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Ankle Arthritis — Total Ankle Replacement: treatment in the Best Hospitals of Germany

St. Vinzenz Hospital for Orthopedics Duesseldorf

9.9/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Orthopedics, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Foot Surgery offers the widest range of modern medical services to patients suffering from musculoskeletal diseases. The department specializes in knee and hip replacement surgery, including revision interventions to replace previously implanted artificial joints. The department has the status of a certified Maximum Care Endoprosthetics Center (endoCert), which means adherence to the requirements of European professional societies for carrying out procedures of this kind, a high level of safety and treatment efficiency. It is worth noting that the department uses the innovative ROSA® robotic system for performing knee replacement surgery. A special Rapid Recovery Program is used for the rapid recovery of mobility after joint surgery, which allows the patients to quickly return to their usual life. An integral part of the department's clinical practice is also the treatment of foot diseases and deformities in adults and children. The medical facility has been operating for more than 50 years, and therefore it provides patients with the highest quality medical care and easily copes even with highly severe pathologies.

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Vitos Orthopedic Clinic Kassel

9.2/10
location_onGermany, Kassel

Department of Adult and Pediatric General Orthopedics, Trauma Surgery

The Department of Adult and Pediatric General Orthopedics, Trauma Surgery offers the full range of diagnostics and treatment of musculoskeletal pathologies. The specialization covers joint replacement surgery, foot and hand surgery, shoulder surgery, treatment of rheumatic joint lesions, treatment of injuries, sports orthopedics, treatment of orthopedic problems in children and adolescents, as well as pain therapy. The key to successful clinical practice is the highest professionalism and unique experience of the department's medical team combined with the very latest infrastructure and advanced equipment.

University Hospital Ulm

9.2/10
location_onGermany, Ulm

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German departments specializing in joint replacement surgery! The department covers the full range of conservative and operative therapy in diseases of the musculoskeletal system, including the special pain therapy in the case of these pathologies, emergency treatment and long-term care for the patients with paraplegia. The department offers many sparing minimally invasive techniques, advanced navigation systems for high-precision interventions.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Adult and Pediatric Orthopedics, Special Orthopedic Surgery and Rheumatic Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics, Special Orthopedic Surgery and Rheumatic Orthopedics ranks among the top German medical facilities specializing in the treatment of orthopedic diseases in adults and children, as well as in hip surgery! The department offers the full range of medical services in these medical fields. It carries out both diagnostics and treatment of patients of all age groups, including very elderly patients, with various musculoskeletal diseases. The therapeutic options include both conservative and surgical treatment methods. The department is distinguished by high professionalism of doctors, advanced infrastructure and invaluable experience in the field of its specialization, due to which it occupies leading positions in the European medical arena and guarantees an optimal treatment result.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Orthopedics, Traumatology

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics, Traumatology ranks among the top German departments specializing in endoprosthetic joint replacement! The department offers the full range of services in the field of diagnostics and treatment of all diseases of the musculoskeletal system. In addition to surgical treatment, a number of effective conservative treatments are available in the department, for example, physiotherapy, occupational therapy, therapeutic exercise. The highly qualified doctors who have a rich experience and outstanding treatment results take care of the patients' health. 

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Orthopedics

The Department of Adult and Pediatric Orthopedics is the center of maximum orthopedic care and offers the diagnostics and treatment of all diseases and injuries of the musculoskeletal system. Along with the full range of modern operative and conservative orthopedics, the department specializes in hip and knee replacement surgery using the minimally invasive methods, replacement/revision of prostheses, orthopaedic oncology, foot surgery and patella problems in the patella.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department for Adult and Pediatric Orthopedics, Trauma Surgery

According to Focus magazine, the Department of Adult and Pediatric Orthopedics, Trauma Surgery ranks among the top German departments specializing in joint replacement surgery! The department offers the full range of diagnostics, conservative and surgical treatment of diseases, injuries of the musculoskeletal system. The department is the certified Center for Endoprosthetics (more than 1,000 primary joint replacement operations yearly), which also specializes in particularly complex clinical cases. In addition, the department has won the status of the Trauma Center of interregional significance, certified in accordance with the standards of the German Trauma Society.

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Orthopedics, Sports Medicine

The Department of Adult and Pediatric Orthopedics, Sports Medicine offers the full range of services in these fields. The department deals with the treatment of all diseases of the musculoskeletal system: bones, joints, muscles, ligaments and tendons. The highly specialized medical team of the department applies only modern diagnostic and therapeutic methods in its practice, while the long experience of doctors guarantees first-class surgical and conservative treatment.

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

Department of Adult and Pediatric Orthopedics

The Department of Adult and Pediatric Orthopedics offers the full range of modern diagnostics and treatment of diseases, deformities of the musculoskeletal system in patients of all age groups. The priority task of all specialists of the department is to preserve the mobility of the patient and improve the quality of his life. In the field of surgical treatment, the main focus is on joint arthroplasty, resection of musculoskeletal tumors, as well as surgical correction of spinal defects and pathologies. In addition, the department specializes in the treatment of sports injuries.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of General Orthopedics and Orthopedic Oncology

The Department of General Orthopedics and Orthopedic Oncology offers the full range of conservative and surgical treatment of all musculoskeletal diseases. The department ranks among the largest medical facilities of this kind in Germany, as well as among the specialized authoritative departments for the treatment of bone and soft tissue tumors in the European medical arena. The treatment is carried out both on an outpatient and inpatient basis, including the outpatient operations. In addition to its successful clinical activities, the department is proud of its productive research work, which has given birth to many innovations in orthopedics, for example, the department's specialists have patented the very latest prosthetic systems, particularly in the field of orthopedic oncology.

University Hospital RWTH Aachen

8.5/10
location_onGermany, Aachen

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German medical facilities specializing in joint replacement surgery! The department offers the full range of diagnostics and treatment for patients with musculoskeletal diseases. The department treats patients of all age groups ranging from young children to elderly people. The department annually treats more than 15,000 patients, and also performs about 1,500 interventions yearly. The department has long traditions, long successful clinical experience, which contributes to its reputable status in the medical arena.

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Orthopedics and Traumatology

According to the Focus magazine, the Department of Orthopedics and Traumatology ranks among the top German medical facilities specializing in the treatment of injuries of any severity! The department offers the full range of diagnostic and therapeutic services to patients with diseases and injuries of the musculoskeletal system. The department has been certified by the German Society of Traumatology as a supra-regional Trauma Center. In addition, the medical institution is a certified Center for Gerontological Traumatology, the Center for Arthroscopy and Joint Surgery.

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Adult and Pediatric Trauma, Hand, Reconstructive Surgery

The Department of Adult and Pediatric Trauma, Hand, Reconstructive Surgery offers all modern surgical interventions in these medical fields. The department specializes in the treatment of patients with polytrauma, pelvic surgery, endoprosthetics, cancer, reconstructive surgery and hand surgery. The department has 62 beds for inpatient treatment and 3 high-tech operating rooms for both planned and emergency operations. The prestigious certificates of the Interregional Trauma Center of the German Society of Traumatology and the EndoCert certificate testify to the outstanding quality of medical services.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Orthopedics, Trauma and Reconstructive Surgery

The Department of Orthopedics, Trauma and Reconstructive Surgery offers the full range of modern diagnostic examinations, conservative and surgical treatment of the musculoskeletal system. The competence also includes round-the-clock medical care for patients with severe and multiple injuries. The department operates a certified Endoprosthetics Center, within which the patients undergo knee, hip and shoulder replacement surgeries. All the department's doctors have excellent qualifications and they are recognized experts in their field of competence, which guarantees the highest quality of medical service.

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the best departments in Germany specializing in joint replacement surgery! The department offers the full range of accurate diagnostics, effective conservative and surgical treatment of all diseases of the musculoskeletal system. The scope of tasks of the department’s medical team is to conduct physiotherapeutic and rehabilitation measures.

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German departments specializing in joint replacement surgery! The department offers the full range of diagnostics and treatment of various diseases, injuries of the musculoskeletal system, and their consequences. Also, the department's doctors specialize in sports orthopedics and treatment of orthopedic diseases in children of all age groups. The doctors have in their arsenal many conservative and surgical treatment methods. Many complex operations are carried out using a highly accurate computerized system

Ankle arthritis causes pain, impaired joint mobility and sharply limits the physical activity of the patient. At the advanced stage of the disease, the pathology has to be treated with surgery. One of the best treatment options is surgical replacement of the ankle joint with an artificial endoprosthesis.

This is a relatively rare surgical procedure, and most doctors have no experience in performing it. Therefore, it is better to go abroad for ankle replacement. In this case, you can count on the best long-term results. Approximately half of all ankle replacement procedures performed in Europe are carried out in Germany. Orthopedic surgeons in this country use the very latest types of endoprostheses, which are implanted with perfect precision. After surgery, patients receive high-quality care and rehabilitation.

To undergo treatment in Germany, please use the services of Booking Health. Here you can get information about the cost of treatment, compare prices and book a medical program at an affordable price.

Content

  1. Who may need a total ankle replacement?
  2. Principle of the treatment method
  3. Types of ankle endoprostheses
  4. Joint replacement in modern hospitals
  5. Why is it worth undergoing treatment in Germany?
  6. Treatment in Germany with Booking Health

Who may need a total ankle replacement?

 

The main indication for ankle replacement is primary or post-traumatic arthritis. Less often, operations are performed for severe injuries, tumors, and inflammatory lesions of the ankle joint.

Ankle replacement surgery for arthritis is not considered a standard surgical treatment. Most patients undergo arthrodesis. During this operation, the bones that form the ankle joint are connected with screws, needles or pins. As a result, mobility in this place is completely blocked.

Such an approach allows the doctors to solve a number of problems, first of all, it relieves a person from chronic pain and joint instability. Arthrodesis stabilizes it and makes it possible not only to walk, but even to run. This type of intervention is considered best for young patients who are physically active.

However, arthrodesis has several disadvantages. These include:

  • Functional deficit that is especially noticeable when walking or running fast.
  • The foot and ankle are involved in walking, and when the ankle joint ceases to function fully, the load on the foot increases sharply, leading to the development of metatarsal and tarsal joint arthritis.
  • Long-term immobilization of a limb – a person must spend several weeks with a cast, which complicates further recovery and leads to muscle atrophy.
  • The load on the knee and hip increases, so the risk of developing arthritis in these joints increases as well (the likelihood that the patient will need replacement in the future increases).

The treatment of ankle arthritis with replacement surgery does not have these disadvantages. Common ankle replacement is a technically complex operation, which is not always successful, but it provides better functional outcomes. When walking, the leg moves naturally, so there is no increasing stress on the adjacent joints. New types of endoprostheses can serve for decades. When they are implanted in a good hospital, the risk of complications and unfavorable functional outcomes is minimized.

Total ankle replacement is substitution of the diseased ankle joint with an artificial prosthesis.

Cost of ankle arthritis treatment with total replacement is from €6,181. You can find prices for other treatment options on the Booking Health website.

The best hospitals in Germany are:

  1. University Hospital Rechts der Isar Munich
  2. Vitos Orthopedic Clinic Kassel
  3. University Hospital of Ludwig Maximilian University of Munich
  4. University Hospital Ulm
  5. University Hospital Frankfurt-am-Main

Principle of the treatment method

 

The essence of the procedure is that the doctor implants an artificial joint instead of the patient's own. He removes the tissues affected by the pathological process. The components of the endoprosthesis are implanted instead.

The ankle joint has a complex structure. It is formed by three bones: talus, tibia and fibula. Its movements and stability are influenced by many soft tissue anatomical structures: ligaments, muscles and their tendons, a connective tissue capsule. For this reason, it was not possible for a long time to create endoprostheses that could completely restore the function of the ankle.

In the second half of the 20th century, the doctors obtained excellent results in knee and hip replacement. It turned out that endoprostheses serve for a long time, completely eliminate pain and restore limb function. They hoped that the creation of endoprostheses for other joints would help to obtain the same results, but the doctors were wrong.

The first successful total ankle replacement was performed in 1970. The authors eventually performed surgery for 25 patients and described the outcomes, but they were unsatisfactory: they achieved good functional results in only 7 cases. Over 10 years of observation, the components of the endoprosthesis loosened in 12 patients, while the stability of the artificial ankle joint was impaired.

The following artificial joints were even worse. At the end of the twentieth century, there were many failures, but in the end, high-quality endoprostheses were created. They are mainly made in Europe (France, England, Germany). In total, about 50 models of ankle endoprostheses have been developed in the world, but only about 15 of them are used in ankle surgery.

Total ankle replacement is a relatively rare surgical procedure in medicine, especially when compared with surgical interventions to replace other large endoprostheses. Hundreds of thousands of knee and hip replacement surgeries are performed every year in Europe. At the same time, total ankle replacements are performed only 3,000 times a year, about 1,500 operations of which are performed in Germany.

Such interventions are very rare in countries with a poor level of medicine. For example, only about 50 ankle replacement surgeries are performed every year in Russia. Most orthopedic surgeons, even among those who specialize in replacement surgery, have never performed or seen ankle replacement surgery.

Types of ankle endoprostheses

 

There are two types of endoprostheses for total ankle replacement. These are:

  • Unconstrained.
  • Constrained.

Whenever possible, doctors give preference to unconstrained ankle prostheses. Information obtained from clinical trials demonstrates that these types of artificial joints are more reliable. However, they cannot be implanted in all patients. In significant damage to the soft tissue structures, it is necessary to resort to the use of constrained endoprostheses.

By the type of movement, artificial joints can be:

  • Single-axis.
  • Polyaxial.

The last ones provide the best function of the limb. Their implantation is especially preferable for patients with a stiff hindfoot. After the implantation of this type of endoprosthesis, the supination and pronation of the foot are restored, which reduces mechanical stress, prevents loosening and increases the service life of the prosthesis.

Constrained prostheses are rarely used, only in the most severe cases, in elderly patients with low physical activity. They cannot stand an active lifestyle. Stabilizing systems compensate for the deficiency of their own ligamentous apparatus, but complications after the implantation of such endoprostheses develop more often. The most common problems are pain or impingement syndrome caused by rubbing of the prosthesis and ankles. The prosthesis wears out quickly: after 9 years, revision surgery is required in 40% of patients.

Joint replacement in modern hospitals

 

Advances in modern medicine have made it possible to successfully perform even such a complex surgical procedure as total ankle replacement. Important conditions for achieving a good result of the surgery are high-quality endoprosthesis of the very latest generation and an experienced team of surgeons.

Modern endoprostheses are functional and resistant to loads. They take into account the biomechanical features of the ankle joint. The new types of prostheses have artificial polyethylene menisci. They are made from a cobalt-chromium alloy with a porous coating on the surfaces in contact with the bone. The metal is coated with calcium phosphate for good bone adhesion. Some endoprostheses have lateral planes on the talus component, which protect the articular cartilage of the ankles – they are suitable for patients with significant damage to the lateral ankle joint. Most modern endoprostheses are fixed using a cementless technique.

It is very important that a total ankle replacement is performed by experienced surgeons. The prosthesis must be perfectly positioned. Bone resection is minimal. This is because the more bone tissue is removed, the less strong it becomes. Economical resection reduces the risk of endoprosthesis protrusion and loosening.

Why is it worth undergoing treatment in Germany?

 

Germany is one of the few countries in the world where ankle replacement is one of the standard treatment methods for osteoarthritis. Most other countries do not resort to such complex interventions, but use only arthrodesis (fixed ankle joints).

If your native country has poor medicine, it is better to undergo treatment in Germany. Perhaps ankle replacement surgery is not performed in your native country at all. Even if they are carried out, then in minimal numbers. This means that doctors have low experience in performing such interventions, and cannot achieve the same high results as German orthopedists.

The results of ankle replacement largely depend on the quality of the prosthesis and the experience of the doctors. The risk of early postoperative complications and long-term results of replacement surgery vary significantly in different hospitals. Here are the following reasons why you should undergo this surgery in Germany:

  • The use of advanced ankle endoprostheses, which can serve for decades.
  • Vast experience – Germany performs as many ankle operations each year as all other European countries.
  • The world's best orthopedists – even patients from other developed countries opt for treatment in Germany.
  • High quality care and good rehabilitation.
  • The cost of treatment is lower than in many other developed countries. At the same time, the quality of treatment is at least not worse.

After replacement surgery, you can stay in the hospital or go to a rehabilitation center. Germany is one of the world leaders in orthopedic rehabilitation. An individual program will be made for you and will be periodically adjusted. Based on the results of treatment and rehabilitation, you can get rid of pain in the ankle and fully restore the function of the lower limb forever.

Treatment in Germany with Booking Health

 

You can undergo total ankle arthroplasty abroad. Booking Health will take care of the organization of your treatment in Germany. On our website, you can see the cost of treatment in different hospitals, compare prices and book a medical program at a favourable price.

Please contact the Booking Health specialists for treatment in Germany. We will provide the following benefits:

  • We will choose the best hospital whose doctors specialize in total ankle replacement for arthritis.
  • We will help you overcome the language barrier, establish communication with the hospital and your attending physician.
  • We will reduce the waiting time for your treatment in Germany and book a doctor's  appointment on the most suitable dates.
  • We will reduce the price. The cost of treatment in Germany will be decreased due to the absence of coefficients for foreign patients.
  • We will take care of all organizational issues: documents for entering the country, transfer from the airport, hotel, interpreter, etc.
  • We will elaborate a program and translate medical documents into German. You do not have to undergo previously performed diagnostic procedures.
  • We will provide communication with the German hospital upon the completion of treatment.
  • We organize additional medical examinations, treatment or rehabilitation, if necessary.
  • We will buy medicines in Germany and forward them to your native country.
  • We will help you keep in touch with the hospital upon the completion of your medical program.

Booking Health makes treatment in Germany easier, faster and cheaper. We will fully organize your trip, and you will only have to focus on restoring your health.

Authors: Dr. Nadezhda IvanisovaDr. Farrukh Ahmed




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