Treatment of coxarthrosis (osteoarthrosis of the hip) in Germany
Coxarthrosis is a degenerative-dystrophic damage of the hip joint. The disease is severe and it is most typical for people of active working age. Coxarthrosis is the same time the most widespread and harsh form of degenerative-dystrophic joints diseases. Majority of patients become disabled because of the hip joint arthritis.
Coxarthrosis – Diagnostics
The diagnosis is easily established with the help of an X-ray examination. Other imaging techniques can be used to obtain detailed information about the stage of the joint’s damage for determining the therapeutic tactics and defining the prognosis for further working capacity. MRI is the most informative technique of all.
Diagnosis criteria according to the laboratory and X-ray data are the following:
- Narrowing of the joint space
- Presence of the femur or acetabulum osteophytes
- Erythrocyte sedimentation rate is below 20 mm/h
The diagnosis is considered to be confirmed in presence of 2 of 3 listed below criteria.
Clinical diagnosis criteria are:
- Reduction of external hip rotation
- The morning stiffness is less than 1 hour
- Painful sensations during the internal hip rotation
- The patient's age is under 50 years
The diagnosis is considered to be confirmed, if a patient feels pain in the hip joint during 2 weeks minimum and if 3 of 4 clinical criteria are present.
Best clinics for the coxarthrosis diagnostics in Germany:
Medipol Mega University Hospital Istanbul
Academic Hospital DRK Berlin Westend
Hannover Medical School (MHH)
Coxarthrosis – Treatment
Stable clinical effect can be reached only with the help of surgery. The other techniques give only temporary effect, like the improvement of the quality of life.
The following conservative treatment methods are used:
- Prescription of medications (non-steroidal anti-inflammatory drugs, chondroprotectors)
- Injections of a hyaluronic acid into the joints
- Health resort treatment
- Exercise therapy
Significant and prolonged clinical improvement is reached with the help of surgeries. Basic types of surgical interventions include:
Decompression myotomy is performed in the elderly people, if the amplitude of movements in the joint is satisfactory. A surgeon cuts off the small and large trochanter of the femur, cuts the femoral fascia and the adductor muscles of the thigh. This allows you to eliminate muscle contractions and reduce the pain caused by muscle spasm. Traction (extension) of the limb and joint training are performed during 2 weeks after the operation.
Cartilage replacement techniques have limitations due to the large size of the joint surface. The material for the cartilage replacement can be either own or from a donor. The following surgeries are applied:
- Mosaic chondroplasty uses the patient’s own biological material, which is taken from different parts of the body
- Allograft transplantation means that the donor’s biological material is used
- Autotransplantation of crushed cartilage with gel
Arthroplasty of the hip joint is a surgery performed to correct the joint structure. The doctor removes cartilaginous and bony growths, foci of necrosis and smoothes the surfaces of the joint. The defect of the bone tissue is replaced with the ceramic implants.
Endoprosthetics of the hip joint is currently considered as the gold standard for the coxarthrosis treatment. Doctors implant an artificial joint instead of the damaged one. As a result of the operation, pain disappears and mobility of the limb returns. The patient can lead a normal lifestyle and restore working capacity.
Coxarthrosis – Innovative Treatment
At the moment, new ways of joint cartilage restoration have been invented and successfully implemented in German hospitals.
Bone marrow stimulation techniques are used for the cartilage tissue recreation from the own stem cells. This is a group of methods aimed at the creation of the special bone tissue defects around the damaged cartilage. As a result, stem cells come out from the bone marrow, differentiate into the chondrocytes, and cover the defect of the joint surface.
Such techniques are applied for this purpose:
- Formation of micro-fractures
- Transplantation of the periosteum
- Matrix-induced chondrogenesis
Cellular technology with the use of tissue engineering. Matrix-induced autologous chondrocytes implantation remains the cutting-edge and effective technique of the coxarthrosis treatment. The essence of the technique is that patient’s own cartilage tissues are cultivated to receive a large number of the cells. As a result, the problem of autologous material deficiency for transplantation is solved.
A patient undergoes two surgeries. Cartilage tissue is obtained during the first procedure. Then chondrocytes are differentiated from the sample and are being cultivated during the several weeks. Doctors fix the cells with a matrix. The second procedure’s purpose is to insert the matrix with the cells into the joint and, thus, to form a new cartilage of these cells. The prolonged remission comes as a result of surgeries. Joint function is restored and pain disappears.
Best clinics for the coxarthrosis treatment in Germany:
Orthopedic Center Munich East Munich
Hospital Neuwerk Maria von den Aposteln Moenchengladbach
Hannover Medical School (MHH)
Coxarthrosis – Rehabilitation
The patient spends the early postoperative period in a hospital. Rehabilitation begins almost at once. It lasts for 3-4 months.
A qualitative rehabilitation program allows to reach the following results:
- To avoid complications
- To recover faster
- To restore completely the function of the operated limb or the spine
Rehabilitation is divided into the early and late one. The early rehabilitation lasts for 2 weeks. It is carried out in the hospital where the patient was operated. The epithelialization and healing of the wound occur at this time.
The bone structures are healing during the next 3 months. During this period it is desirable to undergo a rehabilitation in the specialized clinic. It includes:
- Physiotherapeutic procedures and massage for blood circulation improvement and normalization of the muscle tone
- Improving muscular strength of the lower limbs
- Stabilization of posture and gait (they are often violated in people who used to adapt to their disease for a long time)
- Increasing the range of motion in the operated joint
In the course of rehabilitation, a person develops the correct stereotypes of walking and other actions, like lifting from a sitting or lying position, moving along the stairs, etc. Such healthcare professionals as rehabilitation specialists, kinesiotherapists, and physiotherapists help patients in these affairs.
Best clinics for orthopedic rehabilitation in Germany:
Max Grundig Clinic Buehl
762.57Per daySee More
Author: Dr. Nadezhda Ivanisova
Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.
The program includes the following:
- Issuing of an invitation for getting a visa for treatment as quick as possible
- Fixing an appointment at a time convenient for you
- Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
- Arranging transfer from the airport to the hospital and back to the airport
- Provision of interpreting services and services of a personal medical coordinator
- If necessary, assistance in the organization of further surgical treatment
- Provision of a medical insurance against treatment complications covering up to 200,000 euro
- Preparation and translation of medical records and recommendations from the hospital
- Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc