Background Musculoskeletal injuries-often a result of Road Traffic Accidents (RTAs)-represent a significant burden in sub-Saharan Africa. RTA victims are faced with lifelong disability and diminished employment. Northern Tanzania in particular lacks the orthopedic surgical capacity needed to provide patients with definitive surgical fixation. While there is great potential in establishing an Orthopedic Center of Excellence (OCE), the precise social impact of such an initiative is currently unknown. Methods To demonstrate the social value of an orthopedic OCE in Northern Tanzania, this paper proposes a methodology for calculating social impact. This methodology draws upon RTA-related Disability Adjusted Life Years (DALYs), current and projected surgical complication rates, anticipated changes in surgical volume, and average per capita income to quantify how much social value can be gained by mitigating the impact of RTAs. These parameters can be utilized to calculate an impact multiplier of money (IMM), stating the social returns on each dollar invested.Results Modeling exercises demonstrate that improvements in the complication rate and surgical volume over the current baseline results in significant social impact. In the best-case scenario, the COE is expected to yield over $131 million over 10 years, with an IMM of 13.19. Conclusions Investments in orthopedic care will yield significant dividends, as demonstrated by our novel methodology. The cost-effectiveness of the OCE is comparable to, if not greater, than many other global health initiatives. More broadly, the IMM methodology can be used to quantify the impact of other projects aimed at reducing long-term injury.

Total hip arthroplasty is one of the most widely performed procedures demonstrating excellent clinical outcomes and implant longevity. Enhanced imaging modalities, advancements in material science, and improvements in surgical technique have contributed to the global success of this procedure. One such technique has gained significant attention over the past decade – the direct anterior approach (DAA). First described by Carl Hueter in 1881, the DAA is now more commonly credited to Smith-Peterson. This technique demonstrates rapid recovery, reduced hospital length of stay, and enhanced stability. Despite these advantages, there is a well reported learning curve for surgeons, particularly for those who trained using an alternative surgical approach. In this chapter we explore a methodological approach to mitigate and decrease the learning curve; allowing for a safe and reproducible guide to teach surgeons how to transition to the DAA.