PRESIDENT'S CORNER

SAAS PRESIDENT ACCEPTANCE SPEECH 2024

Thanks Lipalo, for the introduction and congratulations for completing such a successful Presidency. You have had a brilliant 4 years with once again another awesome congress. I will certainly be looking to you for lots of advise over the coming months and years.

I feel truly honoured to take over the reigns of our Arthroplasty society. Arthroplasty has been part of my life since starting medicine many years ago. I can remember sitting on the couch at home with my Dad excitedly explaining the benefit of hip
resurfacing over hip replacements.

This brings me onto my first theme I would like to take into my term as President - that of Mentorship.

I have been very fortunate to have had many amazing Mentors through my arthroplasty career. Starting with my Dad and his enthusiasm for arthroplasty, especially resurfacing. A huge shout out to him for being such an amazing role model. I can’t miss this opportunity to say a few words about him. He was always passionate about his work and that obviously rubbed off on his sons. I
think its amazing that all 4 of us followed his footsteps into medicine and 3 of us into orthopaedics. And already 2 of his grandchildren are studying medicine.

He has not been well recently otherwise I am sure he would have been here for the conference. He still has the confidence to think he can do replacements better than all his sons. The basic surgical principles that he drummed into us about tissue handling and sterility are still lessons I take with me to theatre on a daily basis.

During my time as a medical officer I was fortunate to spend a year assisting Frans Weber - he is a legend of South African arthroplasty and assisting him cemented in my mind that arthroplasty was what I wanted to do.

During my Orthopaedic registrar training , I met and started assisting Prof Anton Schepers. Anton was always a down to earth, logical thinker and he demystified arthroplasty. I have been fortunate to have continued working with him for 20 years.

I recently saw a patient for follow up , whose hip replacement I had done with Anton in 2004. When I started in private practice my Monday assisting with Anton was often my only hands on arthroplasty as case numbers in my own practice were still extremely low.

When I qualified as an Orthopod, Anton spoke to me - advising me to concentrate on arthroplasty and to be careful not to become an Orthopaedic GP.

I think this was excellent advise and I would pass this advise on to any Orthopods wanting to build an arthroplasty practice. Everything you do should be to aid in establishing yourself as an Arthroplasty Practice.

Then Dr Ian Dymond who I started assisting once I had qualified. He persuaded me to move across to Morningside clinic to help establish myself as an arthroplasty surgeon and he was always and still is an amazing Mentor.

Ian has an brilliant, and always critical and forward thinking mind.

He instilled in me the need to try perfect every single case with a critical review of what we had done and how it could be improved. He insisted that we not just looked at the post op Xray but measure all the parameters of what we had done such as leg length, cup angles and offsets. Ian is still very involved in peer review, which actually starts as a personal review including measurements of what we have done.

Then Rob Stein for his tutorship in helping me with revision surgery. For nearly 8 years, Rob came to help me with every revision case. To have senior experience holding my hand on all revision cases gave me the confidence to take on any complex cases and thus build up my confidence as a revision surgeon.

Rob, Thank you for your guidance and mentorship over the years.

In South Africa we have a unique situation where the discrepancies between private and public healthcare is vast.The public health system is overwhelmed by trauma. There are long waiting lists and inefficiencies in the system make it difficult for Registrars to build up experience in arthroplasty and often after qualifying junior surgeons are forced out into private practice. Private practice can be a lonely and daunting place to start working, with low arthroplasty numbers when you start, so it is difficult to gain arthroplasty experience.

I would like to build on Mentorship programs that have been started to assist young Orthopods who are keen on specialising in arthroplasty.

My next theme will be on Revision arthroplasty.There is a growing burden of Revisions. These are a financial burden on Funders and patients. Funders reluctantly pay out huge sums of money to hospitals and the prosthesis companies but then squeeze the surgeons who do these complicated cases and take all the risks.

Funders make the billing process as complicated as possible for the surgeon to get remunerated with every case requiring multiple motivation letters and hours of backroom admin. This often makes revisions a grudge operation and many good & busy surgeons even stop doing revisions.

I would like to work together with the medical aids to help simplify the billing processes and improve on this for all of us.

We are entering a new world in arthroplasty with AI, Robotics and same day surgery becoming common themes.

I feel I fit somewhere between Old and New school. I am probably too old to convert all my practices, but I am young enough to understand what the advantages are and will be keen to assist in moving the thinking of the Arthroplasty Society into the modern era as we embrace these new practices and technologies.

In 4 years time when I hand over the reigns I truly hope to be able to say.

“I did not pass time but have left my mark”