Incidence of Prosthetic Joint Infection, Functional Recovery and Rehabilitation Progress among Orthopaedic Patients at Metropolitan Hospital, Nairobi County, Kenya

Abstract

The incidence of total knee replacement (TKR) is increasing due to factors such as heightened patient satisfaction, an ageing population, increased number of TKR expertise, and advancement in technology, and increase in the obesity epidemic which lead to more significant stress on weight-bearing joints. This study determined the incidence of prosthetic knee joint infection, evaluated functional recovery, and analysed rehabilitation progress among orthopaedic patients who underwent Total Knee Replacement at Metropolitan Hospital in Nairobi County, Kenya. This study employed a longitudinal study design for five months, following 75 patients who had undergone TKR at Metropolitan Hospital in Nairobi County. Each patient was observed for a period of 6 weeks therefore; a total of 450 observations were made for all the 75 patients. Data collection methods included medical record reviews, patient interviews, and clinical assessments. Specifically, standardized questionnaires and assessment tools were utilized, including the short form health survey (SF-12) for quality-of-life assessment, the visual analogue scale (VAS) for pain measurement, and relevant scales for activities of daily living (ADL) assessment. The incidence density of prosthetic joint infection was calculated using the conventional formula, accounting for new cases and patient time at risk. We observed that functional outcomes post-TKR are generally favourable, with patients who were followed up resuming their daily activities in a relatively short timeframe of less than six weeks. By the sixth week, 60% of the patients had undergone excellent rehabilitation progress. The incidence of prosthetic knee infection was notably low (9 cases per 1000 patient weeks) and was only associated with age, perhaps highlighting the effectiveness of the applied surgical techniques and postoperative care. Additionally, we identified that comorbid conditions, particularly diabetes and hypertension, are the primary factors that contributed to delayed healing and resumption of daily activities following TKR. Favourable outcomes and low infection rates indicate that total knee replacement (TKR) is a safe and effective option for patients with severe knee pain, significantly improving quality of life and mobility. However, the association between age and infection risk necessitates thorough preoperative assessments and age-specific care protocols, especially for older patients. Additionally, comorbidities like diabetes and hypertension can delay healing, highlighting the need for targeted preoperative interventions. Optimizing the management of these conditions may enhance recovery and reduce complications. Further research is essential to explore how these comorbidities affect healing post-TKR and to assess the effectiveness of specific interventions. Key Words: Total Knee Replacement (TKR), Clinical outcomes, Functional outcomes, Kenya.