How long is a consultation?

If you are a new patient, you will be booked a half-hour appointment. This includes not only your assessment, but also analysis of investigations and discussion about treatment options. I like to make sure you have had the opportunity to ask all the questions you need to make important decisions about your treatment. You may require an X-ray, so please allow time for this, especially when the X-ray department is busy. Patients that have been seen and are returning from X-ray will be given priority – please do not assume that they have “skipped the queue”.

What payment facilities do you have?

You are welcome to make payment by cash, VISA and MasterCard. Unfortunately we do not accept Diners Club or American Express. We do not accept EFT’s for consultation fees as this should be settled at the rooms in full on the day of the consultation.

Do I need to see a physician before having a procedure?

I normally involve a physician in your care if you are having a joint replacement or if you have a significant medical condition. The reason for this is to ensure that you are fit to have the intended surgery. The physician may need to alter your medication to optimise your health before giving you the all-clear for the surgery. The physician would also be involved in your daily care after the operation and so I normally recommend that you see one of the specialists at the hospital where your operation will be performed, but if you would prefer to see your regular physician then this can also be arranged.

Is having an anaesthetic dangerous?

No – you should not be worried about your anaesthetic at all. Modern anaesthesia is extremely safe and I work with anaesthetists that I would trust to administer an anaesthetic to my own family. Of course there are risks and complications with any anaesthetic, but it is our job to worry about those and to be prepared for any problems. Your anaesthetic will be tailored for you depending on the nature of your procedure and your general health.

Do you use a surgical assistant?

An assistant who is a qualified medical doctor may be used to help with the procedure. They are valuable members of the surgical team and can make extremely beneficial contributions to the success of your operation by assisting in both simple and complicated cases. In some instances where the procedure is complex, I may invite another orthopaedic surgeon to assist with the operation to help ensure that things run smoothly. Their fee is a small percentage of the procedure fee and is reflected by a specific code on your account in order for your medical aid to reimburse you according to your chosen plan.

How long is an operation?

Most orthopaedic procedures are usually no more than an hour or two. A simple arthroscopy may take as little as half an hour. However, when you add in the amount of time for the anaesthetic, positioning, and waking-up in the recovery area, the actual time away from the ward is a lot longer. Please tell your loved ones not to be alarmed if it seems that things have been taking longer than you expected.

How soon can I get back to work after the operation?

This depends on what sort of work you do. If it is mainly a desk-job then you could be back at work within a few days. If your work involves more activity then the amount of time you will need to be booked off for will have to be individualised according to the procedure you have had, your weight-bearing status, the need for crutches and braces etc. I will provide you with an appropriate medical certificate and, with your permission, would be happy to discuss the situation with your employer if this is necessary.

How soon can I drive after an operation?

It is recommended that someone drive you home after surgery and you will certainly not be allowed to drive a car if you have had a procedure the same day. The timing of resumption of driving after your operation can be difficult to establish and should be individualised to each patient, bearing in mind that according to insurance companies and law enforcement agencies, the patient is ultimately responsible for the decision to drive. A general rule of thumb is not to drive if you would require some form of analgesia to do so. Safe driving is usually possible with a simple forearm cast, but an elbow splint or an arm sling can significantly hamper your ability to drive safely. After a shoulder arthroscopy or an acromioplasty, you should be safe to drive by two weeks or earlier, but it may take four weeks after a rotator cuff repair. You should also be able to brake safely and normal braking function after a right knee arthroscopy takes about four weeks, and about six weeks in ACL reconstruction and driving should be avoided with a cast or brace on the right leg. After a left ACL reconstruction, you may be able to drive after two weeks. For a total knee replacement you could drive at about four to six weeks.

Will I need to go to high care or ICU after surgery?

This depends on the nature of the procedure and your general health. For example if you are an older person undergoing a total knee replacement and have co-existing medical conditions like high blood pressure or diabetes, then you may need to spend one or more days in the intensive care unit after the operation so that we can monitor your condition more closely. For most arthroscopic procedures however, and especially if you have good general health, you will not need admission to high care.

Will there be any pain after the procedure?

One of our primary aims is to ensure you are as pain-free as possible after surgery. This is beneficial not only for your comfort, but also for your recovery and rehabilitation. You may receive a nerve block as part of the procedure which will numb the operative field. Your anaesthetist and I will also prescribe the necessary medication you need for optimum pain control, both in-hospital and for when you go home.

What is the approximate length of time in hospital?

For arthroscopic procedures you shouldn’t need to spend more than one night in hospital, and in some instances you may be able to go home the same day as your surgery. For joint replacement surgery your stay will be longer i.e. five to seven days after a total knee replacement.

Do I need to see a physiotherapist after the surgery?

Physiotherapists are an integral part of the success of your procedure. I am fortunate to maintain a close relationship with many physiotherapy practices, and especially with physiotherapists in practices with further qualifications in sports rehabilitation. I prefer to refer you to a trusted colleague who is also located near to where you live or work for convenience. In some instances, you may need sessions before a proposed operation in order to speed up your post-operative recovery.

Do you charge medical aid rates?

No – I am contracted out of all medical aids. This does not mean that your medical aid will not cover the cost of the procedure in full. Medical aids have a variety of plans to suit your budget and your medical needs. If you have one of the more comprehensive plans, the cost of the procedure may be covered in full, whereas with some of the budget plans there may be a shortfall that you need to pay in.

Do you treat back conditions?

Unfortunately not. Surgery of the back and neck is highly specialised and if you need an operation it should be performed by a surgeon with the appropriate training and experience in this field and who can also understand and interpret potentially costly investigations that may be needed in obtaining an accurate diagnosis. My orthopaedic interests and training have helped me focus on conditions of the knee and shoulder, and I recommend that your GP refers you either to an orthopaedic surgeon who regularly treats back problems or to an appropriate neuro surgeon.