Hip Osteoarthritis (coxarthrosis) — Hip Replacement and Rehabilitation: treatment in the Best Hospitals in the World
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Treatment of Hip osteoarthritis (coxarthrosis)
- Diagnostics
- Hip replacement
- Arthroscopic surgery
- Diagnosis and conservative treatment
- Endoprosthesis replacement in coxarthrosis
- Endoprosthesis replacement in coxarthrosis with rehabilitation
- Treatment with autologous conditioned plasma (ACP)
- Bilateral hip replacement
- Bilateral hip replacement and rehabilitation
- Autologous chondrocyte implantation (ACI)
- Orthopedic rehabilitation
Department of Adult and Pediatric Orthopedics, Traumatology
The Department of Adult and Pediatric Orthopedics, Traumatology is part of the specialized Center for Musculoskeletal Disorders, whose medical team consists of highly qualified orthopedists, traumatologists, and spinal surgeons. The department offers modern diagnostics and treatment of the entire range of musculoskeletal diseases. The department's field of competence includes the treatment of injuries of varying severity. The therapeutic options cover both conservative measures and surgical interventions, which are mainly performed using sparing minimally invasive techniques. The treatment concept is based on the comprehensive approach – from the use of conservative methods to physiotherapeutic procedures the day after surgery.
Department of Adult and Pediatric Orthopedics, Traumatology, Foot Surgery
According to the prestigious Focus magazine, the Department of Adult and Pediatric Orthopedics, Traumatology, Foot Surgery ranks among the top German medical facilities specializing in hip surgery! The department offers the full range of high-precision diagnostics and conservative and surgical treatment for diseases of bones, joints, muscles, ligaments, and tendons. One of the department's key areas of clinical practice is large joint arthroplasty. In this area, the department is awarded the prestigious endoCert certificate. The doctors in the department's operating rooms successfully perform knee, hip, and shoulder replacement surgery. Whenever possible, preference is given to minimally invasive joint replacement surgery. An important part of the work of the department's doctors is the treatment of orthopedic diseases and musculoskeletal injuries in children. The specialists at the medical facility also have long experience in helping patients with foot pathologies and deformities, including hallux valgus, hallux rigidus, hammer toes and claw toes, metatarsalgia, etc. The department's doctors have in their arsenal state-of-the-art equipment and modern treatment methods that allow for the achievement of excellent therapeutic results. More than 3,500 inpatients and about 17,000 outpatients are treated at the medical facility every year.
Department of Orthopedics, Traumatology, Spinal Surgery and Foot Surgery
According to the Focus magazine, the Department of Orthopedics, Traumatology, Spinal Surgery and Foot Surgery ranks among the top German medical facilities in treating orthopedic diseases and spinal surgery! The department carries out comprehensive examinations and effectively treats musculoskeletal diseases and injuries. The department has about 130 beds for its patient hospitalization. Doctors annually admit more than 4,000 patients for inpatient treatment. Several thousand surgical interventions of varying complexity are performed on the basis of the medical facility annually. The department offers the services of the certified Maximum Care Joint Replacement Surgery Center (EPZmax) and the certified Trauma Center. In addition, the department's specialists have vast experience in treating spinal and foot pathologies. The main goal of the department's doctors is to restore mobility and eliminate pain. The specialists always prefer an individual approach to each patient and his clinical case.
Department of Adult and Pediatric Traumatology, Orthopedic Surgery, Hand and Foot Surgery
The Department of Adult and Pediatric Traumatology, Orthopedic Surgery, Hand and Foot Surgery offers the full range of modern services to the patients with musculoskeletal diseases and injuries. The key areas of specialization include conservative and surgical treatment of injuries and degenerative changes in the limbs, joints, pelvis and spine. The department is certified by the German Trauma Society (DGU) and has an SAV certificate, which indicates the excellent achievements of the medical facility in the treatment of injuries of any severity. The department performs most surgical interventions using minimally invasive and endoscopic surgical techniques, thanks to which the patients can regain their mobility and return to their usual daily life in the shortest possible time. The department's experienced surgeons perform more than 6,000 operations annually, including particularly complex ones. About 3,000 inpatients and more than 20,000 outpatients receive medical care here every year. The department has 90 beds.
Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery, Hand Surgery and Rheumatology
The Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery, Hand Surgery and Rheumatology offers the full range of diagnostic and therapeutic services in its areas of specialization. The key areas of work of the department's doctors include large joint arthroplasty, arthroscopic interventions on the knee, hip, and shoulder joints, conservative and surgical treatment of foot and hand diseases and deformities, rheumatic joint lesions, orthopedic diseases in children, and musculoskeletal injuries. The key to successful clinical practice is the professionalism and unique experience of the department's medical team, combined with the advanced infrastructure and state-of-the-art equipment. The department has 5 operating rooms equipped with the latest technology. Most surgical interventions are performed using minimally invasive techniques, due to which, in the shortest possible time, the patient is verticalized, their mobility is restored, and a pronounced pain syndrome is excluded. The department annually performs more than 4,500 surgical interventions, including especially complex ones, so the specialists at the medical facility are rightfully proud of their impressive clinical experience in the surgical treatment of orthopedic diseases. Over the years, the department has gained an excellent reputation not only in Germany but also far beyond its borders.
Department of Adult and Pediatric Orthopedics
The University Hospital Ulm is an advanced medical complex that provides patients with high-class medical care using the very latest scientific achievements. The medical facility has been performing successful clinical activities for more than 40 years and has long earned an excellent reputation throughout Europe. The hospital regularly demonstrates high treatment success rates, takes an active part in the training of medical students, and works tirelessly on promising research projects. The university hospital consists of 29 specialized departments and 16 scientific institutes, where more than 7,000 highly qualified employees work for the benefit of their patients. More than 55,000 inpatients and about 300,000 outpatients are treated here every year. The hospital has 1,274 beds. The medical team of the hospital is focused on providing personalized medical services using the most modern and sparing diagnostic and treatment methods.
Department of Adult and Pediatric Orthopedics, Traumatology
According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of modern medicine. A distinctive feature of the hospital is the presence of unique therapeutic methods for the treatment of complex and rare clinical cases.
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.
Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery and Hand Surgery
According to the Focus magazine, the Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery and Hand Surgery is one of the best medical facilities in Germany in its areas of specialization! The department offers its patients modern conservative and surgical treatment of diseases of the musculoskeletal system. The department's priority specialties include knee and hip surgery, including primary and revision arthroplasty, surgical interventions on the spine, shoulder and elbow surgery, operations for musculoskeletal malignancies, and treatment of traumatic injuries of varying severity. The department enjoys a reputation as one of the largest and most reputable medical complexes of its kind in Germany, where more than 8,200 inpatients are treated every year. The department's medical team successfully performs more than 8,500 surgical procedures each year in 8 high-tech operating rooms, which testifies to the excellent qualifications and vast experience of the healthcare facility's specialists. The department also provides medical care for young patients with special emphasis on the treatment of hip dysplasia, slipped capital femoral epiphysis, Perthes disease, scoliosis, osteomyelitis, and benign bone neoplasms. The medical institution has exceptional competence in the treatment of bone and soft tissue sarcomas – certification as a specialized center by the German Cancer Society (DKG). In addition, the department has the status of an interregional Trauma Center in the Berlin and Brandenburg area, certified by the German Trauma Society (DGU).
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.
Department of Adult and Pediatric Orthopedics, Foot Surgery
The University Hospital Rechts der Isar Munich was founded in 1834. It combines long traditions with the very latest advances in modern medicine. The medical facility includes 33 specialized departments and 20 interdisciplinary centers, where patients can receive top-class medical care in all medical fields. The hospital annually admits more than 65,000 inpatients for diagnostics and treatment, and about 250,000 outpatients receive effective medical care. The hospital also performs more than 40,000 surgical procedures every year, and about 2,100 babies are born here annually.
Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery
The Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery offers the full range of diagnostics, conservative and surgical treatment of musculoskeletal diseases and injuries. The department is a certified Endoprosthetics Center – more than 1,000 primary joint replacement surgeries are performed here annually. The surgeons of the Endoprosthetics Center also specialize in particularly complex clinical cases and revision procedures for the replacement of previously implanted artificial joints. In addition, the department has the status of the interregional Trauma Center certified in accordance with the standards of the German Trauma Society. The department has also been awarded a Certificate of Excellence from the German Orthopedic Foot and Ankle Society (DAF) in the field of foot surgery. A separate area of clinical activity is the treatment of diseases, injuries and congenital malformations of the musculoskeletal system in children. Depending on the severity of the clinical case, both conservative and surgical techniques are used in the treatment of orthopedic pathologies in children. The department's medical team prefers sparing low-traumatic surgery, while open operations are performed only if other therapeutic options are ineffective.
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.
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.
Department of Orthopedics and Traumatology
According to the Focus magazine, the Department of Orthopedics and Traumatology ranks among the top German departments specializing in joint replacement surgery! The department specializes in the diagnostics and treatment of all diseases and injuries of the musculoskeletal system. The therapeutic options include both conservative and surgical treatments. The department has 5 modern operating rooms, which meet stringent hygienic standards and a high technological level (for example, 2D and 3D X-rays, navigation systems, surgical microscopes, etc.). Also, it is possible to perform operations on an outpatient basis.
Department of Adult and Pediatric Orthopedics, Foot Surgery
The Department of Adult and Pediatric Orthopedics, Foot Surgery carries out accurate diagnostics, effective conservative and surgical treatment of the full range of diseases of the musculoskeletal system. The department's medical team's responsibilities also include physiotherapy and rehabilitation activities. Surgery for orthopedic diseases is performed in state-of-the-art operating rooms equipped for sparing minimally invasive and arthroscopic interventions. There are also treatment rooms for physiotherapy, including a room with a pool for swimming and physical exercises in the water, and rooms with modern exercise equipment. The excellent infrastructure allows doctors to provide high-quality treatment of diseases of the joints, tendons, and bones, thereby restoring patient mobility as quickly as possible. The department admits patients of all age groups, including children and adolescents. The medical facility has been awarded many prestigious quality certificates, including DGOU, endoCert, and EPRD certificates, and has an impeccable reputation in Germany.
Coxarthrosis is one of the most common orthopedic diseases in the world. It continually progresses, causing chronic pain and disability. The main treatment for advanced coxarthrosis is hip replacement. You can get replacement surgery services abroad. Booking Health will help you choose the most suitable hospital, taking into account the quality of medical services and the cost of arthritis treatment.
Content
- Who may require hip replacement
- Preparing for surgery
- How is hip replacement surgery performed?
- Early rehabilitation
- Fast-track rehabilitation
- Rehabilitation after discharge from hospital
- Why is it worth having surgery in Europe
- Treatment in European hospitals with Booking Health
Who may require hip replacement
Hip arthritis progresses over years and even decades. In the early stages, the disease is often asymptomatic and can be detected only with the help of instrumental diagnostic methods. Pain then occurs only from time to time and is relieved with anti-inflammatory drugs. Therapeutic exercises, weight control and load limitation can help preserve the joint functions.
Nonetheless, the disease inevitably progresses. So far, there are no conservative therapies that can cure arthritis or at least improve the health of the joint. The only radical method that can solve the problem of arthritis completely is hip replacement surgery. After hip replacement and rehabilitation, a person does not feel any pain and can restore physical activity.
The hip is usually replaced in the advanced stage of the disease. During this period, the person can no longer do without a cane, and sometimes he is not able to walk at all. The pain can become severe and persistent. The pain that cannot be controlled with medications often becomes a reason for surgery.
Cost of hip replacement surgery in hip coxarthrosis is from €11,783. You can find prices for other treatment options and hip rehabilitation on the Booking Health website.
The best hospitals for the treatment of hip osteoarthritis in Europe are:
- University Hospital Rechts der Isar Munich
- University Hospital of Ludwig Maximilian University of Munich
- University Hospital Ulm
- University Hospital Frankfurt-am-Main
- Vitos Orthopedic Clinic Kassel
Preparing for surgery
In order to recover faster after hip replacement and minimize health risks, the patient should prepare for replacement surgery in advance. Here are some of the main recommendations:
- Quit smoking 1 month before hip replacement. Smoking affects blood circulation. It slows down the regeneration of hip tissue. In addition, smoking weakens the immune system, and therefore increases the risk of infection in the hip.
- Lose weight. The more body weight, the higher the load on the hip. Body mass index should not exceed 35, and it would be perfect if it was less than 30%. If your BMI is 40 or even more, hip replacement surgery may be contraindicated.
- Arms and abs workout. After hip surgery, the muscles of the upper body will be most loaded. They must be strong enough to withstand this load.
- Practicing skills. One should learn how to walk with support devices, move up steps, on an inclined surface, etc. Under the supervision of the medical staff, you will learn how to stand up, sit down, lie down, etc. All this will allow you to take care of yourself on your own within a few days after surgery, without the need for nursing care. Such patients are discharged from the hospital earlier.
1-2 days prior to surgery, the patient has to undergo a standard set of diagnostic tests. On the day before hip surgery, one must not eat after 6 pm. On the morning of the surgery, one must not even drink water.
How is hip replacement surgery performed?
The surgery is performed either under general or spinal anesthesia. The duration of the procedure is 1-2 hours.
The doctor removes the patient's own hip and implants an artificial endoprosthesis instead of it. It consists of a femoral and pelvic (acetabular) component.
The femoral component imitates the proximal (initial) part of the femur. It consists of a stem, a neck and a head. The pelvic component consists of a cup, inside which the head of the artificial femur will rotate, and a liner – it is usually made of polyethylene.
The doctor resects the bone tissue and implants the prosthesis. According to the method of its fixation, the hip replacement can be cemented and cementless. Whenever possible, the cementless method is used. The artificial joint is fixed with screws, and then it grows into bone. With concomitant osteoporosis, the doctor uses cement with the help of which he"glues" the artificial joint.
The final stage of surgery is wound suturing. Thin tubes (drains) may remain in it for 1-2 days. Blood and lymph (clear liquid) flows through them. This is necessary so that fluid does not accumulate in the tissues.
Early rehabilitation
Total hip replacement requires lengthy rehabilitation. It is necessary for the complete restoration of human mobility and work capacity. The rehabilitation period lasts up to six months. After this time, the patient can tolerate any stress that his general state of health allows.
After hip replacement, the leg is placed in the abducted position. A roller is placed between the legs for this purpose. An active mode in bed is allowed immediately after surgery. The patient can usually get up and walk the next day. The first time the patient gets up with the help of the medical staff, and then he learns to move on his own.
The very first bandaging is made the next day. Later on, the bandaging is made every 2-3 days, until the surgical wound is completely healed.
After replacement surgery, prevention of complications is required. To reduce health risks, the patients take antibiotics. They help prevent infection. The doctors give injections of anticoagulants and bandages on the legs to reduce the risk of thromboembolic complications.
Things to remember after surgery:
- In the early rehabilitation period, one can sleep only on the back.
- One should turn over only by holding the roller between his legs.
- Both knee and hip joints should not be bent more than 90 degrees.
- One can not make rotational movements in the hip.
- Any sudden movements must be avoided.
If the cementless method of fixation was used, one must not stand on the operated leg during the first week. The patient can only touch the floor with it. Starting from the second week, it is allowed to transfer 15-20% of body weight to the operated limb, while half load is allowed only from 3 weeks.
After total hip replacement, the doctor sutures the wound. The surgical sutures are removed after about 2 weeks. Sometimes it is possible not to remove them. Some doctors use threads that dissolve on their own over time.
Fast-track rehabilitation
In some foreign hospitals, recovery after hip replacement is carried out using a fast-track program. It was developed and introduced in Denmark at the beginning of the 21st century, and then gained recognition and began to be used in Western Europe and the USA. This protocol not only shortens recovery times, shortens hospital stays, but also makes replacement surgery safer for health by reducing the risk of complications.
Rehabilitation begins even prior to surgery. The patient is trained to walk with crutches or walkers, get up and walk correctly, climb up and down stairs.
When performing surgery, the doctors do not use general anesthesia, but spinal one. The sensitivity of the lower half of the body is completely "turned off" at the level of the spinal cord. In addition, sedation is used so that the patient is not stressed and can sleep during the surgical procedure.
Spinal anesthesia promotes early activation. It is possible within 2-4 hours after surgery, while after general anesthesia – only the next day.
In order for a person to start walking in the first hours after surgery, it is important that he does not feel severe pain. To do this, immediately after hip replacement, local anesthetics are injected into the soft tissues. Anesthetics continue to be administered through the catheter throughout the day. They reduce the sensitivity of the tissues in the area of surgery. The scheme includes analgesics for oral administration. Whenever possible, the doctors use only nonsteroidal anti-inflammatory drugs, but opiates are used if necessary.
It is important to maintain normal blood pressure to prevent falls because of dizziness. It can occur when the body position changes from horizontal to vertical. To do this, the patient drinks a lot of fluids immediately after surgery. Whenever required, additional fluid is administered by intravenous infusion.
The patient is wearing compression stockings. Elastic bandages compressing the legs reduce the risk of thromboembolic complications. In addition, the effect of local infiltration anesthesia is enhanced and prolonged, since the analgesic substances are more slowly "washed out" from the tissues.
On average, the patients stay in the hospital for only 7 days, although sometimes the period varies greatly from patient to patient – from 3 to 11 days. In each case, the doctors make a decision individually. The patient is discharged only when his health is no longer threatened. Discharge criteria:
- Ability to self-care.
- Ability to get out of bed, sit in a chair and get out of it.
- Ability to move with crutches at a distance of at least 70 m.
Rehabilitation after discharge from hospital
Total hip replacement requires long-term rehabilitation. Although it begins while still in the hospital, rehabilitation activities continue for several months. The patients can stay in the rehabilitation center all the time or visit it every day.
A substitute for professional recovery is home workouts. But it is advisable to switch to independent workouts no earlier than 2 months later, when you have mastered all the exercises, and the health risks will decrease.
The rehabilitation of patients is no less important than the quality of treatment abroad. It is the effectiveness of rehabilitation that determines the quality of life after total hip replacement. The patient's activity, the condition of the thigh muscles, range of motion, gait and motor skills depend on it.
Here are some basic rehabilitation measures in the first 2 weeks after hip replacement surgery:
- Exercises to prevent blood stasis, reduce swelling, and accelerate wound healing. It is advisable to devote all free time in the hospital to physical therapy. Most of the exercises are done while lying in bed.
- Massage helps to improve blood circulation in tissues.
- Physiotherapy promotes wound healing, elimination of puffiness.
At all stages of rehabilitation, it is physical therapy that becomes the main way to restore a person's mobility. It allows rebuilding the thigh muscles and improving the function of the hip.
Passive joint training doesn't make sense. The artificial prosthesis is very mobile, while friction in it is minimal. The range of motion depends solely on the muscles of the thigh, and therefore they need to be trained.
Foreign rehabilitation centers have state-of-the-art equipment. The doctors have at their disposal advanced fitness machines and robotic systems, gyms and swimming pools. The rehabilitation program is developed individually and periodically adjusted. The specialists carefully monitor that the loads are sufficient, but safe for health.
Why is it worth having surgery in Europe
Hip replacement is the most common orthopedic surgery. It is performed in any country. However, developed countries are using new technologies, so the operations here are not only more effective, but also safer for health.
The cost of treatment may be higher than in your native country, but due to the reliability of surgery, the total cost of medical services can be lower. Firstly, in a good hospital, the risk of complications will be minimal, so you will not have to undergo repeated surgery to eliminate the consequences of poor quality treatment. Secondly, the prosthesis is implanted with the highest accuracy, and it is of high quality. After hip replacement, the artificial joint will not wear out throughout life. You will not have to do a second operation in the future, and therefore you will not have to pay for this surgery.
The main benefits of treatment in the best European hospitals:
- The efficiency of surgery is 97%, with a global average of about 90%.
- Minimal risk of infectious complications – the most common reasons for repeated surgery in the first year after hip replacement.
- The use of high-quality prostheses with a service life of tens of years.
- Accurate diagnostics and individual selection of prosthesis components.
- High technologies: if necessary, the parts of the prosthesis are made individually, using a 3D printer.
- Fast-track rehabilitation programs after hip replacement reduce hospital stays to 4-7 days and improve the safety of treatment for health by reducing the risk of complications.
After hip replacement in Europe, you can undergo rehabilitation. The well-equipped rehabilitation centers can fully restore physical activity and work capacity.
Treatment in European hospitals with Booking Health
To undergo treatment in European hospitals, you can use the services of Booking Health. On our portal, you can find out the cost of treatment in different hospitals, compare prices and profitably book a medical program.
Please contact Booking Health specialists to travel to European hospitals for treatment. Here's what we will do for you:
- We will select the best European hospital, whose doctors specialize in hip replacement surgery.
- We will help you overcome the language barrier, establish communication with your doctor.
- We will reduce the waiting time for the start of the medical program and book it on the most suitable dates.
- We will lower prices. The cost of treatment in European hospitals will be decreased due to the lack of coefficients for foreign patients.
- We will settle down all the organizational issues: documents for entering the country, transfer from the airport, hotel, interpreter, etc.
- We will prepare a program and translate medical documents. You do not have to repeat the diagnostic procedures that you have already had.
- We will provide communication with the European hospital after the completion of the medical program.
- If necessary, we will organize additional medical examinations and treatment in European hospitals.
- We will buy medicines abroad and send them to your native country.
- We will help you keep in touch with the European hospital after the completion of the program.
Booking Health makes treatment in European hospitals easier, faster and cheaper. We will fully organize your trip, and you will only have to focus on restoring your health.
Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko
