When pain dominates everyday life

Every day, people in Germany wake up with stabbing pain in their hip or knee. Walks become torture, stairs an obstacle, and even sitting or lying down can become unbearable. The cause: a severely damaged joint – usually due to osteoarthritis. The solution: a hip or knee replacement .

But despite modern medicine and a clear diagnosis, many affected patients increasingly experience the same frustrating scenario: long waits for a surgery appointment. In some regions of Germany, patients wait several months or even a year until the desired joint replacement is finally implanted. This often means months of pain, loss of mobility, isolation, and often even inability to work.

In this comprehensive article we show:

• Why the waiting time for a hip or knee prosthesis in public clinics is getting longer and longer,
• Why even severely affected people are no longer given priority treatment,
• What urgent indications exist in endoprosthetics despite “plannable operations”,
• And most importantly: How you can get a surgery appointment faster – even if you have statutory insurance!

We will present possible solutions, show you alternative care models and give you concrete tips on how you can have surgery earlier – for example, through innovative ways such as covering individual costs in private clinics , such as the curaparc clinic in Mainz or the LILIUM clinic in Wiesbaden , in close cooperation with ENDOPROTHETICUM Rhein-Main .

1. The reality of waiting times – A system increasingly at its limits

1.1 Hip and knee prostheses: Standardized high-performance medicine

In Germany, over 400,000 artificial joints implanted annually, including approximately 250,000 hip prostheses and approximately 150,000 knee prostheses . The operations are considered extremely successful, with excellent long-term results – provided they are performed at the right time. But that's precisely the problem today: The right time is often long past the scheduled surgery date.

1.2 Overburdened clinics – the reasons for long waiting times

Many patients rightly ask themselves: Why is it taking so long to get my hip or knee replacement?

The reasons are complex:

• Staff shortages : Nurses and operating room staff are chronically understaffed. Many surgeries have to be postponed due to a lack of teams.
• Bed closures : Ward beds remain empty because there is a lack of nursing staff – not because there are no patients.
• Capacity bottlenecks : Public hospitals are operating at their limits. Every additional planned operation has to be squeezed in between emergency cases and tumor surgery.
• Prioritization of emergencies : Severely injured or acutely ill people are rightly given priority. However, elective, or planned, procedures such as hip or knee replacements suffer as a result.

1.3 Why endoprosthetics is no longer a priority

In the past, it was common for severely disabled people with joint wear and tear to undergo surgery relatively quickly—especially if they were in severe pain or had difficulty walking. Today, things are different:

• Elective interventions are systematically postponed.
• Even severely affected people with massive osteoarthritis have to wait weeks or months for a preliminary consultation before they are then put off for another few months until an operation date.
• The result: chronic pain, increased need for medication, psychological stress – and an increased risk of poorer rehabilitation after surgery.

1.4 There are also urgent indications for hip and knee prostheses

It's important to note that even though these are formally "plannable procedures," there are situations in arthroplasty that require urgent treatment . For example:

• Massive restriction of movement, e.g. patients who can no longer leave the house ,
• Pain at rest despite strong painkillers,
• Unstable joints, e.g. after joint dislocations (luxations),
• Incapacity to work with imminent job loss,
• Progressive bone loss (osteolysis),
• Joint misalignments with subsequent damage to other structures.

In such cases, rapid surgical treatment is medically sensible and ethically necessary – but the system is not designed to allow this.

1.5 Psychological consequences of long waiting times

Long waiting times are not only a medical challenge, but also a human drama:

• Depression and lack of motivation increase,
• Many patients feel abandoned,
• Chronic pain affects sleep patterns, social relationships, and overall quality of life.

Rapid action is therefore urgently needed not only from a medical but also from a human perspective.

1.6 Large regional differences in waiting times

Particularly problematic is that waiting times vary dramatically depending on the federal state or region. In some large city hospitals, patients with statutory insurance can wait up to 12 months for a knee replacement. In rural areas, however, the process can be shorter – if operations are performed at all. Many small hospitals are closing entire departments because arthroplasty is no longer profitable.

1.7 What do patients say? – Typical testimonials

"I could barely walk, but they told me I would have to wait at least six months. The pain kept getting worse."
– Mr. L., 68 years old, hip osteoarthritis

"I was sent from clinic to clinic. There were waiting lists everywhere. Eventually, I went to a private clinic – and had my surgery three weeks later."
– Mrs. T., 62, gonarthrosis

These statements reflect what many people experience: the system is increasingly failing when it comes to providing timely care for people with chronic pain.

2. Ways to a faster surgery appointment – your options

2.1 Fundamentally: Proactive instead of passive

Many patients endure long waiting times because they feel at the mercy of the structures. However, those who take action can save time—sometimes even months! Importantly,

• Obtain information early,
• Check alternatives,
• Actively involve your own health insurance company,
• Talk to your family doctor or orthopedist,
• Contact specialized clinics directly – including private clinics.

2.2 Tip 1: Get multiple opinions

Especially in joint replacement surgery, it's helpful multiple medical assessments . Why?

• The assessment of urgency can vary.
• Some clinics recognize urgent indications more quickly and prioritize them.
• Alternative proposals such as partial prostheses (e.g. sled prostheses) can be implemented more quickly.

Ask specifically for a second opinion from an experienced endoprosthetics specialist .

2.3 Tip 2: Search nationwide – also in private clinics

Many patients only look for a surgery appointment within a 20-30 km radius. However, it's worth researching regionally or even nationwide , especially if the level of suffering is severe. Some specialized clinics with high surgical capacity also offer prompt treatment for those with statutory insurance – for example, through:

• Reimbursement of costs (according to Section 13 of the Social Code Book V)
• Individual decisions by the health insurance company
• Cooperation agreements with legally approved private clinics

2.4 Tip 3: Use the option of individual cost coverage

A real insider tip that often goes unreported is the individual cost coverage for those with statutory insurance. This allows treatment in a private clinic – at the expense of the statutory health insurance provider .

How does it work?

1. You have a medically justifiable, urgent indication (e.g. severe disability, inability to work).
2. no immediate surgery appointments available in your region (e.g., not for another 6 months).
3. You find a clinic (even a private clinic ) that could operate at short notice.
4. Your treating physician will write a statement explaining why an early operation is medically necessary.
5. You submit an application to your health insurance company for reimbursement of individual costs in accordance with Section 13 Paragraph 2 of the Social Code Book V.
6. With a little insistence and patience, many health insurance companies will approve this option – especially if waiting times elsewhere are unreasonable .

2.5 Why does this work so well? – The example of curaparc-clinic and LILIUM Klinik

The curaparc clinic in Mainz and the LILIUM clinic in Wiesbaden are two examples of state-of-the-art private clinics that regularly operate on patients with statutory health insurance on a cost-sharing basis – with great success:

• Short waiting times : Surgery appointments often within 2–4 weeks,
• Individual support : by specialists, e.g. Prof. Dr. Karl Philipp Kutzner,
• Modern technology : digital surgical planning, navigated implantation, minimally invasive procedures,
• Smooth cooperation with health insurance companies : The clinics provide support with the application process.

👉 Patients with a clear indication and severe symptoms often receive their hip or knee prosthesis more quickly – without having to wait months.

2.6 The right partner: The Endoprotheticum Rhein-Main

The ENDOPROTHETICUM Rhein-Main, based in Mainz, is one of the most renowned addresses for artificial joints in Germany – under the direction of Prof. Dr. Karl Philipp Kutzner , one of the leading specialists for hip and knee prosthetics.

What distinguishes the endoprosthetic:

• Absolute specialization in endoprosthetics – no distraction from other disciplines,
• Personal consultation with detailed diagnostics,
• Concrete support in organizing a quick surgery appointment ,
• Cooperation with several clinics – including the curaparc clinic and the LILIUM clinic,
• Individual assistance in covering individual costs , including the formulation of medical justifications and coordination with health insurance companies.

Patients regularly report that the Endoprotheticum team was able to operate on them several months faster than would have been possible in the public system.

2.7 The most important points in summary: Your roadmap to a faster surgery appointment

✅ Act early – not only in the late stages of osteoarthritis
✅ Obtain several opinions – including specialists in endoprosthetics
✅ Compare clinics – also nationwide and in the private sector
✅ Check individual cost coverage – ideally with medical support
✅ Contact Endoprotheticum Rhein-Main – advice & help with scheduling an appointment

3. Why the system fails – Structural causes of long waiting times

3.1 Health economics meets reality

The German healthcare system is internationally recognized as high-quality, modern, and easily accessible. But this reputation is crumbling – especially when it comes to elective surgeries such as hip or knee replacements . The reason: Economic pressure and structural misincentives have thrown the system into disarray.

3.2 Staff shortages – the limiting factor

A key problem: There is a lack of qualified staff everywhere – especially in nursing and operating room areas.

• More and more professionals are leaving clinical work,
• There are no offspring,
• Services are merged,
• Operations have to be cancelled because no staff is available,
• Entire wards are being closed – not because of a lack of demand, but because of a lack of staff .

What this means in concrete terms is that even if a patient urgently needs hip prosthesis there is simply no one who can operate on it .

3.3 The prioritization crisis: emergency beats pain patient

In German hospitals, emergencies take priority . This is medically and ethically correct—but it has fatal consequences for chronically ill people.

• A patient with polytrauma, stroke or tumor will be operated on at any time.
• A patient with months of pain at rest and end-stage osteoarthritis is repeatedly pushed back .
• Even if the affected person can hardly walk or is unable to work .

As a result, hip and knee prostheses become low-priority procedures – with dramatic consequences.

3.4 Bureaucracy as a brake

Another factor: the increasing bureaucracy in the healthcare system . Doctors and nurses often spend more time on documentation than on patients . Hospitals must perform complex coding and billing processes instead of focusing on efficient processes.

Consequences:

• Less time for medical planning,
• Less flexibility in scheduling appointments,
• Delays in surgical planning.

3.5 Consequences for endoprosthetics: The "displacement effect"

Endoprosthetics – the insertion of artificial hip or knee joints – is particularly affected by these developments:

• It is labor and personnel intensive ,
• It requires well-coordinated teams, specially trained surgeons, postoperative monitoring and physiotherapy,
• It is easy to plan for, but not life-threateningly acute .

That is why it is repeatedly pushed aside as soon as emergencies or economically more “lucrative” interventions intervene.

This so-called displacement effect leads to patients with osteoarthritis waiting for months for a prosthesis – even though the procedure would have been medically indicated long ago.

3.6 Statutory health insurance makes access even more difficult

There are also systemic hurdles outside of the clinics:

• Orthopaedic specialists with statutory health insurance approval often have long waiting times for new patients ,
• Appointments for preliminary consultations or second opinions are difficult to obtain,
• In some regions, there are too few practicing orthopedic surgeons, which leads to regional undersupply.

Patients end up on hold before a surgery appointment can even be discussed.

3.7 Private alternatives as a lifeline

Given this backdrop, it's not surprising that more and more patients are looking for alternatives outside the public system . Private clinics do indeed offer an important complement – especially for:

• People with high levels of suffering,
• Working people who cannot be absent for months,
• Self-employed or caring relatives,
• Older people with fear of deteriorating mobility.

The principle of individual cost coverage (see Part 2) makes this private care possible for those with statutory insurance – and could become an important bridge until the public system is reformed.

4. Conclusion, instructions & your path to faster hip or knee replacement

4.1 Summary – The most important points at a glance

🔹 The waiting time for a hip or knee replacement is several months in many regions – sometimes over a year.
🔹 Causes: Staff shortages, prioritization of emergencies, the DRG system, and capacity bottlenecks in public hospitals.
🔹 Despite severe pain and limited mobility , endoprosthesis patients are rarely prioritized .
🔹 However, there are solutions for faster surgery appointments , particularly through private clinics that cover individual costs .
🔹 Facilities such as the curaparc clinic Mainz , the LILIUM Clinic Wiesbaden , and the ENDOPROTHETICUM Rhein-Main provide effective support to those affected – even those with statutory insurance.

4.2 Step-by-step instructions: How to get to surgery faster

✅ Step 1: Secure diagnosis

Have your orthopedic surgeon confirm hip or knee replacement

✅ Step 2: Document your complaints

Keep a pain diary and document:

• Resting pain,
• mobility restrictions,
• Medicines,
• Restrictions in everyday and professional life.

This information will later help to provide medical justification for individual cost coverage.

✅ Step 3: Contact ENDOPROTHETICUM Rhein-Main

The specialists there will review your documents, provide you with individual advice, and actively support you in finding a quick surgery appointment —for example, at the curaparc clinic or LILIUM Clinic.

📍 Website: www.endoprotheticum.de
📍 Location : Mainz, Rhine-Main area
📍 Director: Prof. Dr. Karl Philipp Kutzner

✅ Step 4: Apply for reimbursement of individual costs

With the support of Endoprotheticum and your doctor, you submit the application to your health insurance company in accordance with Section 13 Paragraph 2 of the Social Code Book V – including all documents, justifications and evidence of long waiting times.

✅ Step 5: Book an appointment & have the surgery performed

As soon as the cost approval is received (usually after 2-4 weeks), your operation can take place in a partner clinic – often within a few days to a few weeks .

4.4 Conclusion: Those who are informed are often treated more quickly

The supply of artificial joints is in short supply – but there are alternatives . Those who take action, are well prepared, and receive appropriate medical support have a real chance of a faster surgery appointment – even if they have statutory insurance.

The team at Endoprotheticum Rhein-Main knows the ways, the procedures, and what is important in individual decisions .

Are you experiencing severe pain and a clear indication for surgery?
Don't wait passively. Get advice – and act.



4.5 Call to Action – We are happy to help you!

Do you need a hip or knee replacement soon?

📞 Arrange a consultation now with the Endoprotheticum Rhein-Main
🌐 www.endoprotheticum.de
📍 Practice of Prof. Dr. Karl Philipp Kutzner, Mainz
💬 We support you every step of the way – from diagnosis to surgery.