THE MANUAL

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CAN I COME TO THE SPECIALIST PRACTICE IN MAINZ AS A PERSON WITH PUBLIC INSURANCE?

OF COURSE! AS A PERSON WITH LEGAL INSURANCE, YOU ARE EXPRESSLY WELCOME TO MY CONSULTATION HOURS!

IF YOU HAVE STATUTORY INSURANCE, I WILL HAVE TO CHARGE YOU FOR THE COSTS OF A PRIVATE MEDICAL CONSULTATION AND EXAMINATION DURING THE CONSULTATION HOURS AS A “SELF-PAYER”, BECAUSE OUR CONCEPT WORKS WITHOUT OUR OWN INSURANCE COMPANY.

HOWEVER, YOU DO NOT HAVE TO BE Afraid OF HIGH COSTS! (SEE ALSO TREATMENT COSTS).

I can bill for a surgical procedure COMPLETELY regularly through statutory insurance (eg in the AUKAMM-KLINIK WIESBADEN)!

CAN I, AS A PUBLICLY INSURED PERSON, HAVE SURGERY IN THE LILIUM CLINIC (PRIVATE CLINIC) IN WIESBADEN?

YES! IN MANY CASES, SO-CALLED "INDIVIDUAL COST COVERAGE" IS POSSIBLE UPON APPLICATION. MOST PUBLIC HEALTH INSURANCE COMPANIES APPROVE THIS COST COVERAGE. HOWEVER, THIS REQUIRES THAT YOU ARE MEDICALLY SUITABLE FOR SURGERY IN A SMALL PRIVATE CLINIC.

ARE THERE ENOUGH PARKING SPACES IN FRONT OF THE PRACTICE IN MAINZ?

YES! YOU CAN PARK IN THE MARKED PARKING SPACES DIRECTLY IN FRONT OF THE PRACTICE OR IN THE IMMEDIATE VICINITY ON THE STREET.

CAN I ARRIVE BY PUBLIC TRANSPORT?

YES! MAINZ-GONSENHEIM TRAIN STATION IS WITHIN WALKING DISTANCE.

BUS LINE 78 ALSO STOPS AT BOTH "GONSBERG-CAMPUS" AND "DER OBERBRÜCKE" (1-2 MINUTES WALK TO ENDOPROTHETICUM).

WHERE DOES THE FOLLOW-UP CARE TAKE PLACE AFTER SURGERY?

FOR PRIVATE PATIENTS, FOLLOW-UP TREATMENT TAKES PLACE IN THE PRACTICE PREMISES IN MAINZ-GONSENHEIM (INITIALLY MAINZ-FINTHEN). IF YOU HAVE PUBLIC INSURANCE, YOU ARE ALSO WELCOME TO COME THERE FOR FOLLOW-UP TREATMENT. AS DESCRIBED ABOVE, I WILL HAVE TO WRITE A SMALL INVOICE HERE AS WELL, AS I DO NOT HAVE KV AUTHORIZATION FOR THE PRACTICE IN MAINZ.

FOR FOLLOW-UP TREATMENT, WE HAVE COOPERATION WITH LOCAL FAMILY DOCTORS TO ISSUE PRESCRIPTIONS (PHYSIO; LYMPHATIC DRAINAGE ETC.)

When can I walk normally again AFTER THE SURGERY?

Immediately after the operation, you can usually bear full weight on the operated leg. To avoid any peak or shock loads when tripping or falling, please use forearm crutches for the first few weeks. The duration varies from individual to individual, but is usually between 2 and 6 weeks.

DO I HAVE TO GO TO INPATIENT REHAB?

NO! THERE ARE EXCELLENT OUTPATIENT REHABILITATION OPTIONS TODAY. PARTICULARLY IN THE REGION THERE ARE MANY OUTPATIENT REHABILITATION CENTERS (E.G. IN MAINZ-MOMBACH, IN MAINZ CITY CENTER, INGELHEIM, IN HOFHEIM, IN ERBENHEIM ETC.), WHICH EVEN OFFER A TRANSPORT SERVICE SO THAT YOU CAN PARTICIPATE IN THE REHABILITATION MEASURES FROM MORNING TO AFTERNOON BUT CAN ALSO SLEEP IN YOUR HOME ENVIRONMENT.

ORGANISING AND PRESCRIBING PHYSIOTHERAPY (INCLUDING LYMPHATIC DRAINAGE ETC.) IS ALSO AN INCREASINGLY USED OPTION.

IF YOU ARE ALONE OR IF YOUR LIVING ENVIRONMENT IS SUBOPTIMISM, THE HEALTH INSURANCE COMPANIES WILL OF COURSE ALSO GUARANTEE THE POSSIBILITY OF INPATIENT REHABILITATION IN A REHABILITATION CLINIC IN THE REGION.

OUR SOCIAL SERVICES WILL TAKE CARE OF THE ORGANIZATION OF THE REHABILITATION MEASURES (OUTPATIENT OR INPATIENT)!

ONLY 90° FLEXION IN THE HIP JOINT - IS THAT TRUE?

ESPECIALLY IN THE FIRST WEEKS AFTER A HIP REPLACEMENT SURGERY, THERE IS A RISK THAT THE JOINT COULD DISASSEMBLE DURING RECKLESS, IMPULSIVE MOVEMENTS. HOWEVER, THIS HAPPENS EXTREMELY RARELY THESE DAYS. BECAUSE THE MINIMALLY INVASIVE TECHNIQUE DOES NOT DAMAGE THE MUSCULATURE, THE RISK OF DISASSEMBLY HAS BEEN SIGNIFICANTLY REDUCED.

THE FUNCTION OF THE HIP JOINT AFTER A SURGERY IS VERY INDIVIDUAL. IT IS NOT UNCOMMON FOR PATIENTS TO BE ABLE TO MOVE WITHOUT PROBLEMS AT AN EARLY TIME AND EVEN BEYOND 90° OF BEND. A GENERAL BAN ON SUCH MOVEMENT THEREFORE DOES NOT DO JUSTICE TO THE DEVELOPMENTS OF RECENT YEARS.

YOU SHOULD START WITH SLOW, CAREFUL MOVEMENTS AND TRY OUT WHICH LEVEL OF MOBILITY YOU CAN DO WITHOUT ANY DIFFICULTY. IF YOU FEEL PAIN OR RESISTANCE, DO NOT FORCE THE MOVEMENT!

IN THE MEDIUM OR LONG TERM IT IS EXPECTED THAT THEY WILL BE ABLE TO MOVE BEYOND THEIR ORIGINAL LIMITS WITHOUT PROBLEMS.

WHEN CAN I DRIVE AGAIN?

INDEPENDENT OF MEDICAL CRITERIA, THE LEGAL ASPECT IS PARTICULARLY IMPORTANT IN THIS QUESTION. IN GENERAL, IF YOU ARE ABLE TO WALK WITHOUT CRUISING AND WITHOUT RESTRICTIONS, YOU CAN PROBABLY DRIVE AGAIN. HOWEVER, IF A CLAIM OCCURS IN THE EARLY PHASE AFTER THE OPERATION, YOUR CAR INSURANCE COMPANY MAY CHALLENGE THE COVERAGE OF THE COSTS. 6 WEEKS IS OFTEN GIVEN AS A GOOD GUIDE TO WHEN IT IS POSSIBLE TO DRIVE A CAR AGAIN.

When can I go back to work?

That depends on the job. A purely sedentary job, e.g. working from home, could theoretically be resumed after 2 or 3 weeks. However, we recommend that you take a break from work for the entire rehabilitation period. A job that involves alternating between sitting and standing can be resumed after around 6 weeks, and a job that involves mostly standing after around 8 weeks. Jobs that regularly require climbing ladders or scaffolding, or that require a bent posture (most manual work) can usually be performed SAFELY again after around 3 months.

What sport can I do with an artificial joint?

All sports that involve consistent and controlled movements are recommended:

- Hike

- Water gymnastics, aquawalking, aquacycling

- Ride a bike

- Swimming (all strokes)

- Cross-country skiing

Caution is advised when playing ball sports (football, handball, basketball, etc.) with contact with opponents and martial arts (judo, karate).

It is difficult to recommend sports such as tennis or skiing. If you have never skied down the slopes before, you should not learn to do such sports again with an artificial joint. Enthusiastic athletes who have mastered their sport technically for decades can start practicing their beloved sport again after good and intensive muscle building (after 6-12 months at the earliest) and after a certain amount of practice.

Regular exercise is a positive thing because it trains your muscles, improves your breathing and strengthens your cardiovascular system. Exercise improves your coordination, reduces the risk of falls and has a positive effect on blood sugar and blood fats. In addition, exercise in the fresh air is good for your soul and prevents you from becoming overweight. If you exercise appropriately, you don't have to worry about premature wear and tear on your joint prosthesis.

How long does a prosthesis last?

THE MAIN REASON FOR A PROSTHESIS BECOMING LOOSE OR A LATE COMPLICATION TODAY IS MATERIAL WEAR. THE ABRASION OF METAL OR PLASTIC PARTICLES CAUSES A CHRONIC INFLAMMATORY REACTION, WHICH CAN ULTIMATELY LEAD TO THE IMPLANT COMPONENTS BECOMING LOOSE. IMPLANTS THAT WERE INSTALLED 25 YEARS AGO MOST OF THE TIME CONSISTED OF A METAL COMPONENT AND A SOFT POLYETHYLENE COMPONENT. THE COMBINATION OF METAL AND SOFT POLYETHYLENE HAS A LIMITED DURABILITY (15-20 YEARS). HOWEVER, SINCE TODAY COMPLETELY DIFFERENT MATERIALS ARE USED, SUCH AS CERAMIC AND HIGHLY CROSS-LINKED, HARD POLYETHYLENE, IT CAN BE THEORETICALLY AND EXPERIMENTALLY ASSUMED THAT PROSTHESES THAT ARE INSTALLED TODAY WILL LAST MUCH LONGER. UNFORTUNATELY, IT IS CURRENTLY NOT POSSIBLE TO JUMP FAR FROM THE FUTURE TO PROVE THESE THEORETICAL ASSUMPTIONS.

IN THE EVENT OF EARLY COMPLICATIONS, IN RARE CASES THE SHELF LIFE CAN BE SIGNIFICANTLY SHORTENED. UNFORTUNATELY, A JOINT OPERATION ALSO INVOLVES CORRESPONDING RISKS.

How do I notice loosening?

A LOOSENING OF IMPLANTS IS USUALLY ASSOCIATED WITH PAIN SYMPTOMS WHEN LOADING. THESE CAN OCCUR EITHER EARLY (E.G. IN THE ASSOCIATES OF AN ACUTE EARLY INFECTION; VERY RARE) OR AFTER YEARS OF BEING FREE OF SYMPTOMS. THIS IS MORE INDICATIVE OF A MECHANICAL (ASEPTIC) LOOSENING.

My operated leg feels longer. Will the operation change the length of my leg?

ESPECIALLY DIRECTLY AFTER A HIP REPLACEMENT IMPLANTATION, THE OPERATED LEG ALMOST ALWAYS FEELS A LITTLE LONGER. THIS IS DUE TO A SO-CALLED FUNCTIONAL LEG LENGTH DIFFERENCE CAUSED BY A CONTRACTURE OF THE MUSCLE GROUPS AROUND THE PELVIS ON THE SIDE WHERE THEY WERE SURGERED. HOWEVER, THIS FUNCTIONAL LEG LENGTH DIFFERENCE WILL SLOWLY EQUIVALENT OVER THE FIRST 6-8 WEEKS.

IN RARE CASES, HOWEVER, AN ANATOMICAL LEG LENGTH DIFFERENCE IS ALSO A CONSEQUENCE OF HIP SURGERY. DURING THE SURGERY, A CAREFUL BALANCE MUST BE MADE BETWEEN ADEQUATE STABILITY (DUE TO MUSCLE TRAIN) OF THE JOINT AND THE LEG LENGTH. IF THE STABILITY TEST SHOWS SUBOPTIMIUM CONDITIONS WHILE THE LEG LENGTH IS THE SAME, A SLIGHT LENGTH OF THE LEG MUST USUALLY BE ACCEPTABLE DURING THE SURGERY, AS INSTABILITY (JUMPING OUT OF THE JOINT) IS A MUCH MORE CRITICAL CONSEQUENCE.

A LEG LENGTH DIFFERENCE OF JUST A FEW MILLIMETRES IS ONE OF THE RISKS OF A HIP REPLACEMENT IMPLANTATION. HOWEVER, IT CAN MOST OF THE TIME BE AVOIDED.

IN THE CONTEXT OF KNEE TEP IMPLANTATION, LEG LENGTH DIFFERENCES ARE ONLY TO BE EXPECTED IN RARE CASES (DUE TO MISALIGNMENTS).

How often do I need to go for follow-up examinations?

After about 6 weeks I will see you again in my consultation. I will then examine the soft tissue, the muscles, mobility and possible changes in the length of the leg. An x-ray is usually also taken. IF NECESSARY, WE WILL ARRANGE ANOTHER CHECK-UP APPOINTMENT.

IF YOU ARE FEELING WELL, NO ROUTINE

FOLLOW-UP EXAMINATIONS ARE NO LONGER ESSENTIAL. REGULAR X-RAY CHECKS ARE ALSO NOT RECOMMENDED IF THERE ARE NO SYMPTOMS.

IF YOU STILL HAVE ANY RESIDUAL COMPLAINTS, If you have any new complaints or unexpected events, please feel free to contact ME OR MY TEAM at any time!

Do I have to pay attention to anything at the dentist or for other treatments BECAUSE of my artificial joint?

Based on the recommendation of the German Society for Endoprosthetics, we advise you to take antibiotic prophylaxis in the first 2 years after the operation for the following procedures:

- Bloody dental procedures (root canal treatment, tooth extraction, gum treatment, etc.)

- Colonoscopies

- Bladder and prostate surgery

Please speak to your treating dentist or doctor!

Antibiotikaprophylaxe:

- 1 hour before 1x 1g Amoxicillin po

- Patients with penicillin allergy: 1 hour before 1x 600mg clindamycin po

PREPARATION

OPERATION

STATIONARY

STAY

AFTER

TREATMENT