Becoming Muslim Patients after Total Hip Prosthesis in Morocco

Introduction: The hip arthroplasty has become a very common practice. It concerns young population. The osteoarthritis is the most common indication for total hip prosthesis. Moroccans patients with osteoarthritis often related an alteration of their prayer and are worried about this. Nevertheless, the hip arthroplasty allows restoration. Objectives: The proposal of our studies is to determine what Moroccans patients with total hip prosthesis become. Methodology: A cross-sectional, prospective study has been conducted at the Department of Physical Medicine and Rehabilitation in collaboration with the Department of Traumatology of University Hospital, IbnRochd, Casablanca, Morocco. Patients who took advantage of rehabilitation sessions before and after total hip prosthesis have been included. Patients with secondary prosthesis, post traumatic total hip prosthesis or cognitive impairment have been excluded. The socio demographic characteristics, the prosthesis indications, and complications have been gathered using a questionnaire. Patients mentioned their style of prayer. The style of prayer has been classified in three groups: non difficult standard prayer, difficult standard prayer and impossible (prayer is done at sit position on a chair). An assessment has been carried out before and six months after total hip replacement. For mobility assessment, passive hip movements have been performed and measured with the universal goniometer. Current pain intensity has been assessed using a 101-point numerical rating scale ranging from 0 (non pain) to 100 (the worst imaginable pain). Disability has been assessed using the Western Ontario and Mac Master (WOMAC) Universities Arthritis Index, the Postel-Merle and Aubigne Index (PMA). Results: 79 patients have been included. Average age was 47.7 years. Sex ratio was 0.61. Eighty-two percent (82%) patients were manual laborers against 18% of office workers. All patients were Muslims. The main causes of hip disease were ankylosing spondylitis (25.3%), rheumatoid arthritis (19%), infection (7.6%), hip osteoarthritis (27.8%), and aseptic osteonecrosis (6.3%). All the operations have been performed through the posterior lateral approach. The total hip replacement has improved pain (p=0.0004), mobility (p<0.05), function (p=0.006). Before the prosthesis, the prayer was impossible in 48.4% and difficult in 31.6% of cases. Eleven point four percent patients after total hip prosthesis could not perform the prayer. Discussion: Total hip prosthesis is a successful surgical procedure for relieving pain, improving function and mobility. In Moroccan patients, total hip prosthesis restored style of prayer and improved the functional capacity. Conclusion: The hip arthropalsty helps improve the quality of life which is strongly influenced by prayer style. Thus, the indication for total hip prosthesis in Morocco must consider the aspect of prayer