Treatments

We pride ourselves in taking the utmost care of our patients.

Our Focus

Shoulder Icon

Shoulders

Trauma Associated:

  • - Repair fractures, e.g. Collarbone (clavicle)
  • - Humerus / upper-arm.
  • - Dislocations of the clavicle and shoulder.
  • - Recurring dislocations of the shoulder.
  • - Repair of torn muscles around the shoulder.


Chronic Shoulder Problems:

  • - Repair of muscles (RTC) around the shoulder.
  • - Shoulder replacements.
  • - Reverse shoulder replacements.
  • - Decompression.

For more information
on shoulder related injuries and/or surgeries please visit:
shoulderdoc.co.uk

Shoulder Icon

Knees

Trauma Associated:

  • - Repair of the ligaments in the knee.
  • - Arthroscopic repair of the anterior and posterior cruciate ligaments.
  • - Repair of dislocating knee cap (patella).
  • - Repair of fractures around the knee.
  • - Meniscectomy of tears of the menisci (cartilage) inside the knee.

Knee replacements:

  • - Primary knee replacements
  • - Revision knee replacements
Shoulder Icon

Sports Injuries

Trauma Associated:

  • - Torn ligaments around the ankle.
  • - Repair of various fractures, dislocations and muscle injuries.

For more Information
on treatment and recovery please via physiotherapy visit:
Colin Hill Physio Or Birkill Physios

Disclaimer

*Be assured, that surgery is not always the curative answer. Many conditions can at first be managed conservatively. Surgery will therefore only be offered if conservative measures will not be of value.

1.

Preparing For Surgery

It is of the utmost importance that you understand not only the reason for your operation but also the exact nature of your ailment. You are therefore encouraged to use the internet and our hyperlinks on this website. You absolutely must ask questions about these scenarios should there be any doubt or something unclear in the matter. A second consultation might be necessary as discussion of your case is best done in person. Telephonic consultations are discouraged for various reasons, including time constraints and being impersonal.

2.

Complications

Whilst we take the best precautions to avoid any and all complications that might arise from surgery, it should be noted that medicine is not an exact science, and that sometimes complications unfortunately can occur.
You should also be cognisant that complications, when they do arise, do not equate to negligence on the side of the doctor. For further information on possible complications you are invited as well as encouraged, to follow this hyperlink as well as discuss your concerns with Dr Prins.
Remember: "The only stupid question is the one you do NOT ask!"
It should further be kept in mind that all surgeries carry an inherent risk of death.

Nerve Injury

By its very nature, Orthopaedic surgery virtually always takes place in close proximity to nerves.
Knowing this, Dr Prins takes the utmost care to look for and protect them during his surgeries.

Deep Venous Thrombosis

Some surgeries, like knee replacement surgery, have a higher risk for you to develop thrombosis (blood clot).
ln order to lessen the risks involved, various interventions are implemented, e.g. early mobilization, calve pumps and anti clotting medicine / injections.
lf after the surgery you feel your limb / leg being too swollen or painful, please inform the nursing staff and Dr Prins immediately.
A thorough examination as well as an ultrasound / sonar will then be conducted in order to quantify the swelling and diagnose a possible thrombosis.
Treatment will then be instituted.

Stuck Drains

Dr Prins makes use of suction drains in the wound/joint to lessen the amount of blood in the joint. This facilitates healing.
All care is taken to not suture the drain as part of the wound.
lt has been described in literature that drains do sometimes get stuck in a wound.
lf this does happen, it is best removed in theatre, under general anaesthetic.

Bleeding

Post operative bleeding occurs in most cases, this is however in small amounts and will be absorbed by the dressings applied in theatre.
In cases of arthroscopic surgery, especially around the shoulder, sterile water is used to facilitate the operation.
The soft tissues around the operation site absorbs some of this water.
ln some cases the water then oozes out of the wounds after the operation. lf you feel that your wounds are too wet, please ask the nursing staff to attend to your dressings.
To alleviate most of the post operative oozing, a suction drain will be put into the operation site in theatre.
Please ensure that you do not inadvertently remove your drain.
Although all care is taken intra-operatively to ensure no active bleeding, a blood vessel might start bleeding post operatively as your blood pressure normalizes. ln most cases this bleeding is controlled by pressure bandages.
ln the worst case scenario, you might be taken back to theatre to control bleeding, however the incidence of this happening in this practise is less than one in five years of surgery.

Infection

Various systems are put in place and strict sterile protocols are followed in order to prevent infection.
These systems and protocols have a proven track record and are aligned with similar international standards.
You are also encouraged to bring to the attention of the nursing staff as well as Dr Prins, should you have an existing wound/sore elsewhere on your body prior to surgery, as this might jeopardise your operation and you will be best served by rescheduling your surgery.
Superficial infection of your wounds might occur.
ln most cases this can be treated with the correct dressings and a possible course of antibiotics.
lt might however be necessary, in a very small percentage of cases, to take you back to theatre and address the problem.
Deep infection is always a devastating complication and surgical intervention is virtually always needed.

Wound Care

After your operation your wounds will be covered, it is advised to leave them closed. The wounds will be assessed and redressed if necessary at your follow-up visit. Should you feel that there has been a complication and you are worried about your wounds/limb, you are requested to come into the office post haste.
Please Note:
Dr Prins cannot assess nor treat you over the telephone.
Should a problem arise over a weekend, you should come into the 24hr emergency department.
lf Dr Prins cannot be contacted, there is always another orthopaedic surgeon on call.

3.

Costs

Prior to your surgery you should be informed of the costs involved. You will receive a cost estimate prior to the operation. This is a binding document for all costs involved. You have to find out what your medical aid will be prepared to pay for the procedure, as you are liable for the difference.
The practise of Dr Prins is not contracted to any Medical Aid. As mentioned above, any excess remains the liability of the patient.
Due to the insurmountable rules and regulations of the different Medical Aids - this practice is not contracted to Medical Aids, apart from Discovery Classic Direct.
We advise all patients to consider GAP Cover for medical expenses not covered by Medical Aids, as Medical Aid Cover in most cases are not market related to Specialist costs.

*Please take note that the following are separate entities and will therefore invoice you separately:

- Anesthetist
- Physiotherapist
- Hospital
- Orthotist

4.

End-Result

The ultimate goal of your treatment by Dr Prins, is for you to have full pain free function of your affected limb. ln most cases this is possible providing certain steps are followed. One of these very crucial steps is that you follow the instructions given to you, including the instructions by the physiotherapists.
We again reiterate that: good directed physiotherapy is of the utmost importance in you regaining full pain free function. Be advised that good directed physiotherapy is not getting a massage and having warm pads applied to your affected limb/joint.

We recommend the following physiotherapists: birkillphysios.co.za and colinphysio.co.za
Good directed physiotherapy almost always includes the patient doing a lot of hard work. Also remember that the protocols set out by our physiotherapists are there for a reason and have reasons why certain exercises are only to be started at a certain time. Do not try and "take over" your rehabilitation protocol by doing certain movements etc. prematurely, even if you feel that your operated limb is much better.
This fact cannot be emphasized enough!!
Wounds and surgery sites sometimes take longer to fully recover (up to 6-8 months). By becoming impatient and trying to force the issue, more harm than good oftentimes is the end result.

5.

Follow-Up

ln order to provide you with the best continuous care, it is necessary for you to follow-up with Dr Prins.
The standard follow-up protocol is a post-op follow-up at 10-14 days post discharge.
At this follow-up your wound will be assessed and redressed as needed. lf you had an operation that needs plaster of Paris immobilization, the temporary plaster slab will be replaced by a circular plaster cast.
lf you had a major surgery, further follow-ups at 8-10 weeks post operation and sometimes at 6 months post operation might be needed. Please verify and confirm your follow-up visit timorously.

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