Hip replacement and rehabilitation (program ID: 392004)
St. Vincentius Hospital Karlsruhe-Academic Hospital of the University of Freiburg
Stephan KirschnerSpecialized in: orthopedics and pediatric orthopedics
Department of Orthopedics
Due to the high qualification of doctors, more than 1150 hip replacement surgeries were performed in the department of Orthopedics in 2017. The department specializes in minimally invasive hip arthroplasty with implantation of high-quality hypoallergenic Swiss endoprostheses with life span of 25 years and more. According to independent ratings, the department headed by PD, Dr. med S. Kirschner is considered to be one of the best departments in Germany in the field of endoprosthetics.
- Initial presentation in the clinic
- clinical history taking
- physical examination
- review of medical records
- laboratory tests:
- complete blood count
- general urine analysis
- biochemical analysis of blood
- indicators of inflammation (CRP, ESR)
- indicators blood coagulation
- x-ray examination of the hip
- MRI scan of the hip
- preoperative care
- hip replacement (hip endoprosthesis)
- symptomatic treatment
- control examinations
- physiotherapeutic procedures
- orthopedic appliances
- the cost of essential medicines and materials
- nursing services
- full hospital accommodation
- explanation of future recommendations
The program includes orthopedic rehabilitation:
- Primary presentation in the clinic
- medical history, including family history
- complex neurological and orthopedic examinations
- X-ray examination
- complex neurophysiological examinations
- individual rehabilitation program, which includes:
- Wii Fit training in the use of the balance
- neuropsychological therapy
- functional therapy of the upper extremities (ArmeoSpring)
- kinesitherapy (physiotherapy)
- biocontrol with feedback
- healing deep muscle massage
- acupuncture of spasticity and pain syndromes
- occupational therapy
- psycho-educational classes
- Individual physiotherapy
- microcurrent treatment
- fangotherapy / cryotherapy
- antispasmodic drug therapy
- mobilization of limb joints
- hydrotherapy / massage therapy / reflexology
- training on special trainers
- and etc.
- nurses care
- stay in the hospital with full board
- symptomatic and drug therapy
How program is carried out
Preliminary preparation for hip replacement includes quitting smoking and drinking alcohol; cancelling non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen); cancelling anticoagulants (warfarin); normalization of body mass, if possible.
Preoperative examination, including consultation with an anesthesiologist and necessary related specialists, takes 1-2 days. According to its results, the most suitable endoprosthesis is selected.
Hip replacement. The operation is performed under general anesthesia. The patient lies on his side, the affected leg is bent and fixed in this position. The surgeon makes an incision 15-20 cm long, minimally traumatizing the muscles and nerve endings. Through this incision, miniature instruments are inserted to remove the damaged joint structures. Healthy bone is adjusted for further reliable implant fixation.
The surgeon installs a femoral stem in the center of the upper part of the femur. Ball-shaped head of the joint is fixed on it. The surgeon also implants a special liner that facilitates movement of the leg and protects the structures of the prosthesis. After the primary fixation of the prosthesis components, the doctor assesses the joint range of motion, as well as the length and symmetry of the lower limb.
The implant is fixed with cement or cementless method. The doctor treats the operating field with antiseptics, conducts its final revision and sutures the wound layer by layer. A temporary drainage is installed in the joint, and a bandage is applied on top.
Postoperative care. During the first day after the intervention the patient stays in the intensive care unit, under round-the-clock medical supervision. After that, with a smooth course of the postoperative period, the patient is transferred to a regular ward and the drains are removed. The range of motion expands gradually, from light toes movements to walking. Walking with the use of walking aids is allowed in 3-5 days after the operation.
Rehabilitation. The rehabilitation program begins after the transfer of the patient from the intensive care unit to a regular ward. It includes physical activity (from exercises in bed in the early days to exercises in the gym), physiotherapy, massage (including lymphatic drainage), exercises in the water. The rehabilitation program is constantly being adjusted according to the needs of the patient.
- X-ray examination of the hip joints
- MRI scan of the hip joints, if available
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About the department
The Department of Orthopedics at the St. Vincentius Hospital-Academic Hospital of the University of Freiburg specializes in the diagnosis and treatment of all congenital and acquired diseases of the musculoskeletal system. The medical team of the department, consisting of experienced doctors, nurses and physiotherapists, provides services to patients of all ages, from infants who are just taking their first steps and ending with elderly people who want to maintain mobility and independence. The head of the department is PD Dr. med. Stephan Kirschner.
In the field of pediatric orthopedics, doctors perform a sonographic study for newborns to eliminate hip dysplasia. If there is slow development of the musculoskeletal system, doctors often use the fact that the the child's bones have great plasticity and in combination with conservative methods of treatment, this helps to achieve recovery. The most common conditions in adolescents treated in the department are O-shaped or X-shaped curvature of the legs, defects in the structure of the feet and the pathology of the spine.
In newborns, conservative orthosis treatment and targeted physiotherapy often lead to successful results in treating orthopedic problems in children. The specialists of the department have many years of experience in this field.
Particular attention is paid to consulting patients with wear of the lower limb joints who need to have joint preservation surgery or endoprosthetics.
Back pain is also common as the current pace of life and the working environment contribute to a sedentary lifestyle. Doctors of the department offer both conservative and surgical treatment of diseases of the spine and bones (osteology).
In addition, a characteristic pathology among adults is valgus deformation of the foot. In the early stages the disease can be cured with comfortable shoes and straightening cuts. In the late stages of the disease, surgical correction is performed, after which patients can wear normal shoes. Less common are degenerative diseases of the back of the foot and upper ankle.
Specialists of the department together with patients discuss possible options for surgical interventions to maintain and strengthen joints to ensure maximum mobility.
Of particular interest for the department is the prevention of wear of the hip and knee joints, since medical team make it its purpose to preserve the joint and its mobility.
Thanks to unique knowledge and many years of experience in endoprosthetics, complex surgeries are performed in the department, for example, for extensive bone defects. The affected bone is replaced by a donor bone obtained in a certified bone bank.
At the moment, the department is preparing to create an Endoprosthetics Center for maximum patient care.
The main directions of Orthopedics:
- Endoprosthetics of the knee and hip joint
- Treatment of deformities of the feet (eg valgus deformity)
- Treatment of diseases of the spine
- Treatment of back pain
The main directions of Pediatric Orthopedics:
- Hip joint examination in newborns (sonography)
- O-shaped curvature of legs
- X-shaped curvature of legs
- Defects in the structure of the feet
- Diseases of the spine
- 1987 – 1989 Graduation 1987 in Hanover, military service in the Bundeswehr Medical Services
- 1989 – 1996 Study of Medicine at the Hannover Medical School
- 1996 – 2001 Advanced training in Orthopedy, University Hospital Würzburg (under the direction of Prof. J. Eulert)
- 2001 – 2003 BG Emergency Hospital, Frankfurt am Main, Prof. Dr. M. Börner
- 2003 – 2004 University Hospital Würzburg, Prof. Dr. med. J. Eulert
- 2004 Board certification in Orthopedics, Munich
- 2004 – 2006 Senior Physician, Department of Orthopedics, University Hospital Carl Gustav Carus of the TU Dresden, Prof. Dr. med. K.-P. Günther
- 2006 Managing Senior Physician
- 2011 Leading Senior Physician
- 2008 Medical specialist in Orthopedics and Traumatology
- 2010 Special Orthopedic Surgery
- Since 2014, Medical Director of the Department of Orthopedics, St. Vincentius Hospital Karlsruhe – Academic Hospital of the University of Freiburg
- German Society for Orthopedics and Orthopedic Surgery (DGOOC)
- German Congress for Orthopedics and Traumatology (DKOU)
- Professional Association for Orthopedics and Traumatology (BVOU)
- German Society of Endoprosthetics (AE)
Photo of the doctor: (c) ViDia Kliniken Karlsruhe
Accommodation in hospital
- Program [Description]
Hip replacement and rehabilitation
- Hospital: St. Vincentius Hospital Karlsruhe-Academic Hospital of the University of Freiburg
- access_time Duration:
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