'Whistle stop' tour of South Africa to enlighten orthopaedic colleagues on the Direct Superior Approach - DSA


Sharing knowledge and skill on the DSA in South Africa

I went back to Cape Town, the city of my birth, to tutor surgeons in South Africa on the minimal access DSA technique for hip replacement. The DSA is one of my preferred approaches to the hip. As a muscle sparing approach, patients that undergo a total hip replacement with the DSA generally experience a faster recovery.


My journey began at 2 Military Hospital, Wynberg where I demonstrated the technique to Orthopaedic Surgeons Dr Cecil Reid and Dr Mourad Hanna, as well as their orthopaedic colleagues. The patient, with avascular necrosis in both hips, was consented for the operation and underwent bilateral surgeries. By the time we had progressed to the second side, the surgeons had warmed to the DSA technique.


During the afternoon of the first day I transferred to Groote Schuur Hospital. This was a special part of the trip as it was the hospital where I undertook my Orthopaedic Surgical Rotation when I was a trainee in South Africa. I met with Dr Marc Nortje, Head of the Arthroplasty Unit, to witness their revision surgical technique in live surgery.

An evening lecture had been arranged for Cape orthopaedic surgeons to attend for what turned out to be a marvellous interactive meeting.


On day two, I demonstrated the technique to Dr Tom Hilton and fellow surgeons. The surgeons were very perceptive and thoroughly enjoyed the interaction and unique instrumentation. Tom Hilton commented on how great it was to have visiting surgeons who add value to their orthopaedic practice.


The next stage of the trip involved a journey to George Hospital on the east coast. Here I met with Dr Tom Barrett and we went through the DSA approach.


From George, I travelled to Stryker Headquarters in Johannesburg where there was a day of lectures and x-ray reviews with surgeons and Stryker staff.  


Finally, I travelled on to another hospital that evoked some powerful memories - Chris Hani Baragwanath Hospital, Soweto. This is one of the hospitals affiliated with the University of the Witwatersrand Medical School where I undertook my undergraduate medical degree. I was a House Officer and Senior House Officer at Bara. Chris Hani Baragwanath Hospital is the biggest hospital in South Africa and the 3rd largest in the world. Some of the admission statistics are astonishing, with approximately 70% being classified as emergencies and 60,000 patients travelling through the Maternity Hospital each year.


Along with Dr Richard Greeff Head of the Arthroplasty Unit, Dr Nabeel Moosa, Orthopaedic Fellow, Vira; and Registrar, Jason we operated using the DSA approach on two patients. The surgeons took to the procedure very quickly.



It was great to be back at Groote Schuur and Chris Hani Baragwanath Hospital.

The surgeons in South Africa to whom I demonstrated the DSA procedure were newly introduced to the special DSA equipment and kit, which was developed by Dr Doug Rogers.


The Stryker Representatives that accompanied me during the trip did a fantastic job.


I returned home feeling fulfilled following the interactions with colleagues and professionals and happy to have imparted surgical skills and knowledge to improve patient outcomes in South Africa. 


Job done!




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