How much does a hip prosthesis cost?

Botkin City Hospital

Hip replacements and prices in Moscow and Prague: cost of the operation

Performing hip surgery in Moscow is much easier than in the regions: there are many institutions that perform such procedures, the state spends more money, the amounts of compensation are also higher (and directly depend on the price of the artificial hip).

Everyone chooses a clinic based on their financial capabilities. How much does a hip prosthesis cost in Moscow and where is the best place to have surgery? It is often more expensive than in Europe. This surgery is considered high-tech, which means it can't be cheap. The price range between the different establishments in the city is quite large and you need to be sure of the quality as well. However, there are a few establishments where value for money is the best, and this is complemented by a government guarantee for the services provided.

Central Research Institute of Traumatology and Orthopedics named after NN Priorov. NN Priorov

NN Priorov Central Research Institute of Traumatology and Orthopedics Central Research Institute of Traumatology and Orthopedics

The operation of tibial arthroplasty costs from 103,000 rubles. The procedure is performed by medical students and professors. The latest equipment and instruments are used. Implants of Russian and foreign production are used.

ESI' endoprostheses, which are widely used in Russia in primary and revision surgeries, were developed in the Department of Traumatology No. 2. Native MATI-MEDTECH implants made with the help of nanotechnology have been introduced. The nitride ceramic is also an invention of this device.

For a free consultation, you will need a referral from the District Health Center Medical Association (for out-of-town residents, a referral from the health center where you live) and bring a copy of your policy and passport. For a fee, you must show your passport and be put on a waiting list.

Types and differences of endoprostheses

Externally, an artificial joint is a complete replica of one's own joint, which can withstand everyday use and has the same functionality as the previously destroyed joint.

Differences and dissimilarities are distinguished according to the type of endoprosthesis:

• superficial. The head and acetabulum are replaced;
• total. Complete replacement of damaged bone and cartilage with femoral neck removal.

Example of a superficial Zimmer implant.

The implants are differentiated according to their anchoring method:

• Fixation without medical cement. Used in young patients with no signs of osteoporosis. If the bone density is good, they grow into the prosthesis and fix it. A titanium alloy stem can be used for cementless fixation.
• Cemented anchorage. This technique is used in elderly patients or in patients whose bone density does not allow cementless anchorage.

Diagram of implant fixation methods.

Recently, the term 'floating implant' has become popular. It has nothing to do with total arthroplasty as it is not a prosthesis. It involves injecting a type of acid that rebuilds the connective tissue of the cartilage. Any professional will tell you that this is impossible. Under the influence of the degenerative-dystrophic process, a pathology, the joint is completely destroyed and can no longer regenerate. The only solution is surgery.

metal-polyethylene, polyethylene-ceramic, ceramic-ceramic.

Pairs of bearings should be considered. It does not make sense to choose a specific brand or put the price in the foreground, but it makes sense to consider other characteristics, since wear and tear products have a negative effect on the surrounding soft tissues and bones. Here's what you should definitely discuss with your doctor.

The hip joint: the price of a prosthesis

The cost of the endoprosthesis and the implant itself varies from one orthopedic center to another. According to statistics of 2014, the average price in Moscow ranges from 90,000 to 120,000 rubles. This price does not include hospitalization and diagnostic tests.

The price of orthopedic constructions depends on the manufacturer and the material used. Foreign companies offer implants at a price of about $1,300-2,000, while domestic implants are several times cheaper.

The quality of endoprostheses is not influenced by the price, but by the quality of the operation and subsequent rehabilitation. Even the most expensive endoprosthesis does not guarantee a therapeutic result if the procedure is not performed correctly and the recovery time is wrong.

When an operation is necessary

Indications for hip replacement are failure of conservative treatment over several months, unbearable pain, rapid progression of the disease, and severe deformation of the tibial plateau and/or the acetabulum.

A hip replacement is performed in the following cases:

• severe osteoarthritis grade 2 or 3;
• fracture of the femoral head with a high risk of fracture due to lack of blood supply to the bone;
• Aseptic necrosis of the femoral head;
• fractures of the upper femur in people over 70 years of age;
• acetabular fractures that cannot be repaired;
• Osteomyelitis of the proximal (upper) thigh bone.

Endoprosthetics are also indicated for patients whose arthrosis has led to a significant impairment of all hip functions.

What to look for in the professionalism of a specialist

When hip arthroplasty is performed by an experienced surgeon, postoperative complications are very rare and usually not due to clinical error. Each risk is calculated in advance. The surgeon not only checks the results of the diagnostic tests in advance. He talks to the patient and asks about the lifestyle he intends to lead after the operation. The patient's answers influence the choice of the endoprosthesis and help to plan the rehabilitation plan. The most important criterion for a highly qualified surgeon is the number of operations performed. Experienced surgeons perform at least 50 prostheses a year.

In Russia, a patient has to pay a minimum of RUB 70,000 and a maximum of RUB 250,000 for a hip prosthesis. The pricing also takes into account the medical equipment used during surgery and rehabilitation.

In Moscow

In Moscow, a primary total hip replacement costs an average of 170,000 rubles. The surgeries are performed in around 80 clinics and the price varies widely:

• Clinics on Clara Zetkin, Yaroslavskaya, Volgogradsky Prospekt, Staropetrovsky proezd – from 90,000 rubles;
• European Medical Center on Shepkina Street – 220 thousand rubles;
• Medis on the Akademika Anokhina – 250 thousand rubles.

The probability of increasing the above endoprosthesis costs is quite high. The price may include additional diagnostic tests and medicines prescribed to patients at the initial stage of rehabilitation.

In other Russian cities

Hip surgeries are usually performed in large regional and peripheral medical centers. These centers employ no fewer qualified surgeons and rehabilitation specialists than the centers in the capital, so the cost of hip surgery in Moscow, Novosibirsk and Krasnodar is about the same. The experience of the specialists in the clinics of the regional and peripheral centers can be even slightly higher, as they often work on a quota basis.

anesthesia

General anesthesia causes a reversible depression of the central nervous system with temporary darkening and suppression of the sensation of pain, so that absolutely nothing can be felt during the procedure. This type of anesthesia is only used in rare cases, e.g. B. if the patient is mentally unstable. Of the 100 % surgeries, only 8 to 10 % are performed under general anesthesia.

About 90% of the operations are performed under regional anesthesia. The person is conscious but can no longer feel the lower part of the body. This type of anesthesia is performed as either epidural or spinal anesthesia.

The anesthetic is injected into the epidural space of the spine via a catheter system. In spinal anesthesia, the anesthetic is injected with a thin needle into the cerebrospinal fluid in the subspinal space of the spine. Both types of regional anesthesia completely eliminate pain sensitivity in the lower limbs.

Description of the surgical procedure

Let's take a look at the classic scheme of the surgical procedure.

1. The limb undergoes liberal antiseptic treatment and compression.
2. The joint is then opened through a special access without crossing the muscles and ligaments. Minimally invasive access methods are advantageous.
3. By gently stretching the soft tissues and fixing them with a clamp, the specialist opens the joint capsule and removes it.
4. The femoral head is then resected at an appropriate angle, and when the procedure is complete, the acetabulum is trimmed of damaged cartilage.
5. A prosthetic socket (metal or ceramic) is placed in the cartilage-free pelvic cavity. Their dimensions are perfectly adapted to the natural bone defect. A spacer made of polyethylene is inserted into the fitted socket. In the case of partial dentures, the socket is not implanted.
6. A regular channel is then drilled into the resected femur and a metal or ceramic endoprosthesis shaft is inserted, with a ball (artificial head) made of the same material attached to the upper end.
7. The head of the implant is placed in the socket. The implanted joint system is tested.
8. Once the surgeon is satisfied that the new joint is working properly, he completes the procedure by irrigating the surgical field, inserting a drain, and closing the wound. Finally, the operated leg is fixed in a favorable position with an elastic bandage.

What is the cost of a knee endoprosthesis?

Even 'neglected' joint problems can be treated at home! Just remember to swing with this remedy once a day.

High-tech knee endoprostheses are more expensive. Implants from foreign companies are more expensive than domestic ones. The prices of modern orthopedic products depend on the manufacturer, the type of construction, the materials of the acetabular cup and stem, the complexity of the mechanism and the method of attachment (with or without bone cement). The cost of a knee arthroplasty in Moscow ranges from 130,000 to 150,000 rubles. A lot depends on the manufacturer. Some set the price at 60-80 thousand rubles, while others increase it to 200-300 thousand rubles.

Zimmer is one of the leading manufacturers of endoprostheses.

Zimmer offers a wide range of high-quality prostheses for Russians, and the price of the products reflects their high quality. The company is one of the five largest manufacturers of endoprostheses in the world. The products are fully compatible with living tissue and well anchored in the body, offering the largest flexion amplitude of up to 155 degrees. They can be used minimally invasively. You get the natural structure of the knee perfectly. The stable function of this joint is guaranteed for at least 10 years. If the implant is chosen correctly, its lifespan will be longer.

The Genesis 2 complex, the price of which ranges from RUB 100,000 to 160,000, is highly appreciated and recognized by surgeons. It enables the surgeon to make full use of his experience and craftsmanship.

Smith & Nephew is also a major player in the joint implant market.

Zimmer and Genesis endoprostheses are almost identical in appearance and function. They differ in the way they are fastened in the limb, the degree of wear, the type of material and coating, and the diameter of the thread for screwing in. If the surgeon is experienced, he will choose the right endoprosthesis for his patient.

How to benefit from a joint replacement referral

Some hospitals give their patients a limit for joint replacement surgery. X-rays and other necessary documents must be presented to the medical institution. On this basis, a protocol is drawn up and sent to the Ministry of Health. A health voucher will be issued there. The patient's data will be included in the general plan for surgical interventions in the city. Then you have to wait several months for your turn.

If the patient has a limitation, an endoprosthesis, which is available in the clinic, is used. These designs are not always made by leading companies.

The good news is that almost all modern endoprostheses are of high quality. The success of the operation depends half on the skill of the surgeon. If done correctly, even the simplest implant will last for many years.

When should the clinic refuse the procedure?

If there is a risk of the prosthesis being rejected or the patient's condition deteriorating, the orthopedic surgeon and the hospital may refuse to carry out the endoprosthesis. This should not be a reason to look for another doctor to perform the procedure. It is better to try to reduce the risks involved.

• aggravation of chronic diseases;
• Poor heart and kidney function;
• presence of blood clots;
• low hemoglobin and increased white blood cell count;
• existing tissue inflammation;
• the presence of acute respiratory infections and other colds.

Many of these causes can be ruled out. Then the question of a possible arthroplasty can be asked again. However, if you want to solve your problems qualitatively and permanently, contact us and we will explain in detail what the Czech Republic has to offer for your recovery.

The price of prosthetics in Russia and abroad

Patients whose means are not limited prefer to be treated in clinics near and far abroad. They believe that prosthetics in the Russian Federation is not yet sufficiently developed, the technological base is weaker, and rehabilitation as the basis for successful recovery is not yet well promoted.

• Where the medical facility is located;
• The technical equipment of the clinic, its modernity;
• the level of qualifications of the medical staff;
• which company uses the prosthesis, the brand name of the company;
• therapeutic measures after implantation – quality of rehabilitation, professionalism of rehabilitation therapists.

The cost of a prosthesis operation is between 80,000 and 120,000. Rubles for a superficial type implant and a little cheaper for a total implant. This amount does not include the stay in the center and subsequent rehabilitation. Additional facilities come at a cost. The total cost, including hip replacement, prosthesis, hospitalization and the first period of rehabilitation can range from 250,000 to 600,000 rubles.

Prostheses on a quota basis

If the financial resources are available, foreign medical centers are preferred. Clinics in Israel, for example, are known for their high orthopedic technology and expertise. Endoprosthetics is considered the most effective here, and the risk of side effects is practically eliminated. The basis of surgery in Israel is minimal invasiveness, which makes the intervention as economical as possible. Again, robotic systems are used where the risk of infection or bleeding is less than 1 %. The success rate of the intervention is 98.5 %.

Not to be forgotten are the diagnostic measures, which are a general requirement. Without tests, the patient cannot be operated on. There are additional costs that range from $1,000 to $4,000.

Comparison of prices for arthroplasty in other countries

country	Proceedings	Costs
Czech Republic	Hip replacement with global manufacturer prosthesis including 10 day stay and initial rehabilitation	From €10,000 to €12,000
Germany	Private. Prosthesis without a long stay and rehabilitation course	From 18,000 euros
	public hospital. Surgery only, no rehabilitation. Inpatient stay of up to 5 days	From 16,000 euros
Israel	private hospital. Adaptation of dentures without additional services	Starting at $23,000
	Public. Operational performance excluding extended hospitalization and rehabilitation services	From 22 thousand USD.

Some patients can undergo endoprosthesis on a quota basis - payment is made at public expense. This service is provided by government and some private hospitals. To take advantage of this opportunity, you must go to the health center in your place of residence, collect the documents and submit them to the health department.

Once the application is successful, a voucher will be issued. The waiting time can be six months or more and is kept on a waiting list. Implants are not expensive; You will only be provided with what is currently available.

Indications and contraindications

Indications for surgery include femoral neck fractures, femoral head fractures with impaired femoral blood supply, displaced hip joint fractures that cannot be restored to their normal anatomical shape, necrosis of the femoral head, arthritis, coxarthrosis, destructive processes and pathological fractures in the proximal thigh segments. If there is a local infection (pustular rash, tooth decay, etc.), surgery is not performed. Joint replacement is not recommended for young patients when organ-sparing treatment is possible.

• Cement-free endoprosthesis fixation (hip socket and femur are pressed in, the bones grow into the metal of the prosthesis).
• Cemented arthroplasty fixation (acetabulum and femur are cemented, allowing early limb loading).
• Cementless acetabulum fixation in combination with femoral cementation.

Cementless fixation is performed on young and middle-aged patients. A combined technique (cemented femur fixation without acetabular cup) is indicated in elderly, active patients. In older, sedentary patients with concomitant pathology and a history of poor mobility, cemented fixation of the prosthesis is indicated.

methodology

The operation is performed under general anesthesia, usually in a supine position, more rarely in a lateral position. The hip joint is opened via a lateral approach (from proximal to the acetabulum to distal; muscles and fascia are pulled apart), an anterolateral approach (L-shaped incision from the hip joint to the abdominal wall), or a transmembrane approach. The hip joint capsule is severed and its intracranial and abdominal portions are excised.

The femoral head is removed, the acetabulum scraped, and the cartilage removed. With cemented prosthesis fixation, the acetabular cup is cemented and the proximal endoprosthesis is inserted. The distal part of the prosthesis is then tried in place and the range of motion checked. In the event of instability or restricted movement, the prosthetic head is replaced with another, better sized prosthesis. If necessary, the medullary canal is cemented, the prosthesis placed, the prosthetic head placed in the acetabulum and the remaining cement removed. The wound is stitched up layer by layer. Subconjunctival and subcutaneous drains are placed. The skin is sewn up with sutures.

postoperative period

Recovery is the most important phase of the operation. surgery. The success of the entire procedure depends on carefully following all recommendations. The most important rules include:

• Getting up and getting into bed properly.
• Wearing compression garments and stockings to reduce swelling and prevent thrombosis.
• Use of crutches to assist with walking.
• Carry out all prescribed physiotherapeutic treatments.
• Participation in the physiotherapy treatments necessary for the development of the limbs and the restoration of joint function.

Inpatient rehabilitation

On the first day after fitting the prosthesis, the patient can be active at rest. On the second day, seated, careful static exercises and breathing exercises can be undertaken. From the third day you can walk with support. The sutures are removed before discharge, that is, about the tenth day.

recovery at home

After about the tenth or twelfth day, you can return home. rehabilitation Further treatment is necessary and the doctor's instructions must be strictly followed. Rehabilitation can also be carried out in a rehabilitation center under the supervision of a rehabilitation therapist. The mobility of the operated leg will be restricted for up to eight weeks. Additional support is required during this time.

You can start with sensitive sporting activities. These include therapeutic physical training exercises, exercises on simulators. Running, jumping, active movement games are not allowed. Cross-legged sitting, deep squats and quick movements are also prohibited.

After the operation, the function of the joint is usually fully restored and no disability card is required. If your job is physically demanding, you may be eligible for a Group 3 disability.

Where to have hip surgery in Moscow

The examination and operation to replace a worn orthosis can be carried out in a modern clinic NCC2 (CENTRAL CLINICAL HOSPITAL) in Moscow. On the site you can find useful information, read opinions patients and prices for Services. A modern scientific and technical base allows us to provide quality medical services with a guarantee of patient safety. Appointments can be made by phone or via the website.

Unipolar Hip Arthroplasty (No Consumables Cost)	30000 rub.
Revision hip prosthesis (without costs for consumables)	60000 rub.
Bipolar Hip Arthroplasty (Without Consumables Cost)	30000 rub.
Hip replacements due to acetabular defects (excluding consumables costs)	30000 rubles

• Different leg length after a hip prosthesis.
• Leg prosthesis below the knee.
• cost of the prosthetic leg.
• How much does a knee replacement cost?.
• How much does a prosthetic foot cost?.
• How much does a shoulder prosthesis cost?.
• How much does shoulder surgery cost?.
• How much does knee surgery cost?.