Mulago surgeons restore knees,  joints of 33 patients

A team of surgeons from Uganda and the United States of America has conducted surgeries on 33 patients at Mulago National Referral Hospital, replacing their damaged knees and reconstructing their joints. 
Dr Alexander Bangirana, a senior consultant orthopedic surgeon at Mulago hospital, who is coordinating the knee project, said this was done during a surgical camp, which started on March 18 and ended yesterday.

 “We are going to do nine arthroscopic surgeries. Already seven have been done, and today [yesterday] we are doing two. And of those seven, which have been done so far, five were anterior cruciate ligament reconstructions and two were diagnostic and meniscectomies,” he said in an interview with Monitor. 

Arthroscopy is where a surgeon inserts a narrow tube attached to a fiber-optic video camera through a small incision — about the size of a buttonhole to guide the expert as he/she operates on the patient. Very small incisions (around one centimetre) that heal quickly are made on the knee or surface that needs repair. 

Anterior cruciate ligament is essential in stabilising the knee which can be damaged in sports activities or other accidents. Meniscectomy is the surgical removal of all or part of a torn meniscus. A meniscus tear is a common knee joint injury. A meniscus is a thin fibrous cartilage between the surfaces of some joints, such as the knee. 

“Today, we plan to do two patients. One is an anterior cruciate ligament reconstruction and multiple ligament reconstruction. And then we have done 26 total knee replacement surgeries. We are also going to do tumor surgery today, for one patient with a tumor, because one of the orthopedic surgeons from the US is an oncology surgeon. He deals with tumors,” he said.  
Dr Bangirana said their partners from the US and Kenya donated these 26 implants, which they have put in the patients. 

Cost
“On average, one knee implant costs about $1,700 (Shs6.6m), which is around Shs8 million. So if you total all the implants that comes to more than Shs200 million and the patients who have benefited are mainly the needy because we do these procedures,” he said.  
“Many of the patients cannot afford so somebody has severe knee osteoarthritis and has nothing to do. Your motion you can’t walk far, it’s very painful so when you get a new knee you get a new lease of life,” he added. 

The surgeries have been done by surgeons of Mulago along with the support of a team of six experts from the US. The experts include two orthopedic surgeons, arthroplasty surgeons, and arthroscopy surgeons, an anesthesiologist, and two medical technologists.

“We also have our partners from Kenya, Prof Timothy Byakika, an orthopedic surgeon and an arthroscopy surgeon,” Dr Bangirana added. 
Dr Jerry Cooper, one of the experts from the US, said since the beginning of the knee project in 2015, they have managed to operate on 100 patients and transfer skills to surgeons in Uganda to continue performing such procedures. 

“Our emphasis has been on knees, which includes knee replacement surgery. And also arthroscopic interventions. So each year we come, we bring implants from our side,” he said.