About

Arthroplasty Solutions

Transforming underprivileged lives
through partnership​

Introduction

The public health sector is South Africa is currently facing a huge crisis regarding the waiting lists for patients that are awaiting their hip and knee replacements. (Arthroplasty). Currently thousands of patients who have advanced degeneration of their joints and is in a lot of pain, are on waiting list countrywide. These patients must wait at least two to three years before their surgeries can be performed. This is due to several limitations within the public health sector.


To help address this crisis, a Public Private Partnership has been established through the organization Arthroplasty Solutions. This is a non-profit organization with the main aim of finding an innovative solution to utilize the available capacity in the Private Hospitals at a vastly reduced cost. This has been achieved through the partnership of the Department of Health, Busamed Private Hospital, and the Private sector.

The big problem and limitation in the public sector is the limited theatre time which limits the number of surgeries that can be done.

Current Project

Patients
The patients are taken from the waiting list at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban,
KZN. These patients will be admitted to IALCH as per usual. To save costs, their pre operative workup (X-Ray and bloods) up will be done on admission. Every week two of these admitted patients will be transferred from IALCH to Hillcrest Busamed Private Hospital where their joint replacements will be done.

Post operatively they will stay in the ward at Busamed Private Hospital where they will receive their post-operative care and physiotherapy until their discharge which is usually two to three days.

After their discharge they will be followed up again at IALCH again as per normal. The patients will thus only be at Busamed Private Hospital during their peri-operative period, which is as mentioned, the limiting factor at public hospitals.

Number of patients
Every week two patients will be done. Surgeries will be done for 50 out of the 52 weeks in a year, bringing the total of joint replacements done per year to approximately 100.

Orthopedic Surgeons
The surgeries will be done by experienced arthroplasty surgeons to reduce the theatre time and possible complications that will extend their hospital stay. The surgeries will however also serve as teaching for newly qualified Orthopedic Surgeons and specialists in training.

The project has 2 phases

Phase 1

This phase has started in March 2024. This is the pilot project which will be done as mentioned above. During this period all the possible pitfalls and shortcomings will be ironed out and a well-functioning working model will be established.

Phase 2

Once the above project is proven to work and more funds become available the exact same model will be rolled out to other provinces who all face the same dilemma. This is a country wide problem, but the project and working model must be proven first before expanding it to other provinces.

Management of the Project

The project will be managed through the organization called Arthroplasty Solutions. This organization is a non-profit organization and has been established by Dr M Ter Haar, a Specialist Orthopedic Surgeon with a special interest in Hip and Knee replacements (Arthroplasty). It also has a trust called the Arthroplasty Solutions Trust, which has been specifically created for the project.

The money allocated to the project will be paid into and managed through this trust. It has PBO (Public benefit organization) status which means the money donated into the trust is tax deductible. The trust itself is managed and audited by the Ewing Trust Company (Pty) Limited, which is an authorized financial service provider with FSP 713.

The actual organization and management of the project itself will be done by Dr Ter Haar and Dr. Paul Ryan (Head of Orthopedic Department at IALCH) in conjunction with Hillcrest Busamed Private hospital.

Cost of the project

The cost of the project will be shared between the Department of Health, Busamed Private Hospital, and the Private sector.

Expenses

The expenses for the project are salaries, orthopedic implants, theatre consumables and theatre and ward usage. The salaries paid to the doctors are greatly reduced to make the project feasible. The implants and theatre consumables are purchased at the normal reduced state price. Busamed Hospital contributes by reducing their theatre and ward costs.

Cost efficiency

The project is very cost efficient for several reasons:

  1. No Capital layout: As mentioned before, by using the existing infrastructure and facilities there
    is no capital layout. This reduces the cost to start and maintain the project significantly. There
    will be no expense or loss of any capital expenditure.
  2. No overheads: There is no management fees or any running costs. The management of the
    project is done pro bono.
  3. Low profit margin: The fact that the salaries are greatly reduced, hospital and theatre costs
    reduced as well as the significantly lowered implant prices makes this project very affordable.
    This project will be doing the exact same hip and knee replacements as is done in the private
    sector but at a very reduced cost.

Beneficiaries

The sole beneficiaries of this project are the previously disadvantaged people who are solely dependent on the state sector for their health. They have no other option but as to wait for the state sector to help them with their joint replacements. For them money is the limiting factor, and the luxury and comfort of medical aids are not available to them.

These previously disadvantaged people can thus be helped much earlier through this project which
would otherwise leave them with a long painful wait.

Social and Economic Impact

The patients that are on the waiting list are in a lot of pain and often greatly disabled and a burden to their families and surrounding communities. Due to their condition, they are often reliant on their families and communities for income, transport etc.

By doing these joint replacements these patients will become independent and self-sufficient again, releasing them from the burden on their families and community. Many of them are still relatively young and will be able to work and earn an income again, thus contributing financially to their respective families.

Conclusion

Currently the state sector Is facing a crisis regarding the huge waiting list for arthroplasty patients. This crisis can be greatly reduced by implementing the above- mentioned public private partnership project. Not only will it relieve the pressure on the health system, but it will make a massive difference to those patients waiting to have their joint replacements done. This project Is not a replacement for the arthroplasties currently being done, but an additional measure to reduce the huge waiting lists.

Contact

call

083 661 0187

Website

www.arthro.co.za

Email

michiel@arthro.co.za