THE MANUAL

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CAN I COME TO THE SPECIAL PRACTICE IN MAINZ AS A LEGALLY INSURED PERSON?

OF COURSE! AS A STATUTORY INSURED PERSON, YOU ARE EXPRESSLY WELCOME TO MY CONSULTATION HOURS!

IF YOU ARE LEGALLY INSURED, I HAVE TO BILL YOU THE COSTS FOR A PRIVATE MEDICAL CONSULTATION AND EXAMINATION DURING THE CONSULTATION AS A “SELF-PAYER” BECAUSE OUR CONCEPT WORKS WITHOUT YOUR OWN INSURANCE SITE.

HOWEVER, YOU DON'T HAVE TO FEAR HIGH COSTS! (SEE ALSO TREATMENT COSTS ).

I can bill for a surgical procedure as normal via statutory insurance (eg at the AUKAMM-KLINIK WIESBADEN )!

CAN I BE OPERATED AS A STATUTORY INSURED PERSON IN THE LILIUM CLINIC (PRIVATE CLINIC) IN WIESBADEN?

YES! IN MANY CASES, A SO-CALLED “INDIVIDUAL COST ASSUMPTION” IS POSSIBLE UPON REQUEST. MOST STATUTORY HEALTH INSURANCE COMPANIES APPROVE THIS COST COVERAGE. HOWEVER, THIS REQUIRES THAT YOU ARE MEDICALLY SUITABLE TO BE OPERATED IN A SMALL PRIVATE CLINIC.

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

YES! YOU CAN PARK IN THE MARKED PARKING AREAS DIRECTLY IN FRONT OF THE PRACTICE OR ON THE STREET IN THE IMMEDIATE SURROUNDING AREA.

CAN I ARRIVE BY PUBLIC TRANSPORT?

YES! THE MAINZ-GONSENHEIM TRAIN STATION IS IN IMMEDIATE WALKING DISTANCE.

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

WHERE DOES FOLLOW-UP TREATMENT TAKE PLACE AFTER SURGERY?

FOR PRIVATE PATIENTS, FOLLOW-UP TREATMENT TAKES PLACE IN THE PRACTICE FACILITIES IN MAINZ-GONSENHEIM (INITIALLY MAINZ-FINTHEN). IF YOU ARE LEGALLY INSURED, YOU ARE ALSO WELCOME TO VISIT THERE AS PART OF THE FOLLOW-UP TREATMENT. AS DESCRIBED ABOVE, I WILL ALSO HAVE TO WRITE A SMALL INVOICE HERE BECAUSE I DO NOT HAVE A KV APPROVED IN THE PRACTICE IN MAINZ.

FOR FOLLOW-UP TREATMENT, COOPERATIONS EXIST WITH SURROUNDING FAMILY DOCTORS FOR THE PURPOSE OF ISSUING PRESCRIPTIONS (PHYSIO; LYMPH DRAINAGE, ETC.)

When can I walk normally again AFTER THE OP?

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

DO I NEED TO GO TO INPATIENT REHAB?

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

ORGANIZING AND PRECIPING PHYSIOTHERAPY (INCLUDING LYMPH DRAINAGE, ETC.) IS ALSO AN INCREASELY USED OPTION.

IF YOU ARE SINGLE OR FIND SUB-OPTIMAL CONDITIONS IN YOUR LIVING AREA, THE HEALTH INSURANCE INSURANCE WILL OF COURSE ALSO GUARANTEE THE POSSIBILITY OF INPATIENT REHABILITATION IN A REHA CLINIC IN THE REGION.

OUR SOCIAL SERVICE WILL TAKE CARE OF THE ORGANIZATION OF THE REHABILITY MEASURES (OUTPATIENT OR INPATIENT)!

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

PARTICULARLY IN THE FIRST WEEKS AFTER A THA TOP OPERATION, THERE IS A BASIC RISK THAT THE JOINT COULD POP OUT DURING UNCONSIDERED, IMPULSIVE MOVEMENTS. HOWEVER, THIS OCCURS EXTREMELY RARE TODAY. BECAUSE THE MINIMAL-INVASIVE TECHNOLOGY DOES NOT DAMAGE THE MUSCLES, THE RISK OF LUXATION HAS NOTICEABLY REDUCED.

THE FUNCTION OF THE HIP JOINT IS VERY INDIVIDUAL AFTER A SURGERY. IT IS NOT RARE FOR PATIENTS TO BE ABLE TO MOVE WITHOUT ANY PROBLEMS EARLY EARLY AND EVEN BEYOND 90° OF BENDS. A GENERAL BAN ON SUCH A MOVEMENT THEREFORE DOES NOT REQUIRE THE DEVELOPMENTS OF THE RECENT YEARS.

YOU SHOULD START WITH SLOW, CAUTIONOUS MOVEMENTS AND TRY OUT WHICH DEGREE OF MOTION IS POSSIBLE FOR YOU WITH LOW DISCOMFORT. IF YOU HAVE PAIN OR RESISTANCE, DO NOT FORCE THE MOVEMENT!

MEDIUM OR IN THE LONG TERM IT IS EXPECTED THAT YOU WILL BE ABLE TO EXECUTE MOVEMENTS BEYOND THE ORIGINAL LIMITS WITHOUT ANY PROBLEMS.

WHEN CAN I DRIVE AGAIN?

REGARDLESS OF MEDICAL CRITERIA, THE LEGAL ASPECT IS PARTICULARLY DECISIVE IN THIS QUESTION. BASICLY, IF YOU CAN WALK WITHOUT WALKING STRAPS AND WITHOUT RESTRICTIONS, YOU CAN PROBABLY BE ABLE TO DRIVE A CAR AGAIN. HOWEVER, IF ANY DAMAGE CAUSES IN THE EARLY PHASE AFTER THE SURGERY, YOUR VEHICLE INSURANCE MAY BE ABLE TO DISPUTE THE COSTS. 6 WEEKS ARE OFTEN USED AS A GOOD GUIDE TO WHEN DRIVING A CAR IS POSSIBLE AGAIN.

When can I work again?

That depends on the professional activity. A purely sedentary job, for example in the home office, could theoretically be resumed after just 2 or 3 weeks. However, we recommend that you take a break from work during the entire rehabilitation period. You can resume an activity that alternates between sitting and standing after about 6 weeks, and a predominantly standing activity after about 8 weeks. Work that requires regular climbing of ladders or scaffolding, or that requires a hunched over posture (most manual tasks) can usually be carried out SAFELY again after about 3 months.

What sports can I do with an artificial joint?

All sports that involve consistent and controlled movements are recommended:

- Hike

- Water aerobics, aqua walking, aqua cycling

- Ride a bike

- Swimming (all positions)

- 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 the practice of sports such as tennis or skiing. If you've never skied down the slopes before, you shouldn't relearn sports like this with an artificial joint. Enthusiastic athletes who have been technically good at their sport for decades can practice 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 positive because it trains the muscles, improves breathing and strengthens the cardiovascular system. Sport improves coordination, reduces the risk of falls and has a positive effect on blood sugar and blood lipids. In addition, exercise in the fresh air is good for the soul and prevents obesity. With appropriate sporting activity, you don't have to worry about premature wear of the joint prosthesis.

How long does a prosthesis last?

THE MAIN REASON FOR EASING OR A LATE COMPLICATION OF A PROSTHESIS TODAY IS MATERIAL WEAR. ABRASION OF METAL OR PLASTIC PARTICLES CAUSES A CHRONIC INFLAMMATORY REACTION, WHICH CAN ULTIMATELY LEAD TO A LOOSENING OF THE IMPLANT COMPONENTS. IMPLANTS THAT WERE INSTALLED 25 YEARS AGO, IN ADDITION TO A METAL COMPONENT, MOSTLY CONSISTED OF A COMPONENT MADE OF SOFT POLYETHYLENE. THE COMBINATION OF METAL AND SOFT POLYETHYLENE RESULTS IN A LIMITED SHELF LIFE (WE TALK ABOUT 15-20 YEARS). HOWEVER, SINCE COMPLETELY DIFFERENT MATERIALS ARE USED TODAY, SUCH AS CERAMICS AND HIGHLY CROSS-LINKED, HARD POLYETHYLENE, THEORETICALLY AND EXPERIMENTALLY A SIGNIFICANTLY LONGER DURABILITY CAN BE EXPECTED FOR PROSTHESES WHICH ARE BUILT IN TODAY. UNFORTUNATELY IT IS NOT CURRENTLY PRACTICALLY POSSIBLE TO JUMP THAT FAR INTO THE FUTURE TO PROVE THESE THEORETICAL ASSUMPTIONS.

IN CASE OF EARLY COMPLICATIONS, IN RARE CASES THE SHELF LIFE MAY ALSO BE SIGNIFICANTLY SHORTENED. UNFORTUNATELY, ENDOPROSTHETIC SURGERY ALSO BRINGS RISKS.

How do I notice a loosening?

A LOOSENING OF IMPLANTS IS USUALLY ASSOCIATED WITH PAIN SYMPTOMS DURING STRESS. THESE CAN EITHER OCCUR EARLY (E.G. AS PART OF AN ACUTE EARLY INFECTION; VERY RARE) OR EVEN AFTER YEARS OF FREEDOM FROM SYMPTOMS. THIS SUGGESTS MORE FOR MECHANICAL (ASEPTIC) LOOSENING.

My operated leg feels longer. Does the operation change leg length?

PARTICULARLY IMMEDIATELY AFTER A THRIP IMPLANTATION, THE OPERATED LEG 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 OPERATIVE SIDE. HOWEVER, THIS FUNCTIONAL LEG LENGTH DIFFERENCE WILL SLOWLY EQUALIZE OVER THE FIRST 6-8 WEEKS.

HOWEVER, IN RARE CASES, AN ANATOMIC LEG LENGTH DIFFERENCE IS ALSO A CONSEQUENCE OF HIP OPERATION. DURING THE PROCEDURE, CAREFUL BALANCE MUST BE BETWEEN SUFFICIENT STABILITY (DUE TO MUSCLE TRAIN) OF THE JOINT AND THE LENGTH OF THE LEG. IF THERE IS SUB-OPTIMAL CONDITIONS WHEN CHECKING THE STABILITY WITH THE SAME LEG LENGTH, A DECENT LENGTH LENGTH MUST BE CONSIDERED DURING THE OPERATION, BECAUSE INSTABILITY (PROJECTION OF THE JOINT) REPRESENTS A MUCH MORE CRITICAL CONSEQUENCE.

A LEG LENGTH DIFFERENCE OF A FEW MILLIMETERS IS THEREFORE ONE OF THE RISKS OF THA THRIP IMPLANTATION. MOSTLY THIS CAN BE AVOIDED.

LEG LENGTH DIFFERENCES ARE ONLY TO BE EXPECTED IN RARE CASES (DUE TO IMPROPER POSITIONS) AS A PART OF TKA KNEE IMPLANTATION.

How often do I need to have follow-up examinations?

After ABOUT 6 weeks I'll see you AGAIN IN THE CONSULTATION HOURS. I THEN EXAMINE THE SOFT TISSUE, the muscles, mobility and possible changes in leg length. An x-ray is usually also taken. IF THERE IS A NEED, WE WILL ARRANGE ANOTHER INSPECTION APPOINTMENT.

IF YOU ARE THINGS OVERALL GOOD, IT'S NOT ROUTINE

FOLLOW-UP EXAMINATIONS MORE ESSENTIALLY NECESSARY. EVEN A REGULAR X-RAY CHECK IS NOT ADVISED IF THERE IS NO SYMPTOM.

FOR RESIDUAL COMPLAINTS, new complaints or unexpected events, you can contact ME OR MY TEAM at any time!

Do I have to pay attention to anything at the dentist or other treatments BECAUSE OF MY ARTIFICIAL JOINT?

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

- Bloody procedures at the dentist (root canal treatment, tooth extraction, gum treatment, etc.)

- Colonoscopies

- Surgery on the bladder and prostate

Please speak to your treating dentist or doctor!

Antibiotic prophylaxis:

- 1x 1g amoxicillin po 1 hour before

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

PREPARATION

SURGERY

STATIONARY

STAY

AFTER

TREATMENT