The specialized Orthopedic Centers and specialized departments of large University Hospitals in Germany offer foreign patients all types of classical joint replacement surgery according to international protocols, as well as uniquely designed techniques by German specialists.
The combination of surgeons' experience in sparing minimally invasive interventions, modern technical basis (high-resolution CT and MRI, 3D planning of operations, endoscopic equipment), high-quality prostheses and individual rehabilitation schemes guarantee the high quality of life for patients and lifespan of prostheses up to 15-25 years.
Indications for joint replacement surgery
In Germany, joint replacement surgery has the role of a second-line therapy, which is used only in the case of ineffectiveness of conservative treatment methods and orthopedic rehabilitation. German surgeons set themselves three purposes:
- To maximally delay joint replacement surgery
- To preserve patient's bone tissue using sparing superficial joint replacement techniques and partial endoprostheses
- To select an individual prosthesis and the high quality of life after surgery
The list of indications for arthroplasty includes:
- Osteoarthrosis (stage III-IV disease with severe pain)
- Rheumatoid arthritis (stage III-IV disease with severe pain)
- Avascular necrosis of the femoral head or humerus, osteonecrosis of other locations
- Congenital hip dislocation or clinically significant hip dysplasia
- Serious traumatic injuries of the joints, including articular cartilage injuries
- Joint stiffness and joint dysfunction caused by other diseases
Knee replacement surgery
In most patients, knee replacement surgery is performed using one of the classical methods with proven effectiveness:
- Total or complete joint replacement surgery includes the replacement of the articular components of the femur and tibia, intra-articular cartilage, and, if necessary, replacement of the patella. Taking into account the high requirements for knee joint function, the components of the prosthesis in most cases are fixed using bone cement.
- Partial or unipolar replacement surgery most often involves the replacement of the medial (inner) part of the knee. As a rule, articular ligaments and cartilages are not affected. Due to the minor scope of the operation and the relatively small size of the prosthesis, the intervention can be performed endoscopically.
- Patella replacement surgery (patellofemoral arthroplasty) involves the replacement of medial patella in its isolated lesion. Patellofemoral arthroplasty is indicated in the complete absence of signs of arthritis or other pathological process in other joint components.
In addition to classical joint replacement surgery techniques, the German clinics offer a less invasive intervention, namely tibial osteotomy. This technique is used in unilateral knee lesion. The surgeon remodels the tibia in order to redistribute the load on the joint. As a result, the affected part of the knee is mainly in the state of the functional rest.
Hip replacement surgery
Hip replacement surgery is the main type of treatment in hip fractures, particularly in elderly patients. At the same time, this type of arthroplasty can often required for young, physically active patients. In order to maximally meet the needs of patients of all age groups, the German surgeons specializing in orthopedics use two fundamentally different treatment methods. These include:
- Total or complete joint replacement surgery involves the replacement of the femoral head and neck, the inner surface of the acetabulum and articular cartilage. A plastic spacer is placed between the components of the prosthesis, which protects the joint components from premature wear and, if necessary, it is a source of antibiotics. The last aspect is important for patients with compromised immune system (for example, with immunodeficiency or diabetes mellitus), as well as with osteomyelitis in medical history.
- Sparing superficial hip replacement surgery according to Prof. McMinn's technique is the best choice for young patients and patients with a high level of physical activities. In this case, the surgeon preserves the femoral head and neck, replacing only the damaged articular surface. This is important for patients who potentially require revision intervention, since the service life of even the highest quality prostheses does not exceed 20-25 years. Arthroplasty according to McMinn's technique creates favorable conditions for subsequent implantation of the total or new superficial endoprosthesis.
Shoulder replacement surgery
In the case of shoulder joint, the replacement surgery in Germany has two anatomically different types of arthroplasty. These include:
- Physiological replacement surgery, which can be total or partial, depending on the degree of damage to the components of the shoulder joint. In physiological arthroplasty, the shape of the prosthesis completely imitates the shape of a normal shoulder joint. This type of operation is used in patients with normally functioning muscles of the rotational cuff. Hemiarthroplasty involves humeral head replacement, whereas total replacement surgery involves the replacement of the humeral head and glenoid cavity.
- In the case of reverse replacement surgery, the supporting surfaces of the joint change places – the spherical head is placed on the scapula, while the humeral cup is placed on the humerus. Such non-standard prosthesis is suitable for patients with injured muscles of the rotational cuff, who are not able to use classical prostheses. The reversible design allows patients to make movements in the joint solely by means of deltoid muscle.
Orthopedic rehabilitation and follow-up monitoring
Regardless of the main disease and type of arthroplasty, the treatment in Germany always ends with orthopedic rehabilitation. The rehabilitation program begins at the hospital on the next day after the arthroplasty. All exercises are performed under the full guidance of a qualified instructor.
After discharge from the hospital, the patient continues to perform the recommended set of exercises at home or visits a specialized center for physiotherapy and exercises on simulators, which include the following activities:
- Exercises to strengthen the muscles of the body and the operated limb
- Physiological load on the operated limb with intensity modulation
- Passive working out of joints or CPM therapy
- High-intensity laser therapy or HIL therapy
- Extracorporeal shockwave therapy
- Electrical stimulation
- If necessary, psychotherapy, individually or in group
Organization of medical treatment in Germany for international patients
The international patients are treated in Germany with the assistance of the certified medical tourism operator – the Booking Health company. The mission of Booking Health is to make qualified, high-tech medical care available for patients from all over the world. The international quality certificate ISO 9001:2015 and feedback of many patients confirm the high level of competence of our specialists.
The employees of Booking Health will help you with such important issues:
- Selection of the right hospital based on the annual qualification profile
- Establishment of direct communication with your physician
- Preparation of a medical program in advance, without repeating previous examinations
- Provision of favorable costs for joint replacement surgery, without overpricing and additional coefficients for foreign patients (saving up to 50%)
- Booking the appointment with a doctor on the necessary date
- Monitoring of the medical program at all its stages
- Assistance in buying and forwarding of medicines
- Communication with the hospital after treatment completion
- Control of invoices and return of unspent funds
- Organization of additional examinations
- Top-class service: booking hotels and plane tickets, transfer organization
Choose treatment abroad and you will for sure get the best results!
Author: Dr. Nadezhda Ivanisova