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Hip Osteoarthritis (coxarthrosis) — Hip Replacement: treatment in the Best Hospitals of Germany

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Hospital Neuwerk Moenchengladbach

9.2/10
location_onGermany, Moenchengladbach

Department of Adult and Pediatric Orthopedics, Traumatology

The Department of Adult and Pediatric Orthopedics, Traumatology offers the 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.

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Catholic Clinic Koblenz-Montabaur

10/10
location_onGermany, Koblenz

Department of Adult and Pediatric Orthopedics, Traumatology, Endoprosthetics

According to the prestigious Focus magazine, the Department of Adult and Pediatric Orthopedics, Traumatology, Endoprosthetics ranks among the top German medical facilities specializing in the treatment of orthopedic diseases! The department offers comprehensive diagnostics, surgical and conservative treatment of all musculoskeletal disorders in adults and children. Also, the department provides an outpatient rehabilitation. The field of endoprosthetics is marked by the endoCert certificate, which indicates high treatment standards. The focus is also on the treatment of injuries of varying severity, including in elderly patients.

Academic Hospital Brothers of Mercy Munich

10/10
location_onGermany, Munich

Department of Orthopedics and Traumatology

According to the Focus magazine, the Department of Orthopedics and Traumatology ranks among the top medical facilities in Germany in the treatment of musculoskeletal diseases! The department offers the full range of diagnostics and treatment of all acute and chronic diseases and injuries of the musculoskeletal system. The main goal of the department’s doctors in the treatment of each patient is the restoration of normal mobility and the elimination of painful sensations. The department has about 140 beds for patient hospitalization. The department’s doctors provide their first-class medical services to more than 4,000 inpatients every year. The Maximum Care Endoprosthetics Center (EPZmax) and the certified Trauma Center are part of the department as well.

Academic Municipal Hospital Karlsruhe

9.8/10
location_onGermany, Karlsruhe

Department of Adult and Pediatric Traumatology, Hand and Orthopedic Surgery

The Department of Adult and Pediatric Traumatology, Hand and Orthopedic Surgery offers the full range of services in these medical fields. Specialization covers the conservative and surgical treatment of injuries and degenerative changes of the extremities, joints, pelvis and spine. The surgical interventions are performed using both classic open, and minimally invasive, endoscopic method. The department performs more than 6,000 surgical procedures every year. It has 90 beds and treats about 3,000 inpatients and 20,000 outpatients annually.

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.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

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 medical facilities in the field of its specialization! It offers the full range of conservative and surgical treatment of musculoskeletal diseases. The department's priorities include knee and hip surgery, including endoprosthetics, spinal surgery, shoulder and elbow surgery, surgical oncology of the musculoskeletal system and the treatment of injuries of varying severity. With an annual number of more than 8,000 inpatients, the department has the status of one of the largest and most reputable in the field of its competence.

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 Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Orthopedics, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Foot Surgery offers the full range of services for the diagnostics and treatment of musculoskeletal diseases: bone, joint, muscle, ligament and tendon diseases. Special attention in the department's clinical practice is paid to knee and hip replacement surgery, including revision interventions to replace previously implanted prostheses, treatment of foot diseases, musculoskeletal cancers, orthopedic diseases in children. In addition, the department's specialists deal with the treatment of rare and especially complex musculoskeletal diseases. The department's highly specialized medical team applies only modern diagnostic and therapeutic techniques in their practice, and the long-term experience of doctors guarantees top-class surgical and conservative treatment. As a certified Maximum Care Endoprosthetics Center, the department's doctors annually perform more than 1,000 surgical procedures for partial and total joint replacement. Every year, more than 10,000 patients entrust their health to the department's medical team. Whenever required, doctors from related medical specialties are involved in the treatment process. The main goal and focus of doctors is to maximally restore the patient's health and give him the opportunity to return to his usual way of life.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Traumatology, Hand Surgery, Plastic and Reconstructive Surgery

The Department of Traumatology, Hand Surgery, Plastic and Reconstructive Surgery covers the whole range of services in these focuses. The department specializes in joint replacement, treatment of tumors of the musculoskeletal system, endoscopic treatment methods for spinal injuries, arthroscopic treatment of joints, etc. The department is also a recognized Center for Sports Orthopedics.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

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.

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 Bonn

9.2/10
location_onGermany, Bonn

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.

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.

Coxarthrosis is a severe disabling disease. In 80% of patients, it sooner or later reaches the advanced stages requiring hip replacement surgery. These surgical interventions are effective in 90% of cases, while in the best German hospitals, efficiency rates reach 97-98%. The essence of the operation is that the patient's own hip joint is removed, and an artificial prosthesis is implanted instead.

Content

  1. Who may need hip replacement for coxarthrosis?
  2. What does an artificial hip joint consist of?
  3. Preparing for surgery
  4. How is the surgery performed?
  5. Is the surgery painful?
  6. Postoperative period
  7. Treatment of hip bursitis
  8. Revision replacement surgery
  9. Why is it better to undergo treatment in Germany?
  10. Treatment in Germany with Booking Health

Who may need hip replacement for coxarthrosis?

 

Coxarthrosis is a degenerative disease of the hip joint. The disease develops gradually. It progresses over the years and even decades, but in the end it inevitably leads to total joint destruction. Even the most modern treatment methods do not allow doctors either to restore the hip joint, or at least to stop the progression of coxarthrosis.

A person can live with this pathology for some time. He suffers from pain but takes painkillers. At first, arthrosis worsens only periodically, and pain appears under load. Then it begins to torment the person at rest, and painkillers become less and less effective. In addition, their constant intake is harmful to health and often causes gastrointestinal bleeding.

At a certain stage, there is a need for radical surgical treatment: total hip replacement. This operation is recognized as the most successful in the world in terms of improving the quality of life. Those who undergo this surgery can fully restore their physical activity and get rid of pain. Modern artificial joints serve a person for decades, and most people will never need a second operation to replace a prosthesis.

Cost of hip replacement surgery in hip coxarthrosis starts from €11,783. You can find prices for other treatment options on the Booking Health website.

The best hospitals for the treatment of hip osteoarthritis in Germany are:

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

What does an artificial hip joint consist of?

 

Coxarthrosis usually requires total hip replacement surgery. This means that not only the femoral component is replaced, but also the acetabular one.

An artificial hip joint for total replacement consists of the following parts:

  • Cup imitates its own acetabulum, which is located on the pelvic bone.
  • Leg becomes an extension of the patient's own femur.
  • Neck and head fit into the cup, and their rotation provides movement.
  • Liner is placed between the cup and the head.

The components of the prostheses are standard, but they are available in different sizes from manufacturers. In addition, their structure and manufacturing materials are different, and therefore doctors individually select for each patient the best combinations of components of the artificial hip joint.

During surgery, the components of the endoprosthesis are fixed using either cement or cementless techniques. The cementless method is most common. In this case, the parts of the prosthesis are fixed with screws and then they ingrow into the bone. The cement method of fixation is usually preferred in patients with osteoporosis.

Preparing for surgery

 

It is advisable to prepare your body for the upcoming surgical procedure. A proper preparation will allow the person to recover easier and faster, improve the tolerance of the postoperative period, and reduce the risk of complications.

Key recommendations:

  • Quitting smoking is required 1 month before surgery. Smoking impairs blood circulation, increases the risk of infectious complications, and slows down tissue regeneration.
  • Workouts for torso and arm muscles, because the main load falls on them in the first 1-2 months after the operation.
  • Weight loss, since for those with BMI over 35 the risk of complications increases significantly, and for patients with BMI over 40 the surgery may be even canceled.
  • Elimination of infectious foci – treatment of teeth, getting rid of chronic inflammation in the throat, genitals, etc.

Several days prior to surgery, you will need to undergo instrumental diagnostics and tests. The medical staff will teach you how to use walkers or crutches, and how to sit down and stand up correctly. You will learn to walk without a load on your leg, which will soon be operated on.

On the day before surgery, you should not eat after 6 pm and drink after midnight.

How is the surgery performed?

 

In standard cases, the surgical intervention for total hip replacement takes 1-2 hours.

The doctor removes the patient's own hip joint. In its place, he implants the components of the prosthesis. The femur is transected. The stem of the endoprosthesis becomes its continuation. The doctors often use a short stem to preserve as much of the patient's own bone tissue as possible. The acetabulum is drilled out and a cup is fixed into its place with screws.

Upon the completion of surgery, the doctor sutures the wound. Drains are often placed in it to avoid the accumulation of fluid – blood and lymph. The liquid flows through the tubes within 1-2 days, and then they are removed.

Is the surgery painful?

 

Hip replacement surgery is performed under general or spinal anesthesia.

With general anesthesia, a deep depression of the central nervous system occurs. A person's consciousness is switched off, so he does not feel anything. Most major operations in all surgical fields are performed using this type of anesthesia.

Medical specialists in Germany often use spinal anesthesia. Nerve sensitivity is blocked at the level of the spinal cord. Deep depression of consciousness does not occur, but sedation is used so that the person does not experience stress. Sedation makes the patients very sleepy, and therefore they often sleep during the operation. Even if they do not fall asleep, they do not feel anything and will not retain the memories of the surgery. Spinal anesthesia is safer and, moreover, it provides the possibility of activating the patient already on the first day after surgery. This not only accelerates rehabilitation, shortens the duration of hospital stay, but also reduces the risk of some complications.

Immediately after the operation, infiltration anesthesia is used. Doctors inject local anesthetics into the tissues around the hip joint. They "turn off" the sensitivity of the nerves. This is a temporary effect. To make it last longer, the doctors use compression stockings (compression garments). In addition, they reduce the risk of thromboembolic complications.

In the first days after surgery, the patient usually experiences pain. It is treated with systemic drugs. Depending on the severity of pain, both narcotic and non-narcotic analgesics can be used. The need for opiates usually persists for no more than 1–2 days after surgery.

Postoperative period

 

Modern Orthopedic Centers try to start rehabilitation as early as possible after hip replacement. If spinal anesthesia was used, then the patient can walk on the first day after surgery. It is not yet possible to lean on the operated leg, so walkers or crutches are used. If general anesthesia was used, the patient's activation is indicated one day after the operation.

While lying in bed, rehabilitation activities begin: exercises, massage, physiotherapy. The leg is kept in the abduction position. There is a roller between the legs. The patient is advised to avoid certain movements, which can harm the operated leg. These include:

  • Any sudden movements.
  • Rotation in the hip joint.
  • Flexion of the knee or hip joint to more than 90 degrees.

When the doctors allow the load on the operated leg depends on the age and health of the patient, as well as the method of fixation of the prosthesis: cement or cementless. If cement was used, the load is allowed immediately after surgery, and a month later it can be maximal. Moreover, the patient is allowed the full load immediately, if he is over 90 years old or is weakened by comorbidities.

With cementless fixation, it takes time before the components of the endoprosthesis are securely attached to the bone. Therefore, in the first weeks, the operated leg is usually not loaded at all. It is allowed to put 15% of body weight to it in 7-10 days. After 3 weeks, the load can be increased to 50%, and after 2 months, the full load is allowed.

Regardless of how much time has passed since the operation, in the case of severe pain in the hip joint, the load on the operated leg is limited. However, moderate pain is tolerated. It often occurs at the initial stages after surgery and should not become a reason for refusing therapeutic exercises. The pain will gradually relieve.

Some patients may develop complications after surgery. The most dangerous are infections and thromboembolism. To prevent them, doctors use medicines. In the postoperative period, the patient receives antibiotics and drugs to reduce blood clotting (anticoagulants).

Treatment of hip bursitis

 

Joint replacement surgery causes complications in 2-4% of patients. One of them is bursitis – an inflammation of the periarticular sac. You can undergo hip bursitis treatments in Germany. This disease causes pain that increases after exercise, and the walking pattern changes.

Whenever possible, hip bursitis treatments in Germany are conservative. Treating hip bursitis in Germany involves the use of painkillers, physiotherapy, limb unloading, blocks, corticosteroid injections. If these procedures do not work, surgical hip bursitis treatments in Germany become an option of choice.

Surgical hip bursitis treatments in Germany involve the excision of hypertrophied areas of the trochanteric bursa. If necessary, tendon repeated fixation is performed. Open surgery is usually required. In addition, treatment options for hip bursitis in Germany may include arthroscopy. You can find out the hip bursitis surgery cost in Germany on the Booking Health website. If you book a program through our service, then the hip bursitis surgery cost in Germany will be lower for you.

Revision replacement surgery

 

Up to 15% of patients require a second hip replacement. There are two most common reasons, one of which dominates in the first year after the operation, and the second – after 5-10 years or more.

Early revision surgery is most often performed for infectious complications. The bacteria cause tissue inflammation in the prosthetic area. In the first year after hip replacement, the infection becomes the cause of revision interventions in 50-60% of cases.

In the long term, the leading cause is aseptic loosening of the endoprosthesis. The number of these complications begins to increase 5 years after surgery, and peaks after 10 years. At the same time, infectious causes during this period are becoming increasingly rare: they account for only 10% of all revision interventions.

Other reasons for revision surgery include:

  • Dislocation of the prosthesis.
  • Its mechanical damage as a result of injury.
  • Bone fractures near the prosthesis.
  • Resorption of bone tissue.
  • Appearance of osteophytes (bone growths).

Infection is the most unfavorable cause of revision hip surgery. To eliminate its consequences, not even one, but several operations may be required.

At the same time, aseptic loosening is essentially wear and tear of the prosthesis. The interventions for this complication are single-stage. In 4 out of 10 cases, the entire prosthesis has to be replaced, in other 4 patients – only the pelvic component is replaced, and in the remaining 2 cases – only the femoral part of the artificial hip joint is replaced.

Why is it better to undergo treatment in Germany?

 

Tens of thousands of hip replacement surgeries are performed in German hospitals every year. Doctors operate not only on fellow citizens, but also on foreign patients. Hip replacement in Germany has the following benefits:

  • The use of high-quality endoprostheses from the best world manufacturers. They can serve for decades without requiring replacement.
  • Not only primary, but also repeated operations are successfully performed.
  • Safe replacement surgery: the risk of complications, including infections or thromboembolism, is minimal.
  • Accelerated rehabilitation under the fast-track medical program – the duration of hospital stay is reduced to 3-7 days.
  • Hip replacement in Germany completely eliminates pain and restores limb function in 97% of cases.
  • Nearly 90% of patients will not need the second hip replacement surgery in the future.
  • Relatively low cost of treatment: it is lower than in many other developed countries of Western Europe, Asia and North America.

Even the most complex surgeries to avoid disability are successfully performed in Germany. The surgeons perform hip replacement for a significant decrease in the length of the limb, cicatricial changes after previous operations, significant post-traumatic deformity of the acetabulum. The patients are successfully operated on after previous unsuccessful surgical interventions, including in the case of the development of infectious complications.

Even if it is not possible to select standard components of the endoprosthesis for the patient, this is not a verdict. To replace the hip joint, individual designs are produced in Germany. After scanning the human body, the computer provides not only the ideal configuration of the acetabular component of the prosthesis, but also indicates the best fixation points and helps the surgeon plan the operation. It is printed on a 3D printer. Although such prostheses increase the cost of treatment, they are as convenient, comfortable and physiological as possible. In addition, they restore limb function even in the most seemingly hopeless cases, when only disability can be an alternative to such treatment.

Treatment in Germany with Booking Health

 

To undergo hip replacement in Germany, please use the Booking Health services. On our website, you can see the cost of treatment in different German hospitals, compare prices and book a medical program at an affordable price.

Please contact the Booking Health specialists to undergo treatment in Germany. Here are our benefits for you:

  • We will choose the best hospitals for hip replacement surgery.
  • We will help you overcome the language barrier, establish communication with the German hospital and your attending physician.
  • We will reduce the waiting time for the medical care program and book a doctor's appointment on the most suitable dates for you.
  • We will reduce the price. The cost of treatment in Germany will be decreased due to the lack of additional 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 prepare the medical care program and translate medical records into German. You do not have to undergo previously performed diagnostic tests.
  • We will provide communication with the hospital after the completion of treatment in Germany.
  • We will organize additional medical examinations, treatment in Germany 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 after hip replacement in Germany.

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. Vadim ZhiliukDr. Sergey Pashchenko




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