Updated 04 April 2016

More joint replacement surgeries in Western Cape

The Western Cape Health Minister, Theuns Botha, announced an innovative intervention to address the problem of long waiting lists for hip and knee replacements.


Many people in the Province have had a long wait for joint replacement surgery, which causes great discomfort and pain on a daily basis. In addition, the backlog has been increasing faster than the Department can address, since more patients have been added weekly to the operating waiting list. An active intervention was thus required to provide additional capacity to undertake the required joint replacement surgery.

During the first year (current 2014/15 financial year) the Department has allocated an additional R6 million while a further R17.5 million has been made available for the next financial year (2015/16). Through this allocation of additional funds about 300 of the most severe cases, patients with the greatest degree of disability will now be operated upon.  As a result, other people on the waiting list will also experience shorter waiting times for surgery.

Read: Joint replacements

A central electronic waiting list for elective hip and knee surgery has also been established. This system, which is based on an electronic central platform, will link all facilities in the province where elective joint surgery takes place. This surgery is currently offered at 8 hospitals in the Western Cape: New Somerset Hospital, Groote Schuur Hospital, Tygerberg Hospital, Paarl Hospital, Worcester Hospital, George Hospital, Victoria Hospital and Mitchell’s Plain Hospital.

The electronic waiting list will ensure that wherever the patient lives in the Western Cape, they will have an equal and fair chance to undergo the required surgery at the earliest opportunity.

Patient-centred approach

Minister Botha said: “With this project the Department shows it can find innovative solutions to difficult challenges. The centralised waiting list and standardised criteria offers patients the opportunity to be ranked professionally and fairly on the platform.  It is a huge improvement for the patient-centred approach.

Read: Joint replacement reinvigorates sex life

“We know that resources are limited in public health care. Therefore it becomes very important to work smarter to stretch the health rand. The intervention is an excellent example where innovation leveraged additional funding, and with the support of partnerships we are now in a position to address the problem of surgery waiting lists in a manner that will tangibly change the lives of people who live in great pain. We are not aware of a similar project in this country, or even internationally.”

Dr Stephan Fourie, supported by Dr Paul Rowe of the Department, has developed the system that enables there to be a single waiting list that is centrally administered. As a result all state orthopaedic surgeons will now use a common set of criteria to assess the urgency of the individual patient’s requirements for joint replacement. This is then collected on the provincial data base which is to our knowledge the first of its kind in South Africa.  Each hospital’s caseload, ability to offer surgery and monitor their waiting lists and waiting times can now be centrally managed. Currently 1800 patients have been placed on the provincial electronic waiting list.

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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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