Kenya has capacity for hip surgery that Sonko requires

Former Nairobi Governor Mike Sonko has asked a court that he be released to urgently travel to South Africa for hip surgery.

Sonko is currently admitted at the Nairobi Hospital under the watchful eyes of police following his arraignment over terrorism-related charges.

A doctor last week said the former governor needs to travel to South Africa for surgery.

In a report to the court seen by the Star, Dr Esther Wekesa from Kenyatta National Hospital said hip replacement surgery is needed urgently because Sonko has already developed severe arthritis.

"If left untreated, avascular necrosis can lead to severe complications such as bone collapse or even fracture," Wekesa said.

She further claims that they have chosen the services of South African-based surgeon Dr. Robert Van Der Plank who is highly recommended.

She said Plank cannot travel to Kenya at the moment and will need to review Sonko in Johannesburg.

"I have spoken with Dr. Plank on phone and email about taking up the case but he has not been to Kenya in the last two years and says he won't be coming anytime soon," the report reads.

Kenya has more than 50 specialists and hundreds more are being trained according to the Kenya Orthopedic Association.

“With current technology, almost every joint in the body can be reconstructed, but in Kenya only three joints are currently reconstructed namely hip, knee and shoulder,” says Professor Josephat Mulimba.

He is the chairman of orthopedic surgery department at the University of Nairobi.

Mulimba, one of Kenya’s pioneer surgeons, says hip replacement surgery was extremely rare in the 1980s because the Ministry of Health was focused on communicable diseases such as malaria.

“Total hip replacement was done once in four to six or even more months. Knee arthroplasty was of course out of the question as early knee prostheses had a very low success rate,” he says.

His comments are contained in a highly acclaimed paper — Is Hip Arthroplasty Viable in A Developing African Country? - in the East and Central African Journal of Surgery.

“The number of trained orthopaedic surgeons in Kenya has changed greatly. Some of these surgeons are very highly trained and have practiced in developed countries carrying out very complicated arthroplasties.”

More than 10 hospitals conduct hip replacement surgeries in Kenya.

However, the Kenya Medical Practitioners and Dentists Council does not have a dedicated national joint orthopaedic registry making it difficult to know the exact number of surgeries conducted annually.

KMPDC however says surgeons should not charge more than Sh80,000 as professional fee for hemiarthroplasty, the replacement of one hip joint.

The professional fee for replacing the entire hip joint, also called total hip replacement, should be less than Sh180,000.

This does not include other fees such as x-rays and hospital admission costs.

Dr Ezekiel Oburu, one of Kenya’s top orthopaedic surgeons, says THR is regularly done in Kenya today.

“Hip replacement has become necessary for your arthritic hip: this is one of the most effective operations known and should give you many years of freedom from pain,” he says.

The operation is simple.

An incision is made over the hip to expose the hip joint.

The socket is prepared and sometimes reinforced with screws or cemented.

The sick head of the thigh bone is cut off and the bone prepared using special instruments, to exactly fit the new metal femoral component.

The femoral component is then inserted into the femur and tested before the muscles and soft tissues are then closed carefully.

“You will be discharged to go home or a rehabilitation hospital for approximately five to seven days depending on your pain and help at home,” he says on his personal website.

“All joints eventually wear out. The more active you are, the quicker this will occur. In general 80-90 per cent of hip replacements survive for between 15 and 20 years.”

Some of the most common reasons people need a total hip replacement in Kenya are related to accidents, death of hip ball bone tissue due to interruption of blood supply (avascular necrosis or AVN), and arthritis.

AVN are mostly caused by use of steroids, alcohol, smoking, HIV, and accidents.