Your Frequently Asked Hip, Knee Surgery Questions Answered
Cape Joint Surgery is part of a managed care system, which makes it possible for patients on a large number of medical aids to have hip replacement and knee replacement surgery at no cost. Patients on medical schemes which are not covered under managed care are often offered medical aid rate joint replacement surgery. If you would like to check which category you fall into, please make use of the JointSure facility. We are able to provide the best rates for private (patients with no medical aid) joint replacement surgery available in South Africa. Patients who are not on medical aid and who are not able to afford these rates may be managed via the Joint Care Trust.
This depends on what you have done during the operation. After a standard meniscal debridement, the patient is usually able to walk immediately and is back to normal activity at 2 weeks after the procedure. If more extensive work, such as a ligament reconstruction/cartilage grafting or microfracture is required, protected weight bearing with crutches may be required. Active and passive range of motion exercises of the knee are usually initiated immediately after surgery. Very rarely is immobilisation of the joint indicated.
Prescribed minimum benefit conditions are defined in the Medical Schemes Act of South Africa and include conditions such as fractures of all the major bones, diabetes, cancer and several other conditions requiring urgent or emergency treatment. They are defined by their ICD 10 codes and not by whether or not the condition is in fact an emergency. The Medical Schemes Act provides for payment in full for the treatment of PMB conditions by any and all medical aid schemes. This was designed to take the pressure off the government health sector. If your medical scheme refuses to pay for the treatment of your PMB condition, you have recourse via the Council for Medical Schemes. Our office staff will gladly check for you wether your condition is a PMB.
Preferred providers are medical practitioners, who have signed an agreement with a medical scheme. They agree that they will accept the medical scheme’s rates in return for preferential referral of patients. At Cape Joint Surgery, cases are often done at- or close to medical aid rates. This is assessed on an individual basis. The ethical implications of preferred provider agreements are unclear. It is worth noting that preferred provider agreements do not guarantee optimal management of patients.
The current consultation protocols have been adjusted to make it as safe as possible for patients, staff and the doctor. It must be noted that the disease is often asymptomatic and screening will not pick up all cases.
Patients do not need X-rays before consultation. Your doctor will decide if- and precicely what X-rays you need and this will be arranged. We have a fast-tracking system in place with Cape Radiology and they are situated very close to our rooms.
In cases of follow-up consultations, you will be provided with an X-ray request form at your previous consultation and you should plan to have the X-ray prior to your booked consultation.
Patients who have had X-rays done should bring the CD containing the images. Most X-rays can nowadays be accessed via the radiology practice’s internet portals, so no need to worry if you do not have a CD.
Medical aids cover surgery at different rates. For hip and knee replacements we offer global fee options negotiated with most of the medical aids. This blanket rate includes surgical fees, anaesthetic, in hospital physiotherapy and the implant cost. There are specific criteria attached and we will discuss these with each patient at their consultation. For other procedures, estimates of fees will be given prior to surgery and the financial aspects will be resolved before surgery. Emergency procedures are covered as PMBs except in the cases of finger injuries.
Patients usually walk the same afternoon and they are subsequently actively mobilised with physiotherapy assistance several times a day. Patients are usually discharged from the hospital at between 2 to 4 days after surgery. If there is adequate support at home, they go straight home, otherwise they may be booked into a stepdown facility for a week or two. Driving may be resumed at around 4-6 weeks.
At Cape Joint Surgery, you are advised of the consultation fees prior to your appointment and you are provided with a quotation prior to any surgical procedure. Our office staff will assist you with regards to establishing what (if any) copayment may be required from your side. It is worth noting that the choice of if- and/or when a procedure is performed and the choice of who performs the procedure is the patient’s alone. No doctor can insist that you have surgery with them, just because you consulted them.
The choice of treating doctor is the patient’s alone. You can request transfer to Dr Martin or Dr Engela at any time. Please note, however, that we deal with hip, knee and hand injuries exclusively. Your treating doctor is best placed to communicate with the recieving specialist.
Joint replacement complications are diverse (infection, fracture, dislocation, loosening) and the golden rule is that early investigation and treatment is always best. If revision surgery is required, this should be carried out by a revision specialist.
We have established a COVID-free corridor for our patients. This effectively means that you will not come into contact with anyone suffering from COVID-19 while in hospital. You are safer in hospital than in the community. All patients are tested on admission and they are then isolated in a special ward until the result is available (usually within 12h). If they are negative, they are then moved to the non-COVID ward and theatre, if required. Staff are screened on a daily basis and PPE is utilised as per protocol (e.g. when staff are in contact with patients who’s COVID results are not yet known).
MRI scans may not be required to make a diagnosis. The cost may not be covered by your funder and it is better to be examined before you have a scan done.
There is no standard consultation fee cost and all funders have different rates of renumeration. We charge private rates and discount for settlement on the day. Your funder may not cover the full cost.