Total Joint Arthroplasty in Rural Trinidad and Tobago: A Pilot Study on Feasibility, Outcomes, and Access.

Abstract

Background. Total joint arthroplasty (TJA) significantly improves quality of life for patients with advanced arthritis, yet access in rural and low-resource settings remains limited. The aim of this study was to describe our initial experience with TJA performed at a rural hospital, to evaluate its feasibility, outcomes and the lessons learned as a first step for developing arthroplasty services in low-resource environments. Materials and methods. A two-year retrospective cohort review was conducted of all patients who underwent primary total hip or knee arthroplasty at a rural hospital. Data including demographics, diagnosis, type and duration of surgery, length of hospital stay, complications, and postoperative outcomes were collected. Descriptive statistics and comparative analyses were performed with significance set at p < 0.05. Results. Ninety-three patients underwent TJA (71 total knee arthroplasties, 22 total hip arthroplasties). The mean age was 62.4 years, with 76% female. Mean operating time was 155.4 minutes (THA 169.5 vs TKA 145.0; p < 0.0014), and mean hospital stay was 5.8 days (THA 7.1 vs TKA 5.5; p = 0.0205). Eleven patients (11.8%) developed surgical site infections, including three deep prosthetic joint infections (3.2%). No perioperative deaths, dislocations, or thromboembolic events were recorded. Conclusions. 1. The findings confirm that TJA can be safely delivered in a low-volume rural hospital, though infection rates remain higher than those reported from high-resource settings. 2. Despite infrastructural and resource limitations, early outcomes demonstrated feasibility and acceptable safety. 3. The study serves as a model for decentralizing surgical services, promoting equitable access, and building sustainable orthopaedic capacity in resource-limited regions.