THE MANUAL

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CAN I, AS A PUPIL WITH STATUTORY INSURED, COME TO THE SPECIALIST PRACTICE IN MAINZ?

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

IF YOU ARE STATUTORY INSURED, I WILL HAVE TO CHARGE YOU THE COSTS FOR A PRIVATE MEDICAL CONSULTATION AND EXAMINATION DURING THE CONSULTATION AS A "SELF-PAYER", AS OUR CONCEPT FUNCTIONS WITHOUT OUR OWN CARE OFFICE.

HOWEVER, YOU DO NOT NEED TO FEAR HIGH COSTS! (SEE ALSO TREATMENT COSTS ).

I can bill a surgical procedure completely normally through the statutory insurance (e.g., at the AUKAMM CLINIC WIESBADEN )!

CAN I, AS A PUPIL WITH STATUTORY INSURED, HAVE SURGERY AT THE LILIUM CLINIC (PRIVATE CLINIC) IN WIESBADEN?

YES! In many cases, so-called "individual cost coverage" is possible upon request. Most statutory health insurance companies approve this cost coverage. However, this requires that you are medically suitable to have surgery in a small private clinic.

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

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

CAN I ARRIVE BY PUBLIC TRANSPORT?

YES! THE MAINZ-GONSENHEIM TRAIN STATION IS WITHIN A FIRST WALK'S DISTANCE.

Bus line 78 also stops at both "GONSBERG-CAMPUS" and "DER OBERBRÜCKE" (1-2 minutes walk to the Endoprostheticum).

WHERE DOES AFTER SURGERY TAKE PLACE?

For private patients, follow-up treatment takes place at the practice in Mainz-Gonsenheim (initially Mainz-Finthen). If you have statutory health insurance, you are also very welcome to come there for your follow-up appointment. As described above, I will also have to issue a small invoice here, as I do not have a health insurance accreditation for the practice in Mainz.

For aftercare, there are collaborations with local general practitioners for the purpose of issuing prescriptions (physiotherapy; lymphatic drainage, etc.)

When can I walk normally again AFTER THE SURGERY?

You can usually put full weight on the operated leg immediately after the operation. To avoid any potential peak or impact stress from tripping or falling, please use forearm crutches for the first few weeks. The duration varies from person to person, but is generally between 2 and 6 weeks.

DO I NEED TO GO TO INPATIENT REHABILITATION?

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

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

Should you be living alone or find suboptimal conditions in your living environment, 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 REHABILITATION MEASURES (OUTPATIENT OR INPATIENT)!

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

Especially in the first few weeks after hip replacement surgery, there is a general risk that the joint could dislocate due to rash, impulsive movements. However, this is extremely rare nowadays. Because the minimally invasive technique does not damage the muscles, the risk of dislocation has been significantly reduced.

Hip joint function after surgery varies greatly from person to person. It is not uncommon for patients to be able to move without problems quite early on, and often even beyond 90° of bending. A general prohibition of such movement, therefore, does not reflect the developments of recent years.

You should start with slow, careful movements and experiment to find out what level of mobility you can manage with minimal discomfort. Do not force the movement if you experience pain or resistance!

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

WHEN CAN I DRIVE AGAIN?

Regardless of medical criteria, the legal aspect is particularly crucial in this matter. Generally speaking, if you can walk without crutches and without restrictions, you will likely be able to drive again. However, should an accident occur in the early stages after surgery, your car insurance company may contest coverage of the costs. Six weeks is often cited as a good guideline for when driving is typically possible again.

When can I go back to work?

This depends on your occupation. A purely sedentary job, for example, working from home, could theoretically be resumed after just 2 or 3 weeks. However, we recommend taking a break from work for the entire duration of your rehabilitation. Jobs that involve alternating between sitting and standing can be resumed after approximately 6 weeks, and jobs that require mostly standing after approximately 8 weeks. Work that regularly involves climbing ladders or scaffolding, or that requires a stooped posture (most manual labor jobs), can usually be performed safely again after about 3 months.

What sports can I do with an artificial joint?

All sports involving smooth and controlled movements are recommended:

- Hike

- Water aerobics, aqua walking, aqua cycling

- Ride a bike

- Swimming (all strokes)

- Cross-country skiing

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

It's difficult to give advice regarding sports like tennis or skiing. If you've never skied or snowboarded before, you shouldn't try to learn these sports with an artificial joint. However, enthusiastic athletes who have mastered their sport technically for decades can resume their beloved sport after a thorough and intensive muscle-building program (at the earliest after 6-12 months) and a period of practice.

Regular exercise is highly beneficial, as it trains muscles, improves breathing, and strengthens the cardiovascular system. Exercise improves coordination, reduces the risk of falls, and has a positive effect on blood sugar and blood lipids. Furthermore, exercising in the fresh air is good for the mind and helps prevent obesity. With appropriate physical activity, you don't need to worry about premature wear and tear on your joint prosthesis.

How long does a prosthesis last?

The main reason for loosening or late complications of a prosthesis today is material wear and tear. The abrasion of metal or plastic particles leads to a chronic inflammatory response, which can ultimately result in loosening of the implant components. Implants placed 25 years ago typically consisted of a metal component and a soft polyethylene component. The combination of metal and soft polyethylene results in a limited lifespan (approximately 15-20 years). However, since entirely different materials are used today, such as ceramics and highly cross-linked, hard polyethylene, a significantly longer lifespan can theoretically and experimentally be assumed for prostheses implanted today. Unfortunately, it is currently not practically possible to jump that far into the future to prove these theoretical assumptions.

In rare cases of early complications, the lifespan of the prosthesis can be significantly reduced. Unfortunately, endoprosthetic surgery also carries corresponding risks.

How will I notice a loosening?

Loosening of implants is usually accompanied by pain symptoms under stress. These can occur either early (e.g., as part of an acute early infection; very rare) or even after years without symptoms. This then suggests a mechanical (aseptic) loosening.

My operated leg feels longer. Does leg length change as a result of the surgery?

Especially immediately after a hip replacement, the operated leg almost always feels somewhat longer. This is due to a so-called functional leg length discrepancy, caused by a contracture of the muscle groups around the pelvis on the surgical side. However, this functional leg length discrepancy will gradually equalize within the first 6-8 weeks.

In rare cases, however, an anatomical leg length discrepancy can also result from hip surgery. During the procedure, a careful balance must be struck between sufficient stability (due to muscle tension) of the joint and the leg length. If, despite the same leg length, the stability assessment reveals suboptimal conditions, a slight leg lengthening must usually be accepted during the operation, as instability (dislocation of the joint) represents a far more critical consequence.

A leg length difference of a few millimeters is therefore one of the risks of hip replacement surgery. In most cases, however, this can be avoided.

Leg length differences are only to be expected in rare cases (due to malpositions) during knee replacement surgery.

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

I will see you again in about six weeks for an appointment. I will then examine your soft tissues, muscles, range of motion, and any changes in leg length. An X-ray is usually taken as well. If necessary, we will schedule a follow-up appointment.

IF YOU ARE IN GOOD ALL AROUND, NO ROUTINE ARE NECESSARY

Follow-up examinations are no longer absolutely necessary. Regular X-ray check-ups are also not indicated if there are no symptoms.

FOR REMAINING COMPLAINTS, In case of newly occurring complaints or unexpected events, you may contact ME OR MY TEAM at any time!

Do I need to take any precautions at the dentist or during 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 surgery:

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

- Colonoscopies

- Procedures on the bladder and prostate

Please speak to your dentist or doctor!

Antibiotic prophylaxis:

- 1 hour beforehand, 1 x 1g Amoxicillin orally.

- Patients with penicillin allergy: 1 x 600mg clindamycin 1 hour beforehand.

PREPARATION

OPERATION

INPATIENT

STAY

AFTER

TREATMENT