THE MANUAL

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CAN I COME TO THE SPECIALIZED PRACTICE IN MAINZ AS A STATUTORILY INSURED PERSON?

SELBSTVERSTÄNDLICH! ALS GESETZLICH VERSICHERTE/R SIND SIE AUSDRÜCKLICH HERZLICH WILLKOMMEN IN MEINER SPRECHSTUNDE!

If you are statutorily insured, I have to charge you for the costs of a private medical consultation and examination in the consultation hour as a 'self-payer' because our concept functions without its own cash register.

However, you don't have to fear high costs! (See also TREATMENT COSTS).

I can bill a surgical intervention completely regularly via statutory insurance (e.g. at the AUKAMM CLINIC WIESBADEN).

Can I, as a statutory health insurance holder, be operated on at the LILIUM CLINIC (private clinic) in Wiesbaden?

YES! IN MANY CASES, A SO-CALLED 'INDIVIDUAL COST ASSUMPTION' IS POSSIBLE ON APPLICATION. MOST STATUTORY HEALTH INSURANCES APPROVE THIS COST ASSUMPTION. HOWEVER, THIS REQUIRES THAT YOU ARE SUITABLE FROM A MEDICAL POINT OF VIEW TO BE OPERATED ON IN A SMALL PRIVATE CLINIC.

Are there enough parking spaces in front of the practice in Mainz?

JA! SIE KÖNNEN AUF DEN GEKENNZEICHNETEN PARKFLÄCHEN DIREKT VOR DER PRAXIS ODER IN UNMITTELBARER UMGEBUNG AUF DER STRASSE PARKEN.

KANN ICH MIT ÖFFENTLICHEN VERKEHRSMITTELN ANREISEN?

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

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

Where does the follow-up treatment take place after surgical interventions?

FÜR PRIVATPATIENTEN FINDET DIE NACHBEHANDLUNG IN DEN PRAXISRÄUMLICHKEITEN IN MAINZ-GONSENHEIM (ANFANGS MAINZ-FINTHEN) STATT. SIND SIE GESETZLICH VERSICHERT, SIND SIE EBENFALLS HERZLICH WILLKOMMEN SICH IM RAHMEN DER NACHBEHANDLUNG DORT VORZUSTELLEN. WIE OBEN BESCHRIEBEN, WERDE ICH AUCH HIER EINE KLEINE RECHNUNG SCHREIBEN MÜSSEN, DA ICH IN DER PRAXIS IN MAINZ KEINE KV-ZULASSUNG BESITZE.

FÜR DIE NACHBEHANDLUNG BESTEHEN KOOPERATIONEN MIT UMLIEGENDEN HAUSÄRZTEN ZWECKS AUSSTELLEN VON REZEPTEN (PHYSIO; LYMPHDRAINAGE ETC.)

When can I walk normally again AFTER SURGERY?

Immediately after the operation, you can usually fully load the operated leg. To avoid possible peak or shock loads when stumbling or falling, please use forearm crutches for the first few weeks. The duration varies individually, usually between 2 and 6 weeks.

DO I NEED TO GO INTO STATIONARY REHABILITATION?

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

Also, organizing and prescribing physiotherapy (including lymphatic drainage etc.) is an increasingly used option.

SOLLTEN SIE ALLEINSTEHEND SEIN ODER IM WOHNUMFELD SUBOPTIMALE BEDINGUNGEN VORFINDEN, WIRD SEITENS DER KRANKENKASSEN SELBSTVERSTÄNDLICH AUCH DIE MÖGLICHKEIT EINER STATIONÄREN REHABILITATION IN EINER REHA-KLINIK DER REGION GEWÄHRLEISTET.

Our social service will take care of organizing the rehabilitation measures (outpatient or inpatient)!

NUR 90° BEUGUNG IM HÜFTGELENK - STIMMT DAS?

In particular, in the first few weeks after a hip replacement operation, there is a fundamental risk that an impulsive, unpremeditated movement could cause the joint to dislocate. However, this is extremely rare today. Because the minimally invasive technique does not damage the musculature, the risk of luxation has noticeably decreased.

The function of the hip joint is very individual after a procedure. Not infrequently, patients can already move without problems early on and even beyond 90° flexion. A general ban on such movement is not justified in light of the developments in recent years.

You should start with slow, careful movements and try out which degree of mobility is possible for you with little discomfort. You should not force the movement if you have pain or resistance!

In the medium to long term, it is to be expected that you will be able to perform movements beyond the original limits without any problems.

WHEN CAN I DRIVE AGAIN?

REGARDLESS OF MEDICAL CRITERIA, THE LEGAL ASPECT IS PARTICULARLY DECISIVE FOR THIS QUESTION. IN PRINCIPLE, IF YOU CAN WALK WITHOUT WALKING AIDS AND WITHOUT RESTRICTIONS, YOU CAN PROBABLY DRIVE AGAIN. HOWEVER, IF A DAMAGE OCCURS IN THE EARLY PHASE AFTER THE OPERATION, YOUR CAR INSURER COULD UNDER CERTAIN CIRCUMSTANCES CHALLENGE THE ASSUMPTION OF COSTS. AS A GOOD ORIENTATION FOR WHEN DRIVING A CAR IS OFTEN POSSIBLE AGAIN, 6 WEEKS ARE OFTEN MENTIONED.

When can I return to work?

This depends on the type of work. A purely sedentary job, e.g. in home office, could theoretically be resumed after 2 or 3 weeks. However, we recommend a break from work during the entire rehabilitation. A job that involves alternating between sitting and standing can be resumed after about 6 weeks, a predominantly standing job after about 8 weeks. Work that involves regularly climbing ladders or scaffolding, or requires a bent or flexed position (most manual trades) can usually be performed safely again after about 3 months.

Welchen Sport kann ich mit einem künstlichen Gelenk machen?

All sports that involve smooth and controlled movements are recommended:

- Hiking

- Aquatic gymnastics, aqua walking, aqua cycling

- Cycling

- Schwimmen (alle Lagen)

- Cross-country skiing

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

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

Regelmäßige sportliche Betätigung ist positiv zu bewerten, da die Muskeln trainiert, die Atmung verbessert und das Herz-Kreislauf-System gestärkt werden. Sport verbessert die Koordinationsfähigkeit, reduziert das Sturzrisiko und wirkt sich günstig auf Blutzucker und Blutfette aus. Außerdem tut Sport an der frischen Luft der Seele gut und verhindert Übergewicht. Bei angemessener sportlicher Aktivität müssen Sie keine Angst vor einem vorzeitigen Verschleiß der Gelenkprothese haben.

How long does a prosthesis last?

THE MAIN REASON FOR A LOOSENING OR A LATE COMPLICATION OF A PROSTHESIS TODAY IS MATERIAL WEAR. DUE TO THE ABRASION OF METAL OR PLASTIC PARTICLES, A CHRONIC INFLAMMATORY REACTION OCCURS, WHICH ULTIMATELY CAN LEAD TO A LOOSENING OF THE IMPLANT COMPONENTS. IMPLANTS INSERTED 25 YEARS AGO CONSISTED MAINLY OF A METAL COMPONENT AND A COMPONENT MADE OF SOFT POLYETHYLENE. THE COMBINATION OF METAL AND SOFT POLYETHYLENE RESULTS IN LIMITED DURABILITY (SPOKEN OF 15-20 YEARS). HOWEVER, SINCE COMPLETELY DIFFERENT MATERIALS ARE USED TODAY, SUCH AS CERAMICS AND HIGHLY CROSS-LINKED, HARD POLYETHYLENES, IT IS THEORETICALLY AND EXPERIMENTALLY ASSUMED TO HAVE A SIGNIFICANTLY LONGER DURABILITY FOR PROSTHESES THAT ARE INSERTED TODAY. UNFORTUNATELY, IT IS CURRENTLY NOT POSSIBLE TO JUMP FAR ENOUGH INTO THE FUTURE TO VERIFY THESE THEORETICAL ASSUMPTIONS.

IN THE EVENT OF EARLY COMPLICATIONS, DURABILITY CAN ALSO BE SIGNIFICANTLY REDUCED IN RARE CASES. AN ENDOPROTHETIC SURGERY UNFORTUNATELY ALSO INVOLVES CORRESPONDING RISKS.

How do I notice a loosening?

LOOSENING OF IMPLANTS IS USUALLY ASSOCIATED WITH PAIN SYMPTOMS UNDER LOAD. THESE CAN OCCUR EITHER EARLY (E.G. IN THE CONTEXT OF AN ACUTE EARLY INFECTION; VERY RARE) OR EVEN AFTER YEARS OF SYMPTOM-FREE PERIOD. THIS THEN SPEAKS MORE FOR A MECHANICAL (ASEPTIC) LOOSENING.

Mein operiertes Bein fühlt sich länger an. Ändert sich die Beinlänge durch die OP?

ESPECIALLY DIRECTLY AFTER A HIP TEP IMPLANTATION, THE OPERATED LEG FEELS ALMOST ALWAYS 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 OPERATED SIDE. THIS FUNCTIONAL LEG LENGTH DIFFERENCE WILL SLOWLY EQUALIZE WITHIN THE FIRST 6-8 WEEKS.

In rare cases, however, an anatomical leg length difference is also a consequence of the hip surgery. During the intervention, a careful balance must be made between sufficient stability (caused by the muscle pull) of the joint and leg length. If, at the same leg length, suboptimal conditions arise during the stability test, a decent leg lengthening usually has to be accepted during the operation, as instability (popping out of the joint) represents the by far more critical consequence.

A leg length difference of a few millimeters is therefore one of the risks of a hip TEP implantation. Most of the time, however, this can be avoided.

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

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

After about 6 weeks, I will see you again in the consultation hour. I then examine the soft tissue conditions, the musculature, the mobility and possible changes in leg length. Usually, an X-ray is also taken. If there is a need, we will then arrange a renewed follow-up appointment.

SOLLTE ES IHNEN RUNDUM GUT GEHEN, SIND KEINE ROUTINEMÄßigen

Further examinations are more imperative. Regular X-ray control is also not indicated in the absence of symptoms.

BEI RESTBESCHWERDEN, Bei neu aufgetretenen Beschwerden oder unerwarteten Ereignissen dürfen Sie sich jederzeit mit MIR ODER MEINEM TEAM in Verbindung setzen!

Do I need to consider anything when visiting the dentist or undergoing other treatments because of my artificial joint?

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

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

- Colonoscopies

- Interventions on bladder and prostate

Please speak with your treating dentist or doctor!

Antibiotic prophylaxis:

- 1 Stunde vorher 1x 1g Amoxicillin p.o.

- Patients with penicillin allergy: 1x 600mg Clindamycin p.o. 1 hour before.

PREPARATION

OPERATION

INPATIENT

STAY

AFTER

TREATMENT