years old), typically male, and had avascular necrosis, osteoarthritis, and femoral neck fractures as the main reasons. These conditions were often linked to comorbidities such as sickle cell disease and HIV, among others.

Results

Across studies, THA consistently produced significant functional improvement, with Harris Hip and Oxford Hip Scores averaging between 81 and 93, high rates of independent ambulation, and marked pain reduction. Although revision rates varied from 4 to 8% in prolonged follow-up, implant survival at five years was above 95% at sites with strong support. As a result of inadequate infrastructure and personnel, complications such as infection, dislocation, aseptic loosening, and periprosthetic fractures were more common in environments with fewer resources. Exorbitant out-of-pocket expenses, difficulties obtaining implants, protracted wait periods, and regional disparities brought on by a lack of surgeons were among the obstacles to care.

Conclusion

Novel approaches have shown promise in increasing access and enhancing results, including public-private partnerships, specialized mission hospitals, regional high-volume centers, and cost-effective implant utilization. However, significant gaps remain in standards, equal access, and registration data. To expand sustainable hip replacement services throughout Africa, it will be crucial to fortify surgical training, implant supply networks, and health funding systems.