This is a common concern among patients. Remember that there are many different medical aid options, with different pricing structures and different exclusions. The costs can be discussed at the time of booking your appointment. Some medical insurance options may require a referral from a General Practitioner or a reference number before you can see a Specialist. We have payment arrangements with some medical aids, such as Discovery and Fedhealth, so no further fees are payable with these options. For surgical procedures, most of the time a pre-authorisation is obtained, which means that the medical aid has agreed to pay for the given procedure. Please feel free to discuss fees with our staff before presenting for consultation.
The short answer is: "probably not". Back pain is a common condition which should be considered a lifestyle disease. Its causes are multifactorial, but is associated with poor posture, weak core muscles, certain occupations such as long distance driving, depression, lack of exercise, obesity and other factors. There are very few indications for surgery. Avoid consulting a surgeon, unless you have definite weakness of a limb or problems with bowel or bladder or if you are elderly with other symptoms such as weight loss, fever etc. For all cases develop an exercise plan which includes core muscle strengthening and stretching. Pilates and Yoga are excellent and quite safe and will improve your overall well-being as well. Partner with a good Physiotherapist or Biokineticist, rather than a spine surgeon.
Hip or knee replacement is probably the most successful of operations, as its outcomes are good most of the time. However it is a major surgical procedure, may require approximately five to six days in hospital, often one night in ICU immediately after the surgery. Every patient is different, depending on age, psychological make-up, and co-existing medical conditions. Some patients walk independently with no crutches after a week, and others may take 6 weeks or longer. It is prudent to take off work for at least 6 weeks. You will walk on day one after surgery, with the help of a physiotherapist. It is important to get going early, as prolonged bedrest is harmful, as it can lead to blood clots, pneumonias, and even bedsores. Getting up and walking early will not harm the implants in any way. Pain usually subsides over a few days. After knee replacements, expect swelling to last for many months, even after 6 months. Although long term outcome is usually good, it is wise to be sensible with your new hip or knee joint. It is after all a mechanical device and therefore can wear out over time. No Marathons, but everyday activities are fine!
Many joint procedures are now performed arthroscopically, ie using a camera inserted into the joint via tiny (1cm) incisions. This allows the entire joint to be visualised on a monitor, magnified and clear. This has revolutionised sports medicine practice, and this procedure is widely performed in our practice, especially in the knee, shoulder and ankle joints. Recovery is quicker, and in most cases it will be performed as a day procedure. The actual surgery performed is usually the same whether performed open or arthroscopically. Most shoulder and knee procedures can be performed arthroscopically. The final decision can only be made after consultation.