Find German Implants Performing Orthopedic Surgeons

German Implants Performing Orthopedic Surgeons

INFORMATION ON THE FIELD OF Endoprosthetics

Are you interested in locating a German implants performing orthopedic surgeon? At PRIMO MEDICO you will only find specialists experienced in endoprosthetic ...

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TREATMENT FOCUS Endoprosthetics

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INFORMATION ON THE FIELD OF Endoprosthetics

Are you interested in locating a German implants performing orthopedic surgeon? At PRIMO MEDICO you will only find specialists experienced in endoprosthetic procedures such as prosthetic leg or hip replacement surgery.

What Are the Costs for German Implants?

For patients from abroad, the cost for an orthopedic surgeon specialized in German implants is strictly regulated by the German government (GOÄ Department). German physicians are not entitled to determine their own self-calculated fees for medical services. They are legally obliged to adhere to the official fixed tariff rates for doctors.

In order to calculate the costs for an endoprosthetic procedure such as prosthetic leg or hip replacement surgery, endoprosthesis clinics first require detailed information on the specific prosthetic need. This data can be handed over to the hospital in form of medical reports, findings or images taken prior to treatment. The endoprosthetics center then prepares a cost estimate. In most cases, the amount due must be paid ahead of the prosthetic treatment.

What is the Field of Endoprosthetics in General?

Endoprosthetics is a branch of human medicine which deals with permanently anchored implants supporting or replacing damaged joints such as a prosthetic leg or a hip replacement prosthetic.

Endoprosthetics is most commonly applied for hip restoration, but also shoulder joints, knee joints or elbow joints can be replaced prosthetically. In general, any type of foreign material that is placed into the body is called prosthesis or implant. A distinction is made between endo and endo-exo prostheses. For example, dental implants are referred to as endo-exo implant, since the prosthetic restoration takes place partly outside the body, namely in the oral cavity. The following chapter provides an insight into orthopedics and trauma surgery.

How Do Orthopedic Surgeons Perform Anchoring in the Bone and Which Materials Do They Use?

In general, the anchoring of a prosthesis is always a result of the formation of new bone structure around the prosthesis and thus firmly enclosing it. For this purpose, the prosthesis must be perfectly matched to the bone to achieve an optimal grip. This hold can be facilitated by "cementing" the prosthesis. Specialists in endoprosthetics then speak of cemented prostheses. However, a prosthesis can also be inserted without cement or used as a so-called hybrid prosthesis containing a cemented and a cement-free part.

Typically, the prosthesis consists of titanium alloys or special plastics as well as ceramics or so called CoCrMo alloys. Especially in the area of the joint capsule and the condyle, physicians use specific polyethylenes (nowadays XUHMWPE for better stability: cross-linked ultra-high molecular weight polyethylene).

The Hip Endoprosthesis

Basically, orthopedic surgeons perform two types of hip endoprosthesis: TEPs (total endo prostheses, condyle and joint capsule replacement) and HEPs (Hemi-Endo prostheses, only replacement of condyle or joint capsule). In addition, they also carry out surface prostheses, in which larger parts of the natural hip can be preserved. Here, surgeons only remove the surface of the condyle and replace it with a metal cap. This technique is beneficial in younger patients because later revisions can be accomplished more easily. Also physiological mobility as well as reduced danger of joint dislocation (luxation) can be preserved. An alternative to surface replacements in younger patients is short shaft prostheses, which however, does not make a big leap in terms of effectiveness but anyways, it always depends on the individual case.

Surgical procedures can be performed under local spinal anesthesia or under general anesthesia. To do this, orthopedic surgeons first create access to the joint, mill out the worn parts and then prepare the bone for the prosthesis. For the implantation it is necessary to pursue certain maximum angles to avoid the risk of a large abrasion and a dislocation of the prosthesis. As the saying goes, surgeons should adhere to a maximum abduction of about 50 degrees and a maximum anteversion of about 20-25 degrees. Eventually, the bone specialist prepares a test head on the joint shaft and re-sets the displaced hip in place to check hold and shafts. Once he has reached both holding and stability, he explicitly repositions the hip prosthesis once again and closes the wound. Afterwards, an outpatient stay of six to ten days occurs.

Nowadays, there is also the possibility of minimally invasive implantation of a prosthesis. In this case, doctors try to find the smallest possible access to the prosthetic restoration area. Beneficial here is the rapid rehabilitation of the patients and a significantly reduced trauma to the surrounding soft tissue. A disadvantage of the minimally invasive technique is its limited usage. Even at later stages of the surgery there is no difference in terms of long-term success.

In addition to hip endoprostheses, shoulder prostheses, knee joint prostheses and, to a lesser extent ankle prostheses exist.

The Aftertreatment

In the first postoperative days, wound pain is treated with pain medications. At the same time, physiotherapy of the operated areas begins. The type of prosthesis used is crucial to the kind of postoperative care. If cemented prosthesis is in place, full body weight can be put on from the first day on. On the other hand, if cementless prosthesis is applied, full pressure must be avoided in the first few days until the prosthesis is really anchored in the bone. To be able to walk safely, the patient is dependent on walking aids. After ten days of hospitalization, further treatment takes place in rehabilitation clinics.

Risks in endoprosthetic surgery are the commonly known wound healing disorders, hematomas, nerve injuries or infections. Deep vein thrombosis in particular is one of the most important risks to avoid. In order to prevent thrombosis, prophylactic measures are taken immediately after surgery for a period of up to six weeks. A special risk is the detachment of bone tissue in the area of the prosthesis. If the bone splinters off, it requires further intervention methods using screws and plates to stabilize the loose parts.

Which Doctors and Clinics in Germany are Specialists in Endoprosthetics?

Patients wishing to receive German implants want to know which orthopedic surgeon is best suited for them. PRIMO MEDICO helps patients to find an expert for their condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in the field of endoprosthetics and await treatment requests.

Sources (German):

https://www.nzz.ch/article95DIE-1.335421
http://www.prof-faensen.de/index.php?id=mcminn_oberflaechenersatz_huefte


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