Hip Specialists Wiesbaden (Hesse): Dr Dirk Eiwanger and Dr Alexander Mayer

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Dr Dirk Eiwanger and Dr Alexander Mayer are specialists in hip surgery and senior physicians at the ATOS Klinik Wiesbaden.

The highly specialized physicians Dr Eiwanger and Dr Mayer stand for the best possible diagnosis and treatment of hip joint problems, regardless of the triggering cause. They always try to preserve the hip joint but, if necessary, have broad experience in implanting and replacing hip prostheses.

Hip Specialists in Hessen: Implantation of Hip Prostheses

Over time, the cartilage in various joints, including the hip joint, wears down. Other factors, such as misalignments, injuries, rheumatic diseases, hip dysplasia, obesity, or circulatory disorders, can contribute to accelerated degeneration. Cartilage defects beyond the normal aging process are referred to as osteoarthritis - in the hip joint, specifically coxarthrosis. As it progresses, this leads to symptoms such as pain, joint effusion, and deformation of the hip joint.

The treatment of advanced coxarthrosis consists of replacing the partially destroyed hip joint with a TEP (total endoprosthesis), which is one of the surgeries in which Dr Eiwanger and Dr Mayer specialize. There are two options for attaching the artificial joint:

Cemented Hip TEP

In this procedure, the parts of the artificial joint are cemented to the pelvic or femur bone using a polymer plastic called bone cement. This type of fixation is particularly advantageous for patients with a lack of bone stability, for example, due to osteoporosis, as the prosthesis does not have to be anchored in the bone.

Cementless Hip TEP

For cementless TEP, the artificial femoral head is anchored in the femur using a metal stem coated with a substance that stimulates bone growth. This allows the bone to grow together with the prosthesis quickly. The metal shell, inserted into the hip socket and forms the second part of the artificial joint, is also coated. A plastic inlay is inserted between the two parts.

Cementless fixation is preferred for younger patients, as it is easier to change the prosthesis than the cemented version. If there are no complications, a hip prosthesis has to be replaced after about 25 years so that a later replacement is not unlikely for people under 65. In addition, there is no risk of allergic reactions to the bone cement.

In the case of severe deformities, which can be congenital or acquired through an accident or surgery, a customized hip prosthesis can be designed at ATOS MVZ Wiesbaden using a special CT scan.

Physiotherapy using forearm crutches can begin already 24 hours after the surgery.

Hip Surgery in Wiesbaden: Therapy for Hip Impingement

An overdeveloped acetabulum roof or bony attachments on the femur cause hip impingement. The head of the femur and the acetabulum collide during specific movements, which can lead to chronic irritation with pain and joint damage and, ultimately, to coxarthrosis.

The hip specialists at ATOS MVZ Wiesbaden diagnose this clinical picture using X-ray, ultrasound, and MRI examinations. Physiotherapy can help if the condition is minor. If surgical correction is necessary, this is done using minimally invasive hip joint endoscopy, which minimizes the risk of bleeding, the duration of wound healing, and post-operative pain.

Highest Level of Expertise in the Treatment of Bone Fractures Near an Implant

A bone fracture near an inserted prosthesis is also known as a periprosthetic fracture. It is usually caused by falls or other accidents. However, it can also be caused by applying too much strain, leading to a loosening prosthesis. Due to increasing life expectancy, the incidence of such fractures is rising.

The surgical treatment of a periprosthetic fracture is generally more demanding than the correction and fixation of a fracture without an implant and requires unique expertise from surgeons. The bone bridge must be returned to the correct position in relation to each other and to the soft tissue and prosthetic material. They are then fixed in place with wires, screws, plates, or titanium bands so that the fracture can heal properly.

Excellent Expertise in the Field of Replacement Surgery

Thanks to improved surgical techniques and materials, the average lifespan of a hip prosthesis today is more than 20 years. With time, however, even with well-fitting prostheses, the bone cement in cemented prostheses and the plastic inlay in non-cemented prostheses wear away. Excessive and incorrect loading accelerates this wear. The abrasion of these foreign substances activates the immune system and leads to the loosening of the implant, which must, therefore, be replaced. In rare cases, a bacterial infection may also make replacement necessary.

The replacement of a hip TEP should only be carried out by experienced surgeons, such as the specialists at ATOS MVZ Wiesbaden, as it is a complicated procedure. The old prosthesis and the destroyed bone and scar tissue must be removed before a new implant can be fixed in place. In the case of a bacterial infection, removal of the old and insertion of the new hip TEP take place in two stages, as the infection must first be controlled.

Please visit the ATOS Klinik Wiesbaden website for more information.