Shoulders - Trauma associated:
- repair fractures of for e.g. The clavicle (collarbone)
- humerus / upper arm
- dislocations of the clavicle and shoulder
- Recurrent dislocations of the shoulder
- Repair of torn muscles around the shoulder
Chronic shoulder problems:
- Repair of muscles (RTC) around the shoulder
- Reverse shoulder replacements
Elbow surgery – arthroscopic and open procedures around the elbow
Knees - Trauma associated:
- Repair of the ligaments in the knee - arthroscopic repair of the anterior and posterior cruciate ligaments.
- Repair of dislocating patella (knee cap)
- Repair of fractures around the knee
- Menisectomy of tears of the menisci (cartilage) inside the knee
- Primary knee replacements
- Revision knee replacements
Other sport injuries e.g.:
- Torn ligaments around the ankle
- Repair of various fractures and dislocations and muscle injuries.
Complications of surgery
Preparing for your surgery
After your surgery -
ln order to fully reach the goal of your surgery namely pain free function of the operated limb, it is imperative for you to undergo a vigorous rehabilitation I physiotherapy regime. lt is preferable for you to make use of our in-house physiotherapists. Only after you have completed your rehabilitation with them, and only on their instruction, are you to start with biokinetics, should you want to.
The practise of Dr Prins is not contracted with any Medical aid schemes. You are therefore solely responsible for the setting of your account. You are requested to ask for and sign acceptance of a quotation for your treatment. Also, please take note that the physiotherapy practise is a separate entity and they will invoice you separately.
Wound care - after your operation your wounds will be covered. lt is advisable to leave them closed. They will be assessed and redressed if necessary at your followup 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. 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 an orthopaedic surgeon on call.
COMPLICATIONS OF SURGERY:
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 do occur.
You should also be cognisant that complications, when they do arise, does not equate to negligence on the side of the doctor.
The following is a brief discussion of the possible complications that might arise from your surgery. This discussion will not attempt to claim to be 1000 complete. For further information on possible complications you are invited as well as encouraged, to follow this hyperlink as well as discuss you fears with Dr Prins. Remember: "The only stupid question is the one that you do NOT ask!"
- lnfection - superficial
- Nerve injury
- Drein vassit
Post operative bleeding occurs by and large 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 thp shoulder, sterile water is used to facilitate the operation. The soft tissues (muscles) 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 the bleeding. The incidence of this happening in this practise is less than one in five years of surgery.
To prevent infection, various systems are put in place and strict sterile protocols are followed. These systems and protocols have a proven track record and are aligned with similar international standards. You are also asked 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
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.
Some surgeries, like knee replacement surgery, have a higher risk for you to develop a thrombosis (blood clot). ln order to lessen the risks involved various interventions are implemented for 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 done in order to quantify the swelling and diagnose a possible thrombosis. Treatment will then be instituted.
As already mentioned, Dr Prins makes use of suction drains in your wound to lessen the amount of blood in your joint. 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. lt this does happen, it is best removed in theatre.
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 up 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.
As already mentioned, 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 qteps.ig 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 you affected limb / joint.
Good directed physiotherapy almost always includes you 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 prematurety, even if you feel that your operated limb is much better.
This fact cannot be emphasized enough!!
Wounds and surgery sites sometime 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.
Preparing for your 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. Telephone consultation are discouraged for various reasons, including time constrains and being impersonal.
Prior to your surgery you should also be informed of the costs involved and what your medical aid will be prepared to pay. You should have received and signed a quotation for the costs.
Remember the practise of Dr Prins is not contracted to any Medical Aid and will have no dealings with them. This unfortunate state of affairs have been brought on by the Medical aid industry by continuously interfering and prescribing to the Medical Profession.