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Arriving in Cape Town South Africa
- Expedited Customs and Immigration Clearances for wheelchair
and immobile patients
- a Surgery Abroad representative to meet the patient at
the airport and facilitate transfer to accommodation or
Hospital
Hospital Stay
- Doctors and Nurses are ALL English Speaking
- All Hospitals are certified to internationally chartered
standards, with advanced surgical/critical care facilities
and highly qualified physicians and specialists of all medical
disciplines
- All Hospitals ensure the highest standards of patient
care at times
- All Specialists and Hospitals ave the minimum required
level of Professional Indemnity insurance cover as required
by Law.
For comfort and added peace of mind
- a daily visit from a Mediscapes assistance staff member,
who will also liaise with the medical staff of the hospital
- a 24 hour 7 day a week Assistance Helpline with qualified
staff on hand to answer patient emergencies
- a complete travel package for any accompanying relatives
or friends to be arranged if required
- a daily English Language newspaper during hospital stay
- Satellite Tv and Radio with English networks
On leaving hospital
- transfer to a quality Inn located near to the hospital
for further rehabilitation, if required, before returning
to the UK
- any special facilities required when the patient is returning
to the UK to be arranged by a Mediscapes assistance team
member,including:
- travel assistance with nurse or doctor in attendance
- wheelchair assistance + extra seating on airline
- air ambulance + assistance on arrival in UK and transportation
home
- sufficient supply of drugs/medications for 7 days, a
letter for the patient¹s G.P/ Specialist and detailed
case notes for the referring hospital/Specialist
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hip replacement |
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The development of hip-replacement surgery in the 1960s –
and the rapid technological advances to date – have opened
up a whole new world to literally tens of thousands of people
in need of joint replacements.
Arthroplasty, a surgical procedure in which diseased parts
of the hip joint are removed and replaced with new, artificial
parts, is generally recommended for sufferers of osteoarthritis,
rheumatoid arthritis, avascular necrosis and bone tumours,
all of which may result in the gradual wearing down of the
hip joint.
Hip replacement with a prosthesis is recommended after walking
aids and non-surgical therapies such as medication and physical
therapies have not been successful in relieving pain and improving
hip function.
In the past, hip replacement surgery was an option primarily
for people over the age of 60, who were typically less active
and consequently put less strain on an artificial hip than
do younger, more active people. In recent years, however,
doctors have found that hip replacement surgery can be very
successful in younger people as well. New technology has improved
the prostheses, allowing them to withstand more stress and
strain. The overall health and activity levels of a patient
are now considered more important than age in determining
the success of hip replacement.
Hip replacement may be problematic, for example, in people
who suffer from severe muscle weakness or Parkinson's disease,
who are more likely than healthier patients to damage or dislocate
an artificial hip. Doctors may also not recommend hip replacement
surgery for people who are at high risk for infections or
in poor health generally, as they are less likely to recover
successfully from surgery.
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are there
alternatives to total hip replacement? |
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If an exercise programme, or treatment with nonsteroidal anti-inflammatory
drugs or corticosteroids, does not relieve pain and improve
joint function, a medical practitioner may recommend corrective
surgery such as an osteotomy.
Less complex than total hip replacement, this procedure consists
of surgically repositioning the joint after damaged bone and
tissue has been removed. Recovery from an osteotomy takes
between six to 12 months and, while it relieves pain in many
cases, some patients may find that the functioning of the
hip joint continues to worsen.
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what
does hip replacement surgery involve? |
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The hip joint is located where the upper end of the femur meets
the acetabulum. The femur, or thighbone, looks like a long stem
with a ball on the end, while the acetabulum is a socket or
cup-like structure in the pelvis, or hipbone. This ball-and-socket
structure makes it possible to sit, stand, walk and carry out
a wide range of other daily activities.
During hip replacement, the surgeon removes diseased bone
tissue and cartilage from the hip joint, leaving the healthy
parts of the hip intact, after which the head of the femur
(the ball) and the acetabulum (the socket) are replaced with
new, artificial parts. The new hip is made of materials that
allow a natural, gliding motion of the joint and surgery usually
lasts between two to three hours.
Sometimes the surgeon will use a special glue, or cement,
to bond the new parts of the hip joint to the existing, healthy
bone. This is referred to as a "cemented" procedure.
In an uncemented procedure, the artificial parts are made
of porous materials that allow the patient's own bone to grow
into the pores and hold the new parts in place. Doctors sometimes
use a "hybrid" replacement, which consists of a
cemented femur part and an uncemented acetabular part.
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is a
cemented or uncemented prosthesis better? |
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Each person’s condition is unique, so the orthopaedic
surgeon and patient must weigh the advantage and disadvantages
of each type of prosthesis, but uncemented prostheses may last
longer simply because there is no cement to break away. And,
if the patient needs an additional hip replacement, which is
likely in younger people, the surgery is often easier if the
person has an uncemented prosthesis.
The primary disadvantage of an uncemented prosthesis is the
extended recovery period. Because it takes a long time for
the natural bone to grow and attach to the prosthesis, people
with uncemented replacements must limit their activities for
up to three months to protect the hip joint. The process of
natural bone growth also can cause thigh pain for several
months after the surgery.
Research has proven the effectiveness of cemented prostheses
in reducing pain and increasing joint mobility. These results
usually are noticeable immediately after surgery, and cemented
replacements are more frequently used for older, less active
people and patients with weak bones, such as those who have
osteoporosis.
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what can
be expected after surgery? |
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Patients are allowed only limited movement immediately after
hip replacement surgery, while the hip is braced with pillows
or a special device that holds it in the correct position. A
patient may, however, be able to sit, stand, or even walk with
assistance as little as a day or two after surgery.
The patient will undergo hip-strengthening physical therapy
and learn techniques for using the new hip.
Usually, a patient does not spend more than 10 days in hospital
after hip replacement surgery, but full recovery takes between
three to six months, depending on the type of surgery, the
overall health of the patient, and the success of rehabilitation.
It is usual for Mediscapes clients to stay on in Cape Town
for an additional 4 to 6 weeks following discharge from the
hospital for mobility rehabilitation and physiotherapy before
returning home.
Patients are fully counselled, however, on the steps necessary
both before and after surgery to ensure successful recuperation
and a speedy recovery. Mediscapes organises everything for
your total peace of mind.
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total
knee replacement |
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Total knee replacement is a surgical procedure in which injured
or damaged parts of the knee joint are replaced with artificial
parts. The procedure is performed by separating the muscles
and ligaments around the knee to expose the knee capsule, which
is opened, exposing the inside of the joint. The ends of the
thighbone (femur) and shinbone (tibia) are removed and often
the underside of the kneecap (patella) is removed. The artificial
parts are cemented into place. Your new knee will consist of
a metal shell on the end of the femur, a metal and plastic trough
on the tibia, and if needed a plastic button in the kneecap.
Total knee replacements are most often performed on patients
suffering from severe arthritic conditions. Most are over
the age of 55, but the procedure is performed on younger people.
Individual circumstances vary, but generally you should consider
total knee replacement if you have been advised by your physician
or Orthopaedic consultant and:
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- You have daily pain
- Your pain is severe enough to restrict not only work
and recreation, but also everyday activities
- You have significant stiffness in the knee
- Your knee constantly gives way
- You have significant deformity – lock-knees of bowlegs
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Total knee replacement is an elective operation. The decision
to have the operation is not made by the doctor; it is made
by you. Your surgeon may recommend surgery, but the decision
must be based upon your weighing the benefits of the operation
against the risks.
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what
can I expect from an artificial knee? |
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An artificial knee is not a normal knee, nor is it as good as
a normal knee, however the operation will provide pain relief
for at least ten years. Provided the replacement provides you
with pain relief and you do not have any other health problems,
you should be able to carry out most normal activities. You
may even be able to return to active sports or heavy labour
under your surgeon’s guidance.
About 85% of total knee replacements are successful for up
to ten years. The major long-term problem is loosening. This
occurs because either the cement crumbles or the bone melts
away from the cement. By ten years, 25% may look loose on
x-ray, and about 10% will be painful and require another operation.
Loosening is in part related to your weight and activity.
For that reason, total knee replacements are not usually performed
on very obese or young patients. A loose, painful artificial
knee can usually, but not always, be replaced. The results
of a second operation are not as good as the first, and the
risks of complication are higher.
Total knee replacement is a major operation. About one in
four patients develop one or more complications. The effect
of most complications is that you must stay in hospital longer.
The most common complications are not directly related to
the knee and usually don’t affect the result of the
operation. These complications include blood clots in the
leg, blood clots in a lung, and urinary tract infections.
Complications affecting the knee are less common, but in
these cases the operation may not be as successful. Some of
the direct complications include:
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- Some knee pain
- Loosening of the prosthesis
- Infection in the knee
- Stiffness
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A few complications may require re-operation,
and infected artificial knees sometimes have to be removed.
This would leave a stiff leg about one to three inches shorter
than normal, however your leg would usually be reasonably comfortable
and you would be able to walk with the aid of a cane, crutches
or a shoe lift. After a course of antibiotics the surgery can
often be repeated.
Preparation for the operation begins several weeks ahead
of the surgery date. Maintaining good physical health is important
and activities, which increase upper body strength, will improve
your ability to use a walker or crutches after the operation.
Your physician may order blood tests and urinalysis before
surgery to ensure a urinary tract infection is not present.
Teeth need to be in good condition as an infected tooth or
gum may be a possible source of infection for the new knee.
When making preparation for surgery, you should begin thinking
about the recovery period following surgery. You will need
help at your residence for the first few weeks after your
discharge from hospital – hospitalisation is usually
7 –10 days. Mediscapes can and will organize caregivers
and visiting physiotherapists at your accommodations for the
4-6 weeks of your recovery period.
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after
surgery |
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After the operation your overall progress, amount of pain, and
condition of the incision will determine when you will start
physiotherapy. If there are no complications your doctor will
have you start one to two days after surgery. You will work
with your physiotherapist until you meet the following goals:
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- Independent getting in and out of bed
- Independent walking with crutches or walker on a level
surface
- Independent walking up and down stairs
- Independent home exercise
- Able to bend your knee 90 degrees
- Able to straighten your knee
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How well you regain strength and motion is, in
part, dependent upon how well you follow your physical therapy.
Patients are fully counselled and closely monitored by Mediscapes
throughout the entire procedure, - before, during and after
the operation - with the aim of reviving the spring in your
step.
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hip replacement