Knee replacement surgery is one of the most
common joint replacement surgeries performed by orthopaedic
surgeons and also one of the most successful. In South
Africa we have surgeons who are very experienced in
knee replacement surgery as they are involved in international
follow-up registries and attend international congresses
on an annual basis. Our surgeons have access to state-of-the-art
implants and are often at the cutting edge of advanced
surgical techniques. These factors, together with the
excellent first-world hospital- and operating theatre
facilities, makes South Africa an attractive destination
for knee replacement surgery abroad.
The primary indication or reason for undergoing knee replacement is osteoarthritis of the knee joint. The knee joint consists of the end of the femur (thigh bone), the top of the tibia (shin bone) and the patella (kneecap). The femur and tibia articulate in a similar fashion to a hinge. The articulating surfaces in a healthy joint are covered in cartilage and cushioned by menisci within the joint. As arthritis sets in, the menisci may become damaged and the cartilage wears away - resulting in bone grinding against bone. Once this occurs, your knee joint becomes extremely painful and stiff. There is never really an ”ideal time” for a knee replacement - rather it is when the pain and stiffness starts to limit your lifestyle and reduce your quality of life. These changes are obvious on an x-ray.
In simple terms, any knee replacement surgery involves a 'resurfacing' of the joint surfaces of the knee. The femoral- and toboa side of the joint is replaced with a metal component, with the tibial side replaced with a poly-ethylene liner locked into it. These components are all matched exactly, to closely mimic the normal motion of the anatomical knee joint. Depending on the degree of deformity of the knee pre-operatively, the surgeon may also choose to resurface the back of the patella with a poly-ethylene ”button” which facilitates a smooth motion of the knee. These components are all cemented to the exposed surface of the bone. The 'life-expectancy' of a knee replacement is usually between 15-20 years, although it can be even longer. It is also possible to 'revise' a knee replacement if it becomes necessary. Revision surgery is somewhat more complicated as there is bone loss involved. Thus, it is not recommended to replace the knee joint in a young person.
If you are reading this and are in need of total knee replacement surgery, you will by now have consulted an orthopaedic surgeon and will have had the necessary x-rays taken. We do not have long waiting lists in South Africa for this type of surgery, as most of our surgeons work in private hospitals. We would thus be able to schedule your surgery at a time that is convenient for you. To initiate the process you would need to fill in the questionnaire below. We will then communicate directly with you by phone or e-mail, in order to obtain more detailed information and initiate the contact between yourself and the surgeon. The surgeon would need to see the x-rays before making a decision regarding your surgery and we will gladly help in facilitating this.
Before any final decisions are made, you will have had ample opportunity to discuss your options with the surgeon. The surgeon will also discuss the risks of surgery with you. A well-documented risk of knee replacement surgery is the development of a DVT (blood clot in the calf). This risk can be further increased after any long-haul air travel. For these reasons, the surgeon will require you to arrive in South Africa at least ten days prior to your surgery. You will also receive daily drug treatment post-operatively to prevent the development of a DVT.
Once you have arrived in Cape Town, the first step is to undergo a pre-operative medical evaluation. This will include:
Evaluation by the orthopaedic surgeon who will assess your fitness for the surgery as well as explain the post-operative rehabilitation process.
An evaluation by a specialist physician which may be necessary to assess your fitness for surgery and adjust any chronic medication that you are taking. The physician will also be involved in your post-operative care should it be needed.
Evaluation by your anaesthetist where the anaesthetic and post-operative pain control will be discussed with you.
It is standard procedure to spend a day in intensive care after a knee replacement. You will then be moved to a private room where you will spend another four to seven days depending on the rate of your recovery. During your hospital stay you will participate in daily physiotherapy. Your physiotherapist will help you to get up and get walking again and teach you all the dos and doníts for a full recovery. The physiotherapist will teach you an exercise program that will ensure a successful result. You will be provided with the most appropriate walking aid for your needs and receive a supply of medication to take home upon discharge from the hospital. This will include pain medication, antibiotics and drugs to decrease the chances of a blood clot
Once discharged from hospital, you will continue to recover at your hotel or guest house. If you still need nursing help or physiotherapy, these services will be provided to you where you are staying. As this is major surgery, we strongly recommend that a loved one accompany you on your trip, as you will need help during your initial recovery.
You will need to take it easy for about another three weeks before you will be able to fly home (in other words, you will be in South Africa for approximately six weeks). We will assist with making sure that you receive the care that you require from the airline on your flight home.
We realise that six weeks away from home after having surgery can be a long time. For that reason, we make sure that your stay will be in luxurious, comfortable medical accommodation with excellent personal service; affording you such peaceful diversions as libraries, DVDs, beautiful garden settings or sea views. Prior to your surgery we will organise day tours as you should take the time to enjoy the beauties of our wonderful city and winelands. Once you are past the initial recovery stages, we will also organise activities appropriate to your physical ability. We will go out of our way to make this an extremely pleasant experience. You will return home not only with a new hip joint, but relaxed and rested after your surgery in Cape Town and with wonderful memories to boot.