Provision of a hip replacement quota. Deforming coxarthrosis. Free treatment in Moscow hospitals under the compulsory medical insurance policy Make endoprosthetics under the compulsory medical insurance policy

In 2015, there were changes in the legislation of the Russian Federation. The result was the removal from the list of rehabilitation funds provided at the expense of the federal budget. This means that quota hip replacement is now available to fewer citizens. Most patients are required to pay for the prosthesis. The medical institution will provide the rest of the services free of charge.

Let's figure out who is entitled to quotas in 2019, how to get them.

What is a hip replacement quota

Conditions for inclusion in the state support program

To receive government support, you need to collect papers proving the need to provide a quota.

Therefore, a citizen needs to have in his hands such certificates as:

compulsory health insurance policy (mandatory condition);
documents proving a visit to a doctor, describing previous treatment;
certificates and extracts demonstrating the course of the disease.

The above papers are drawn up by the medical institution that decides on quotas. However, the process of documenting the disease should be monitored so as not to face the elementary carelessness of doctors.

Apply to the hospital for a quota even if you do not fit the above categories. The legislator is constantly improving the regulatory framework. Sometimes the changes expand the list of beneficiaries.

Algorithm for assigning a quota

Currently, the decision on state support for the patient is made in the medical institution, which is engaged in his constant service. This means that the citizen should go to the hospital where he is being treated. In this institution, a special commission has been created that deals with the consideration of quotas.

The Commission considers the following circumstances:

results of a complete examination;
conclusions of orthopedic specialists;
medical history;
X-rays, analyzes and more.

The decision of the commission is formalized by the protocol of the quota decision. This document is handed over to the patient. It is the key to getting free help.

If a person refuses to be examined, which takes enough time, then he will be denied a quota.

Do you need on this issue? and our lawyers will contact you shortly.

Obtaining a quota coupon

The next step is to contact a government agency. To do this, you need to collect the following papers:

Copies:
- passports;
- Compulsory medical insurance policy;
- pension insurance certificate;
- disability document (if any);
- conclusions on the need for surgical intervention from the clinic (and the original too). This paper contains data:
  - about the state of health;
  - diagnostics;
  - about the measures taken for the purpose of diagnostics.
Originals:
- directions given by the observing orthopedist;
- quota decision protocol;
- written statement.

All of the above papers should be taken to the health department. It is advisable to ask the clinic at what level this issue is being resolved now.

The patient's confidant has the right to apply to the state agency with an application.

Timing when assigning a quota

The state agency considers the application no more than ten working days.
After making a positive decision, the package of documents is sent to the clinic, where the manipulation will be carried out.
The quota committee of this institution appoints the date of hospitalization and informs the health department.
An employee of a government agency informs the applicant about the decision.

Hospitalization, as a rule, has to wait for a long time: from 3 months to a year (or more).

About the individual rehabilitation program

Patients are often not satisfied with the length of the waiting time.

There is another legal method to get government support for prosthetics. But for its implementation, a serious amount of money is needed.

The essence of an individual rehabilitation program

The meaning of the event is that the citizen pays the clinic for the costs of manipulation and treatment from his own savings.
After completing all the necessary activities, the money spent is paid to him by the budget.

The benefits in this case are received by all sides of the process, they are as follows:

There is no need to wait for the government agency to pay for the purchase of the prosthesis.
The clinic has the necessary funds to purchase all materials and medicines.
Dentures are purchased only from the most trusted suppliers and are of high quality.
The budget pays only for the assistance provided, so to speak, after the services performed.

There is only one drawback of the program: a significant amount is required, which will be returned to the citizen after a certain time. The cost of a hip joint prosthesis varies from 120 to 190 thousand rubles. It depends on the design and material of manufacture.

Charitable organizations can fund the purchase of a hip prosthesis.

Who is provided with an individual program

Payment for the prosthesis at the expense of the budget is made in such cases:

if the person is disabled for the disease in question;
the right to receive a prosthesis was documented until 01/01/2015.
others (individually).

Citizens who have received the right to a quota before 01.01.2015 are allocated a fixed amount. It is 160 thousand rubles. Additional expenses must be repaid from your own funds.

Dear Readers!

We describe typical ways of solving legal issues, but each case is unique and requires individual legal assistance.

For a prompt solution to your problem, we recommend that you contact qualified lawyers of our website.

Last changes

There is currently legal confusion.

On the one hand, by order of the Government of the Russian Federation No. 1776-r dated 01.01.2015 (clause 8), prostheses are excluded from the list of funds allocated to disabled people for public money.
On the other hand, the moment of payment for surgery under the compulsory insurance policy has not been regulated. That is, citizens and clinic managers are faced with bureaucratic funding problems. Their resolution takes a lot of precious time.
The individual rehabilitation program is approved taking into account the medical and social expertise. And when it passes, it is likely that it will be included in the prosthetics program at the expense of the state.

Our experts monitor all changes in legislation in order to provide you with reliable information.

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Hip replacement quota

February 23, 2017, 01:45 AM Mar 3, 2019 13:50

Endoprosthetics of joints, as well as other reconstructive orthopedic operations are high-tech medical care.

High-tech medical care is medical care carried out using complex and unique medical technologies based on modern achievements of science and technology, by highly qualified medical personnel.

These types of medical care are provided free of charge in the manner determined by the order of the Ministry of Health and Social Development of the Russian Federation "On the provision of high-tech medical care at the expense of the federal budget in federal medical institutions and medical institutions under the jurisdiction of the constituent entities. Russian Federation and municipalities ”.

According to the Order, residents of the city of Moscow with permanent registration at the place of residence and having a policy of compulsory medical insurance can receive high-tech medical care under a quota in City Clinical Hospital No. 67.

You can familiarize yourself with the regulatory documents in detail on the website of the Priority National Project "Health".

In order to be able to perform endoprosthetics surgery under the program of providing high-tech medical care in our clinic, you must:

1. Apply to the city polyclinic at the place of residence and get a referral for consultation at City Clinical Hospital No. 67.

2. In the direction of the city polyclinic, come for a consultation at the Consultative and Diagnostic Center of the City Clinical Hospital No. 67 (see).

3. After consulting an orthopedic doctor when establishing indications for endoprosthetics, you will be entered into the register of those in need of surgery. You should leave us information on the method of contacting you - indicate several phone numbers by which you can be contacted.

4. As your turn approaches, an authorized employee of the orthopedic department of City Clinical Hospital No. 67 will contact you and inform you of the date when you should appear for hospitalization at the clinic. Your personal visit to the Department of Health is not necessary, as your turn approaches, we will arrange everything ourselves Required documents.

5. Before hospitalization, you need to undergo an examination in accordance with the program of the required preoperative examination given to you (you can familiarize yourself with it here).

6. The examination is carried out in your local polyclinic or any other medical institution on an outpatient basis.

7. Hospitalization is carried out strictly at the appointed time, subject to availability all necessary analyzes and results of instrumental studies.

It depends on what degree of arthrosis ...

Table 1. Prices for hip replacement surgery

Total joint replacement, when all parts of the hip joint are completely replaced by an endoprosthesis Surprisingly, with the help of IPR, a good, high-quality prosthesis can be delivered. To deliver this endoprosthesis in one of the leading Moscow clinics, in excellent conditions and in the shortest possible time. And all this was carried out at the expense of quotas until 2014. Since 2014, quotas for most of these transactions

Medicine has about 60 different types of endoprostheses, which differ in the type of construction and material of manufacture. But any prosthesis consists of 3 components:

As with any surgical procedure, there is a risk of complications after surgery. There are a number of cases when joint replacement is impractical:

How the rehabilitation after surgery on the hip joint is carried out is described in detail in the video. Restoration of tissue integrity and wound suturing.

Ceramics - plastic. An X-ray examination of the vehicle should be performed.
The formation of the hip joint (TC), which is a simple synovial joint, occurs with the participation of two articulating bones - the ilium and the femur.

As with any surgery, some complications are possible after arthroplasty. At the expense of budget funds

Canceled
Plastic cup;

Fragility of the bone, which will not allow holding the implant;

Vehicle prosthetics surgery is a high-tech process.

Why is the joint affected?

The video clearly shows how the hip arthroplasty is going on.

All the necessary information on preparation for the operation will be presented to you by the attending physician.

Solving the problem

The cup-shaped depression on the outside of the pelvic bone (acetabulum) and the spherical bone of the femoral head together form the hip joint, which is a kind of hinge structure. The orthopedist in his clinic will arrange everything.

, With the exception of some systemic diseases, for example, systemic lupus erythematosus or for iatrogenic reasons (doctors' mistake during the initial replacement).

When and who needs hip replacement

A metal ball that replaces the head of the femur; Damage to nerve endings in the joint;

In 2015, the inclusion of high-tech medical care (HMP) in the system of compulsory medical insurance is provided for by a new legislative project “On compulsory medical insurance in the Russian Federation.” Any surgical intervention in the body can have its negative consequences. Complications after the procedure most often occur in However, there are times that the patient will have to prepare in advance (especially for those who are lonely).

For a worn out or irretrievably injured joint, arthroplasty may become, which may be indicated in such
The head of the femur is connected with the femur by the neck, which in the common people is called
Anaida
At the first stage of preparation for endoprosthetics, a consultation with the attending physician and surgeon is required. This is necessary to determine contraindications, if any. An x-ray should also be taken to show how damaged and worn out the hip joint is.
How does it work? As they say - all ingenious is simple.
In most cases, there are simply no quotas for hip replacement. The picture is the same with knee arthroplasty, but since 2015.

What types of operations does medicine offer?

Leg - a metal rod for the strength of the prosthesis. Joint instability;

Therefore, here we will not specify who will pay for the operation - the patient or the insurance companies. Operated:
Since rehabilitation after the replacement of the joint continues at home, it is worth preparing your home for the postoperative period in cases:
"Neck of the thigh" In the quota department of your city you will find out the list of documents (for each disease your own), collect them and hand them over, then wait in line - in general, the orthopedist who guides you (well, or the surgeon, if there is no orthopedist) in your clinic knows everything you need.

Types of endoprostheses

The next stage is to pass all tests and diagnostics. Hospitalization is carried out a couple of days before the operation, consultation with a doctor, then preparation of primary documents for the IPR and hospitalization in the clinic. Further, the operation and, at the time of discharge from the hospital,

Joint replacement surgeries
Underdevelopment of the bone;

Hip replacement cost With a large deformation of the joint;

Recovery:
Non-healing fracture of the head of the vehicle;
... The inside of the acetabulum and the femoral head itself are covered with a layer of special articular cartilage (hyaline).
STOM.RU

Preparing for surgery

The procedure is as follows: the leg of the prosthesis is inserted into the center of the femur, it will be installed instead of the neck of the hip bone, then a head with an insert is inserted, thanks to which the leg can move. After the head is repositioned, the surgeon checks the length of the limb, selects the endoprosthesis of the required length and size and installs it. The prosthesis is fixed using a special bone cement that adheres to the bone. As a result, the incision where the prosthetics was made is washed with a special antiseptic agent and all tissues are sutured in layers. Special staples are installed on the top layer of the skin. Perhaps a person will be interested in the process of such a procedure itself. You can watch videos and photos of the operation on the Internet. How long the procedure takes depends on the specialists, in general, it takes about an hour.

Paperwork for a refund

Are expensive and most citizens cannot afford to pay both the cost of the endoprosthesis and the cost of the operation itself. It was planned that joint replacement operations would be carried out at the expense of the compulsory medical insurance policy, but so far this period is a transitional period and, often, there is misunderstanding and confusion on the part of hospitals and doctors. with the human body. Those materials that interact with each other in the endoprosthesis are called a friction unit:

Rheumatoid arthritis;
Consists of a prosthesis and the operation itself
With obesity or large muscle mass;
Purchase special equipment in the form of walkers or crutches, a special toilet seat, etc.
Fractures of the femoral neck or acetabulum in elderly patients;
Cartilage is an elastic and, at the same time, strong and smooth layer in the joint. Provides sliding during the work of the joint, secreting articular fluid, distributes the load during movement and the necessary shock absorption.

- The general procedure for granting quotas for high-tech medical care (HMP), including the list of necessary documents, was approved by Order of the Ministry of Health and Social Development of December 28, 2011 No. 1689 n. To obtain a quota, a patient first of all needs to contact the attending physician of the medical organization where he is being treated or observed. The attending physician must prepare an extract from the medical history and submit it to the medical commission. The medical commission within 3 working days decides the issue of referring the patient to the commission for the selection of patients for the provision of HMP of the constituent entity of the Russian Federation. In case of a positive decision, the medical commission forms and sends to the commission of the constituent entity of the Russian Federation a set of necessary documents: an extract from the protocol of the decision of the medical commission, a written statement from the patient, consent to the processing of personal data, copies of a passport or birth certificate (for children under 14 years old), and copies of the medical policy and pension certificate. If a legal representative or a confidant acts on behalf of the patient, then a copy of the passport and a document confirming the powers of the representative are additionally submitted. The patient has the right to submit a set of documents to the commission of the constituent entity of the Russian Federation and independently. In this case, an extract from the protocol and an extract from the medical documentation are handed over to him. The decision to grant a quota is made within 10 working days from the date of registration of documents, after which the commission for the selection of patients for the provision of high-tech medical care will agree with the medical organization the terms of hospitalization and ensure the referral of the patient for treatment.

The hip replacement procedure in Israel, Germany, Russia is carried out taking into account the anatomical structure of the operated area. The intervention requires general or epidural anesthesia. The incision is made small, and the implants themselves are made of durable material... After the operation, for example in Germany, the patient is in the clinic for another week, he is monitored by specialists, since the new artificial hip joint must take root. The only drawback of this scheme is that initially, before hospitalization, you buy this joint yourself by bank transfer from one of the manufacturing companies. But then this money is returned to you! Consider several options for replacing joints. Immediately, we note that there is a way out and it can be significantly

Joint replacement surgery

Metal-plastic. Nice and reliable a budget option... Such an operation to replace the hip joint is recommended for elderly people, since the plastic in the prosthesis wears out quickly due to increased physical activity in young people and requires a second operation.

Osteoporosis;

... To date, the cost of the operation (total hip arthroplasty) is from Having a number of serious concomitant diseases - diabetes, diseases of the blood, heart and the entire CVS, etc.

Stop taking certain drugs (aspirin-containing, anti-inflammatory);
Aseptic necrosis;

Around the head of the joint there is a capsule consisting of a very dense and durable fibrous tissue. Andrey

As with any intervention, arthroplasty can have complications. These include:
The average time from initial visit to surgery is approximately 3-4 weeks. The money is returned, as a rule, within three weeks after discharge from the hospital.
Reduce costs
Ceramic-plastic. The head of the endoprosthesis is made of composite or aluminum ceramics, and the cup is made of plastic. Acceptable wear resistance, but, as in the 1st version, the plastic wears out quickly.
Decompensated cardiovascular diseases;
210 to 300 thousand rubles

Joint replacement can cause such

Possible complications

If necessary, reduce your weight; Tumor-like diseases of the TS;

The attachment of the joint occurs with
In the regional hospital in the booth providing quotas for high-tech medical care. Sign up in the queue and in 3-6 months a call will come))
Dislocation of the femoral neck - such complications occur when the ball-shaped head of the prosthesis moves away from the acetabulum.

On average, good and high-quality endoprostheses cost from 100,000 to 150,000 rubles. The amount of compensation varies depending on the region. Moscow returns , And in most cases avoid financial losses altogether. But let's start in order.

Ceramics. The prosthesis is made of composite pink ceramic. Such material is resistant to wear and tear and is biologically compatible with the body. In addition, ceramics allows the manufacture of heads with an increased diameter, which makes it possible to increase the range of motion in the joint. Disadvantages include fragility (chance of splitting) and high cost.
Acute vascular diseases of the lower extremities;
(Depending on the cost of the prosthesis).
Complications:
Do physical training;
Deforming arthrosis of the third stage;

Rehabilitation after surgery

Help:

* Lina * Infectious complications. Up to 168 800 rubles

This is the most quick way joint replacement. It also has its own nuances: metal. The most expensive and reliable type of prosthesis design available. Recommended for implantation in young and active people.the presence of a purulent focus of infection;

Replacement of hip joints in Russia is done as in federal budgetary institutions healthcare (Federal Center for Traumatology, Orthopedics and Endoprosthetics, regional clinical hospitals, research institutes), and in private clinics of the Russian Federation.

Incorrect positions of the endoprosthesis; Visit the dentist; Congenital dislocation of the hip, etc.

Ligaments.

There are many such clinics.

Damage blood vessels and nerves of nearby tissues.

Where can you get an operation in Russia

Inclusive. Moscow region and regions: about 110,000 rubles.

In the first case

After the operation, the patient spends a few more hours in intensive care, and then, if there are no complications, he is transferred to the ward. In addition to pain relievers, antibiotics, anticoagulants and fibrinolytics are prescribed. A day later, the patient is removed the catheter and removed the postoperative drainage (if installed). A series of X-rays are taken to check that the prosthesis is properly installed. If the pictures confirm the success of the operation, then on the same day the patient should begin the recovery process: change the position in bed (sit more than lie down), take a few steps, leaning on crutches in the presence of a doctor.

Infectious diseases of the joint; For example: Damage to nerve fibers, arteries; Give up bad habits (smoking). In the conditions of modern medicine, patients are offered by the type of prosthetics

The outer ones are attached at one end to the femur, the other to the pelvic. And the internal ligament of the head of the pelvic bone connects the head itself with the acetabulum of the pelvic bone.

National Medical and Surgical Center named after N.I. Pirogov, as an example.

Complications associated with intubation during anesthesia (eg, pneumonia).
Thus, the Individual Rehabilitation Program (IPR) enables almost any patient to replace a joint with a modern endoprosthesis. To do this in a short time and absolutely free.
You can go to a commercial clinic, have a joint replacement in Moscow and pay both for the joint and for the operation, as well as for a bed-day, medicines, anesthesia, etc. Prices in Moscow vary from 300,000 to 700,000 rubles for
The hospital stay does not exceed 10 days. During this time, the patient must learn to get out of bed and move around on his own. The postoperative period takes several months.
Mental disorders.
JSC "Medicine";
Violations of the process of postoperative wound healing;
Usually, hospitalization is carried out 2-3 days before the operation. These days are needed to conduct an in-depth examination of the patient - versatile blood tests, research of already existing diseases with the advice of relevant specialists.
Three types of operations:

osteocure.ru

Hip replacement surgery

You can also call the Health Department / Min. Healthy

In order to avoid the development of complications, it is important to quit smoking and not take alcohol, to fight excess weight, if such a problem exists, to treat all foci of infection in the body.

Indications for the operation

Details can be found by calling or sending a request for treatment.

Large joint The first exercises after the operation begin to be done the next day (in a sitting position).

Family Clinic;

The occurrence of infections;

Before surgery
Replacing vehicle surfaces
They surround the hip joint - the gluteal joint behind and the femoral joint in front. The better developed the muscular frame of the joint, the less traumatic stress on it when running, unsuccessful jumps and moving weights. It is also important that a good volume of strong working muscles delivers a sufficient amount of nutrients to the joint with the blood.
Your settlement, Department of VMP (high-tech medical assistance)
After surgery, a period of rehabilitation begins. The patient is discharged in Russia a few days after the intervention, in Germany strictly in a week. This is not a sufficient period for the restoration of a new joint to be complete. The duration of the process depends on many factors, one of which is the presence of possible complications.
Good luck!
(Knee or hip).
You should be prepared for the fact that recovery in the first weeks will be accompanied by mild pain in the hip. Great importance in the postoperative period, exercise therapy plays. Exercises that help normalize limb movement and strengthen muscles are selected individually for each patient.
The main methods for diagnosing hip joint disease include:
City Clinical Hospital No. 67 (Moscow);
Fracture of the hip bone, dislocation or "jumping out" of the prosthesis;

Diagnosis of the disease, types of endoprosthetics

The patient is obliged

- removal of cartilaginous layers from the acetabulum with replacement with a special artificial material and turning of the femoral head with a metal cap on it. The sliding, thanks to this replacement of the articular surfaces, is achieved close to natural.

With the help of the hip joint, a person is simultaneously provided with such functional
And clarify where they can issue a quota in your case.
The rehabilitation period after surgery can be quite long
It is necessary to install an endoprosthesis by replacing the hip joint with it after injuries, fractures and in the presence of other severe pathologies.
The second option is the Moscow State Clinic or a large federal center... In this case, you only pay
Upon discharge from the clinic, the doctor will give Full description contraindications and exercises that you can do yourself.
Clinical examination: pain during exertion and movement, asymmetry, limited movement.
KB MGMU them. Sechenov;

Thrombotic phenomena in deep veins.

Draw up the necessary documents (carrying out an operation for cash, under an agreement within the framework of medical insurance or according to quotas of the federal program for the provision of free high-tech medical care); talk with an anesthesiologist about the most favorable anesthesia option for you; stop eating at least 12 hours before the operation.
Partial prosthetics

Opportunities:

LADY with a dog

Dependence on the previous pathology can be traced:

Types of hip endoprostheses

It should be noted that endoprosthetics, for example, in Germany is carried out according to the following indications:

Joint cost
The danger that can lie in wait immediately after surgery is infection. To prevent it, a course of antibiotics is prescribed. To avoid thromboembolic complications, it is recommended to perform exercises for the lower leg, wear a special stocking, and also carry out preventive treatment with anticoagulants. Do not reload the joint, as excessive stress can lead to dislocation or destruction of the implant (fracture). This is especially true for overweight people.
A series of X-rays taken in different projections.

CM-Clinic;

Rehabilitation after arthroplasty can be long and take up to 6 months.

Modern medical advances make it possible to carry out both open surgery for endoprosthetics of the TS, and minimally invasive and minimally invasive.
- replacement, for example, of the head of the pelvic joint with part of the femoral neck, articular bed.
Body stability (support, balance);
Start with your clinic there everyone will prompt and give directions

Rehabilitation and complications after joint replacement

If there was a fracture of the neck, then the time after which the prosthesis was installed is important. When not much time has passed, the muscles start to work quickly enough.

Congenital dislocation of the femoral neck. ... The operation and stay in the clinic is carried out

Due to the presence of a foreign body in the body, the joint located next to the endoprosthesis can be destroyed. This reaction occurs for the following reasons:

Ultrasound examination.

Central Design Bureau of the Russian Academy of Sciences;
The patient

Today, minimally invasive surgeries (MO) are most common because of their minimal impact on the body.
Complete prosthetics
Variety of movements.

Pyramidonovna

Operation cost

If the prosthetics was after a few years, then the atrophied muscular frame needs more time to fully perform its function again.

Osteoarthritis and severe osteoarthritis.
Free of charge
An allergic reaction of the body to the material from which the endoprosthesis is made;

MoiSustav.ru

Endoprosthetics of joints. How to cut costs and where to start treatment in Moscow?

Is it possible to make a joint replacement in Moscow as efficiently and at the lowest cost as possible? Investigation of the "Doctors of the Big City" project

Magnetic resonance imaging. Multidisciplinary medical center "K + 31"; Must monitor For carrying out the MO - Removal of the entire hip joint and its replacement with EP (endoprosthesis). In what cases are the exercises for the spine according to Norbekov especially effective and what are the rules?

They stir up. Contact the regional health department (now - the Ministry of health of the region) in the department of high-tech medical care - they will tell you for sure. If a person has been in pain for years, cartilage and bones wear out, muscles atrophy, and replacement is done "at the last moment", then rehabilitation can take quite a long period.

Endoprosthetics of joints

, Under the compulsory medical insurance policy. Must be done! Be careful. Some hospitals also ask to pay for the operation itself. To put it mildly, this is not entirely correct. This option is ideal when there is no time to collect medical and administrative documents. Incorrectly installed implant; Contrast X-ray examination (angiography).

Fully commercial joint replacement surgery in Moscow clinics

DKB them. Semashko;

1. Operation in a private clinic

Behind the seam, body temperature and your sensations. Pain during this period can pass and return, the patient should be ready for this and make efforts to full recovery motor functions of the body.necessary: B modern medicine day there are more than six dozen modifications of endoprostheses. They are subdivided according to the method of fixation and material. Fixation methods are offered today We advise you to replenish your knowledge about how to treat gonarthrosis of the knee joint and what complications this serious disease can cause.

2. Operation in a state clinic

Natella Discharge after joint replacement is carried out in a week. In Russian medical institutions, the patient can be discharged in a few days. But this does not mean that the body has recovered. How long the recovery period will take depends on many factors, including the possibility of complications. Tumor processes in the hip joint. Since quotas have not yet been finally canceled, we will consider this option in more detail. This path has both pros and cons. The main positive point is that everything is done initially. Improper cementing.

Joint replacement by quota

Bone scintigraphy (isotopic examination). Central Design Bureau No. 2 of JSC Russian Railways, etc. The first few days

High qualification and professionalism of the surgeon and the entire medical staff;

Obvious causes of injury include injury. Examples are hip fracture, hip dislocation or subluxation.
At 22, you need to try to restore your joints, surgery is an extreme case!

It is also important to take into account the pathology, due to which the joint replacement was carried out:

When considering the issue of arthroplasty, other aspects are also taken into account, such as the general condition of a person, comorbidities, the degree of damage to the operated area and the entire hip joint.

Individualized Rehabilitation Program (IPR)

Free The most common complication, even after a full recovery course, is loosening or displacement of the prosthesis.

Hip replacement or arthroplasty is a surgical operation to partially or completely replace a joint with an artificial prosthesis. Such prosthetics are resorted to in cases where the joint is severely destroyed, the pain syndrome is severe, motor functions are impaired, and drug treatment gives no results.

The patient is prescribed Availability of technical capabilities (endoscopic equipment, high-tech materials). Cementless - fixation occurs due to the fact that the joint bone grows into the surface of the EP;

The non-obvious ones are diseases (infectious and no arthritis, osteoarthritis, inflammatory processes in the joint and periarticular tissues).

Endoprosthetics of joints. Issue price

Dr. Sexy If the bones and cartilage are worn out, the muscles are atrophied, after the prosthetics has been carried out, the rehabilitation period can take a long time.In addition, like any manipulation, this operation also has contraindications. The endoprosthesis cannot be installed if there is:

... And the algorithm itself is quite simple and looks like this:

The cost of endoprosthetics surgery depends on the type of implant chosen, the country in which the medical institution is located and the cost of its services. Therefore, it is impossible to name a specific figure. For example, a hip replacement in Germany will cost approximately 15,000 euros, in Israel - 12,000 euros, in Russia - 3,000 euros.

Analysis of blood and synovial fluid. Allows to reveal the presence of inflammatory and other pathological processes.

med-kvota.ru

Such surgery leads to a significant reduction in joint pain or even its complete disappearance. The operation is carried out as planned after a complete examination and assessment of the complexity of the surgical intervention. In addition to a full medical examination, the patient must without fail pass urine and blood for examination, as well as take an X-ray of the lungs and take an ECG reading.

Pain relievers, anti-inflammatory.

Depending on the complexity of the operation (partial or full prosthetics), its time can last from one to three to four
Cement - the endoprosthesis is fixed using special bone cement;
At the same time, various complications develop over time, which are expressed in damage to the components of the pelvic joint - cartilage tissue, capsule, bone.
If you do not want to restore the hip joint, ask the clinic where you want to undergo hip arthroplasty. The operation itself is done free of charge, if there is a quota. But usually, there is a considerable queue for them up to six months, and the prosthesis itself is not always of good quality. If you want to skip the line or a "super-quality" prosthesis, then as mentioned above - you need to find out at the clinic where you plan to operate.

Prosthetics performed after a fracture depends on how quickly the operation was performed. The sooner, the sooner the muscles adapt.

The presence of an infection in the body.

Initially, you go to the clinic, provide images and medical documents. If the clinic has quotas for joint replacement, after consultation you will be given the so-called "Quota Decision Protocol". With this official document, passport and compulsory medical insurance policy, you are sent to the Ministry of Health of the city, where within 10 working days your coupon for the provision of VMP (High-Tech Medical Aid) and your data will be included in the general plan of operations for the near future. Then you just have to wait.
There are 2 ways to pay the cost of the operation: with your own funds and with a medical quota.
The operation is prescribed after drawing up a complete picture of the patient's condition and selecting a prosthesis. There are 2 types of endoprosthetics:

During prosthetics, there is a risk of blood loss, therefore, some time before the operation, the patient donates blood to reduce the risk of donor transfusion. The operation is performed under general anesthesia. For many patients, arthroplasty is often the only possible way to restore limb motor function.

Types of endoprosthetics

Further rehabilitation after replacement of the hip joint consists in the appointment of special light gymnastics and breathing exercises.

Hours:
Mixed (hybrid) - the cup is attached without bone cement, and the leg is attached with cement.

Operation stages

Consider

Tamara shkrobat

If the prosthetics was carried out several years after the injury, it will take a long period of time for the muscular frame to fully adapt to the prosthesis.

Cardiovascular disease.

Waiting times can vary greatly from clinic to clinic. On average, this is 3–8 months. In large centers, you can wait for more than a year. This is just the first minus. Further. The time for the operation has come and here a number of questions arise:

Possible troubles

In the first option, the patient pays for everything necessary for the operation himself. As for the second option, there is a special state program for the provision of free high-tech medical care (quota). To get it, the patient needs to collect the necessary documents and sign up for a queue at the health department, which is located at the place of registration. The operation is carried out free of charge under a medical quota. The cost of treatment and the prosthesis itself are paid by the state. As a rule, after the registration of all documents and until the issuance of the quota, it takes about a year.

Complete replacement of the joint (head and acetabulum).

Often, arthroplasty is prescribed for people with progressive arthritis and degenerative osteochondrosis. The bulk of these patients are elderly people, as such diseases develop with age. But it is possible that these diseases may occur as a result of injury or congenital joint anomalies.
To prevent cicatricial contractions of tendons and skin, to strengthen the muscle frame around the prosthesis for the patient
Anesthesia;
Modern combinations of materials from which prostheses are made are selected depending on the patient's disease, his age and lifestyle. They can be

Main:

Recovery after intervention

The operation is very effective

One way or another, the body of each patient is individual, and this also matters in the duration of the recovery period.

Severe renal and hepatic impairment.

What endoprostheses are put on a quota?
After arthroplasty, many are wondering how they can live from now on. Sometimes a prosthesis is much better than your own joint, which causes pain or restricts movement. You cannot lift weights, you need to monitor your weight, avoid hypothermia, treat all colds and infectious diseases in a timely manner, do not make sudden movements with your leg. The load on the operated leg should be minimized as much as possible. We must not forget about the set of exercises that will keep the leg muscles in good shape.
Hemiarthroplasty is a unipolar replacement. Only the femoral head is implanted.

Recovery period

Hip implantation may also be needed in people with necrosis or severe fractures of the hip bones.

Physiotherapy exercises are prescribed

Inserting a catheter into the urethra (to prevent involuntary urination and control the amount of fluid excreted by the body);
Are as follows:
Inflammation of the pelvic joint - usually caused by arthritis of various etiologies, bursitis, synovitis, etc.;

Olga

Endoprosthetics cost

Fortunately, you don't have to travel to Germany or anywhere else to get prosthetics. In Russia, such a procedure is carried out in Moscow on a quota paid by the state. It is worth noting that joint replacement is very expensive. For example, in Germany, the cost of a hip replacement is from $ 10,000. In addition, you will need to pay for a place in the ward, tests, and so on. As a result, the cost will be about $ 20,000. Rehabilitation after hip replacement is also expensive.

Before endoprosthetics for hip replacement is performed in Germany, Israel or another country, examinations (laboratory and instrumental) are prescribed, the patient is consulted by specialists. It is possible to correct the condition with drugs and physiotherapy before surgery and joint replacement.

Who will operate: an experienced orthopedist or a young surgeon?

Endoprosthetics of joints in Moscow

prokoksartroz.ru

how to get a hip replacement quota

Full or total joint replacement implies the replacement of all joint components with artificial ones. From the femur, the support is transferred to the implant stem and through the head to the acetabular component, which is installed in place of the destroyed acetabulum. A person can move a leg (joint) due to the interaction of artificial components of the prosthesis.

Bone necrosis is often the result of systemic disease or a postoperative complication of kidney transplantation. Certain drugs and alcohol can damage bones.

An incision from the outside of the thigh (or two small ones - on the thigh and in the groin);

Metal - metal;

Joint deviation pathology - dysplasia;

It is necessary to get on the line and do it according to the quota If you want it urgently, then pay

To operate on a quota is not an easy task. First, the quota itself needs to be issued, and then with a coupon for the provision of high-tech assistance (VMP coupon) you need to go to the hospital. Your data is entered into the queue for endoprosthetics surgery for the current year. Waiting in Moscow takes on average about six months, this must be taken into account in your plans.

In which hospitals are hip replacement surgeries performed for coxarthrosis on a quota?

Endoprosthetics and replacement of a damaged hip joint can be carried out in two ways:

According to the quota, those endoprostheses are installed that are currently in the clinic. It is far from a fact that these will be endoprostheses from leading companies. But no matter what endoprosthesis is installed, the success of the operation mainly depends on the experience of the orthopedic surgeon. An incorrect installation will not help even with the "best prosthesis" endoprosthetics. Agree, this is also a minus of this path when replacing a joint.
Until recently, it was carried out at the expense of quotas for a high-tech operation, which were allocated by the state. To be more precise -
An artificial hip joint with total replacement is installed and fixed using a cement, cementless and combined method. The cement method involves filling the space between the implant stem and the inner cortical layer with bone cement. The perimeter cement cup has ribs that enhance adhesion to the cement.

As indicated by the reviews of patients who underwent arthroplasty, it is worth adhering to the recommendations of specialists as much as possible, and then the rehabilitation will be quick and practically painless.

Peeling and shearing of tissues around the vehicle;

Metal - very high quality plastic;

Necrosis in the head of the vehicle of some areas bone marrow- non-infectious necrosis (avascular).

Hatalya

Hip replacement (Moscow)

How much prosthetics will cost depends primarily on the material from which the prosthesis is made, the clinic where the operation is performed. The cost of the operation depends on the qualifications of the doctor, patient care, location in the ward and patient care, depending on how long he will be in the institution. Before the operation, doctors discuss all these nuances, and also show the patient in a photo how the new limb looks from the inside. The photo will help the patient understand exactly which appearance will be at the joint from the inside.

Unipolar replacement - replacement of only the hip component, instead of it the prosthesis stem is installed. With this type of endoprosthetics, the acetabulum remains intact.

The question is: is there still an alternative for joint replacement? We dare to assure you that there is such an alternative. So the third way.

Hip arthroplasty

Cementless fixation of the prosthesis is carried out due to the ingrowth of bone tissue into the prosthesis, which for this purpose has a rough surface, after the endoprosthesis is implanted into the bone by a tight fit. With the combined method of installing the prosthesis, its leg is fixed with cement, and the cup is cementless. Unipolar replacement is most often used after fractures of the femoral neck in the elderly. The prosthesis is installed both on cement and by a tight fit. Such an operation restores the ability to move independently, but due to the fact that the head of the endoprosthesis directly affects the acetabulum, pain often occurs when walking.

In the case of congenital joint inferiority (dysplasia), in which the bone initially develops and functions incorrectly (this leads to its rapid wear), there is no other treatment but surgery to replace it with an implant. At normal development and the absence of any injuries, the hip joint has a smooth surface. This allows a person to move without discomfort and pain. With pathologies, the head of the joint wears out, which causes pain when walking or other leg movements.

The recommendations of specialists how to move and sit, what kind of load to allow during the rehabilitation period (power loads - running, jumping - to remove, to swim) will allow patients to return to normal life in the shortest possible time.

Installation of a prosthesis;

Ceramics - ceramics;

The occurrence of pain in the hip joint is a signal that you should consult a professional to determine its causes. To do this, at the initial stage

In order to carry out a high-quality hip replacement operation and prevent large costs, it is possible to use a special quota. Until 2015, these privileges were provided to all patients who received prosthetics. different types joints.

However, today, at the level of legislation, numerous changes have been introduced, according to which the quota can be obtained in the first place if the surgeon made a mistake when replacing the hip joint, as a result of which the operation must be repeated. Also, the benefit can be used in other cases, for example, with some types of systemic diseases.

It is no secret that replacing any joint is quite an expensive undertaking that may be beyond the means of many patients. At the same time, not only prosthetics are expensive, but also the purchase of a hip joint prosthesis.

As planned at the legislative level, since 2016, the quota in the form of allocating funds for the operation should have been received under the compulsory health insurance policy. However, at the moment this issue has not yet been resolved and is under discussion.

Meanwhile, doctors performing hip replacement surgery are still unable to fully answer patients' questions and establish a cost recovery system.

Despite this, there are certain ways out of this situation that you can use if necessary. This will significantly reduce financial costs or completely cover the costs of the operation and the purchase of a prosthesis.

Paid hip replacement surgery today is performed by:

On the territory of a private clinic, while the patient pays for prosthetics in full.
In a public medical institution, where you can get compensation and spend less money.

Naturally, such expensive treatment in private clinics will not be provided free of charge. Here you have to pay for the operation and the purchase of a new artificial joint.

Also, the patient will need to make additional funds for being in the ward, anesthesia, and the purchase of the necessary drugs. Thus. Treatment will cost from 300 to 800 thousand rubles on average. It is clear that such an operation will be carried out at a high quality level.

On the territory of state clinics, if you are lucky, you can get a certain benefit for prosthetics, thanks to which the operation can be carried out at a lower cost. In this case, the endoprosthesis is acquired by the patient independently. The privileges also apply to surgical intervention and stay in a medical clinic.

According to the current legislation, these costs must be covered by the Mandatory Health Insurance policy. However, as mentioned above, today not all hospitals have adopted this system.

A controversial situation may also arise if the medical institution does not intend to collect and prepare the necessary medical and administrative documents.

How to get a quote for an operation

Since some types of quotas currently remain valid at the legislative level, they can be used if necessary. This will allow the operation and purchase of a prosthesis free of charge at the expense of the state.

At the same time, it is quite simple to document a quota and in a short period of time.

To take advantage of the benefits, the patient must go to a medical clinic, provide the required set of documents and X-rays of the affected hip joint. Next, you should worry about getting the protocol of the quota decision, which is issued at the hospital.

After that, the following documents are submitted to the Ministry of Health:

Quota decision protocol;
Written application;
Testimony and identity of the patient;
Compulsory health insurance policy;
State Pension Insurance Certificate;
Disability certificate;
An extract with information about the patient's condition, diagnosis and types of studies performed;
The results of the laboratory tests carried out.

After all the documents are provided, within a ten-day period, a medical aid ticket and patient data are entered into the general plan for hip replacement surgery. Then you just need to wait for the announced turn to come.

It should be borne in mind that the waiting period can be different, which depends on the system of work and the workload of a particular medical clinic. In some cases, the queue can last about three months, and if the hospital is a large medical center, then the waiting period can be up to several years.

It is important to understand that the operation is carried out on a free basis using endoprostheses, which are currently available in the medical clinic. Therefore, no one can guarantee that the artificial joint will be of high quality and a well-known manufacturer.

Meanwhile, according to doctors, first of all, the quality and effectiveness of hip arthroplasty depends on the experience of the surgeon who performed the operation.

Even the most expensive and high-quality joint from leading manufacturers will not work fully if the doctor makes any mistake during the installation of the artificial joint.

If the treatment is on a quota, there is no guarantee that the operation will be performed by an experienced surgeon with many years of experience and high level qualifications.

Using an individualized rehabilitation program

You can also purchase a high-quality endoprosthesis free of charge with the help of an individual rehabilitation program. In this case, the operation, even on the territory of the leading clinic, will be carried out at the expense of public funds, as well as rehabilitation after hip arthroplasty.

To take part in an individual program and take advantage of the benefits, you need to consult with your doctor who will help you complete the necessary paperwork.

Unlike the first option, in this case the system consists in full reimbursement of the funds spent on prosthetics. After the operation is completed, at the time of discharge, a document is drawn up, on the basis of which the money is returned.

In other words, the patient must pay in full the cost of the prosthesis being installed, but after a while the funds spent are returned.

The advantage of using an individual rehabilitation program is that the waiting period in this case is noticeably shorter than when the patient contacts the Ministry of Health.
Today, the cost of a high-quality endoprosthesis ranges from 100 to 150 thousand rubles. The average waiting period is about three weeks.
The refund of the spent funds will be returned to the patient within a month after the operation.
The use of high-quality endoprostheses from leading manufacturers is also considered a big plus, so the patient can be sure of the quality of the installed artificial joint.

Which option should you choose?

Thus, there are two main ways to get free medical care during prosthetics. However, it is very difficult to obtain a quota from the Ministry of Health today. As a result, the most acceptable option is considered to independently purchase an endoprosthesis through a rehabilitation program, if finances and time for waiting allow.

If there is no time to wait, in any case, the most profitable option would be to seek treatment at a government clinic. But in this case, it is important to carefully choose a medical clinic, study the experience of doctors and find out what kind of prostheses are available in this medical institution.

And Elena Malysheva will help in studying the issue in the video in this article, dedicated to just the prosthetics of the hip joint.

The hip joint is the largest joint in the body; without it, a person cannot stay upright, run, stand up, squat and walk. Due to the load, the joint undergoes pathological processes that cause pain and impairment of its functions. There are situations when a hip replacement is the only chance for a patient to live a full life. After such an operation, many return to normal life and become active people.

The hip joint acts as a connection between the pelvis and legs. In such a connection, the femur takes part, or rather, its head, which is inserted into the acetabulum, it is also the basis of the pelvis. As you know, the surface of the joint is covered with cartilage, the ligamentous apparatus and the muscular frame are located around it.

In the absence of joint pathologies, a person can live a full life, since this joint is responsible for posture, gait, rotation and flexion of the limbs, as well as turns and tilts of the trunk. These actions are performed by a person unconsciously, but when a change appears in the hip joint, the person feels that it is difficult for him to perform the usual movements, moreover, it brings discomfort and pain.

Both a passive lifestyle and stress can lead to changes in the elements of the joint. The presence of infection, inflammation or injury to the joint can also provoke pathology. In some cases, these factors cause such consequences when surgery is required to replace the hip joint, after which it takes a certain period of time to restore the replaced joint and return the patient to a normal life.

Indications for the operation

Arthrosis is a disease that leads to degenerative processes of the joint, as a result, the destruction of cartilage tissue occurs, and the surface of the bone is deformed. In patients with such a diagnosis, at an advanced stage, there is no chance of recovery with conservative treatment methods.

With arthrosis, the load on the affected joint is shifted, which contributes to the occurrence of pain and stiffness of movements. The fact is that cartilage is not restored, for this reason arthrosis leads to irreversible consequences.

Age wear

Hip replacement is most often done in older people. At this age, due to body weight, heavy lifting and a slowdown in metabolic processes in the body, the hip joint wears out. The joint does not perform shock-absorbing functions, the cartilaginous tissue becomes brittle and fragile, and the nutritional process of the joint deteriorates.

Such patients often undergo hip replacement according to a quota, since they often have a number of concomitant pathologies, this will help to reduce the cost of the operation, since part of it is paid by the state. Many are given disability after replacement. But before getting a quota, a person needs to go through a special commission, this is in the event that he does not yet have a disability. Hip replacement in Germany is also possible on a quota, but for this the clinic must specialize in arthroplasty.

Joint injury

When a hip joint is injured, the femoral neck breaks. This happens most often with older people. According to statistics, in most cases, women receive a cervical fracture, since hormonal changes begin with age. Brittle bones or osteoporosis are especially helpful.

The fact is that with age, the articular elements change, the process of nutrition of bone and cartilaginous tissue is disrupted, as a result, the fracture is irreversible, since the fragments will no longer grow together. Patients who are unable to cope with the cost of hip replacement surgery are forced to lead a recumbent lifestyle.

A sedentary lifestyle leads to an exacerbation of chronic diseases of blood vessels, heart and lungs. Doctors also warn that such patients are at times more likely to develop pneumonia, thromboembolic complications, and stroke. It is for this reason that it is necessary to look for an opportunity to operate, otherwise, after such a joint injury, disability is provided. Many people returned to their old way of life after the operation.

If the injury is associated with dislocation, tearing of cartilage tissue or damage to ligaments, post-traumatic coxarthrosis develops. And for the treatment of this disease, an operation is laid, otherwise tissue restoration in the absence of treatment will be impossible.

In the case when a joint injury occurred in infancy (congenital dislocation or dysplasia) and during intrauterine development, the baby's degeneration and trophism of the osteochondral base are disturbed. In the absence of treatment, the child is painful and difficult to move, the process of arthrosis development starts. At this age, the operation is extremely rare, massage is used as a treatment, since the child's body is malleable to recovery.

Inflammatory process

Trauma, connective tissue diseases, gout, rheumatoid arthritis can cause inflammation. The destruction of the articular elements occurs, which is an indicator for joint replacement.

Sometimes replacement is required in diabetes, trophic disorders, obesity, or when aseptic necrosis of the femoral head develops as a result of closure of the feeding arteries.

Contraindications to the operation

Before prescribing an intervention, doctors always take into account contraindications and risks. The fact is that most of the patients are elderly people who have many comorbidities. So before you know how much the operation costs and which specialized doctor can do it, you need to know the factors that make the operation impossible.

Joint replacement is contraindicated

with an exacerbation of the inflammatory process in the joint cavity;
in the event of acute infectious diseases before replacing;
when there are some untreated chronic infectious foci (abscesses, caries, boils);
when the disease of the internal organs is in the stage of decompensation.

A special group of patients includes young people. As a rule, in this case, the operation is indicated after injury. And since the body is still young, it may well restore the joint on its own. The appointment of the intervention and preparation for the operation occurs only after conservative treatment has failed.

Preparing for a joint replacement

The length of the rehabilitation period depends on how well the patient is prepared. It is important to understand that if a study of all organs is not carried out, the prevention of chronic diseases, etc., complications may arise after replacing the hip joint. The patient begins to prepare for the intervention at least one month before the intervention.

To prepare, the patient needs

Conduct clinical studies - coagulogram, urine and blood tests.
Make an ECG, ultrasound throughout abdominal cavity, fluorography.
Perform an X-ray of the affected joint in different projections.
Consult with specialists.
Obtain permission from a therapist to perform the operation.

The entire list of studies is available in the clinic where the operation will be performed. But such a service can have a high cost, therefore, in order to save money, you can be examined in a polyclinic, and bring ready-made results for a consultation.

It is imperative to warn you about taking medications that thin the blood before the operation. They should be discontinued for some time. The same applies to taking other drugs, some funds can provoke endoprosthesis rejection.

The next step in the preparation is the choice of anesthesia. The surgeon determines the course of the intervention. Also, the patient must fill out all the documents and give consent after informing about the consequences after the operation to replace the hip joint.

12 hours before the operation, the patient is forbidden to drink water and eat for the reason that vomiting or other side effects with the introduction of anesthesia. Before starting in bladder a catheter is inserted, it is removed only the next day.

Operation

The selection of the endoprosthesis is carried out individually. Its design is made of different materials (polymer, ceramic, metal) that can withstand the load.

The implant itself consists of a ceramic or metal analogue of the femur, it is inserted into the artificially created acetabulum. This includes a hinge, which consists of a rod, it is inserted into the femur, located in the acetabulum, it is pressed into the pelvic bone.

Methods for fixing the prosthesis to the bones

Bone cement. It is a solution that strengthens the acetabulum and the nail in the bones. This method is used for elderly patients.
Cementless method. It is used when the pressing process involves the use of a rough surface, which prevents the graft from slipping. This method is used for young patients.
Hybrid full fixation. It involves cementing the rod, and the acetabulum without cement. This method is used for middle-aged patients.

Operation progress

The duration of the operation is about 2.5 - 3.5 hours. Often, surgeons try to use a minimally invasive approach, which involves minimal tissue damage. Hip replacement surgery is considered a high-tech manipulation, so it should be performed by an experienced and highly qualified surgeon. The postoperative period after replacement of the hip joint and the occurrence of pain after surgery largely depend on this.

For the operation, the patient is laid on one side, the leg is fixed in a bent position.

Stages of the operation

Access to the diseased joint. To do this, the surgeon makes an incision without touching the ligaments and muscles, they are pushed back. It is important that the surgeon does everything correctly, since the duration of the rehabilitation period depends on this. The minimal incision prevents damage to the ligaments and muscles, and also preserves the aesthetic appearance in the future.
The second stage involves the installation of a prosthesis. The rod is fixed in the femur, after which the femoral head and acetabulum are fixed. Next, the surgeon checks the range of motion and leg length. Adjusts the prosthesis and fixes it in a suitable way.
The final stage. The incision is washed with antiseptic preparations, the soft tissues are sutured and staples are applied to the skin surface. The doctor inserts a drainage into the wound itself so that excess fluid comes out.

Endoprosthetics is a very successful procedure for overcoming the consequences of joint diseases that cause their degeneration and wear of the articular cartilage. Patients note a decrease in pain, an increase in the range of available movements and a general improvement in well-being. Naturally, the demand for such procedures in last years is growing, so the question of the cost of prosthetics of the hip joint and other cartilaginous joints is relevant for many.

On the left of the image, you can see a correctly installed right hip joint endoprosthesis. This is the most common way of replacing the hip joint, it is the most durable and durable.

In this image, the operation was performed in a superficial manner, in which most of the bone tissue was preserved. Many people mistakenly think that this method of operation is preferable, despite the fact that it is more expensive. But the big problem is that it uses a metal head of the femur, which, when worn out, oxidizes and inflames the surrounding tissue.

When is endoprosthetics necessary?

The main indications for this kind surgical intervention are extreme, advanced forms of joint diseases (arthritis and arthrosis), the consequences of severe injuries:

osteoarthritis(deforming arthrosis). As a result of deformation and wear, cartilage is destroyed, and the joint takes on an irregular shape. The patient has severe pain, stiffness in the joint, the range of available movements is reduced;
aseptic necrosis or bone destruction. Can be called like different kinds injuries, and a number of other reasons;
cervical fracture hips. Most often occurs in older people. The main risk group is women in the post-climatic age. Due to age-related changes, the hormonal background changes, the bones become fragile. The likelihood of spontaneous fusion in people after 65 years of age is practically absent;
rheumatoid(inflammatory) arthritis. Affects large and small joints, most often the knee and hip. It is accompanied by constant pain, stiffness and swelling in the affected area.

If conservative therapy no longer helps with these diseases, and painkillers give a temporary, gradually diminishing effect, most often, in the absence of contraindications, the installation of an artificial implant is recommended.

Formation of value

The cost of this procedure can vary significantly even within the same country. Directly the price for prosthetics of a joint, hip or other cartilaginous connection, announced to you by the clinic, depends on many factors, including:

general hospital stay... Depends on the type of surgical intervention, the general condition of the patient, the presence of concomitant ailments. For example, if we consider the prosthetics of the hip joint, total, superficial or bilateral prosthetics can be performed. The price in the latter case is much lower;
used implant(refers to the material from which the prosthesis is made);
surgical techniques use of individual tools or specialized computer technology);
the need for preliminary hospitalization... You may need extra hospital care, certain precautions during the surgical procedure;
type of anesthesia used... It can be local, spinal, or general;
unforeseen costs associated with possible complications.

Hospital stay

When clarifying the prices of a particular clinic, do not forget to ask questions of the following plan: "Does the cost of the hip joint replacement, which you announce, include the time of stay and all the procedures carried out in the hospital?" This clarification is not accidental, otherwise an unpleasant surprise may happen. For example, in the United States, as you can see from our summary table, the cost of hip joint replacement starts at $ 40,000, but none of the clinics takes into account about $ 7,500 in their prices for the procedures that you will be subjected to during your hospital stay.

In the absence of insurance and benefits that can fully or partially cover the cost of treatment in a number of clinics, discounts are provided, an individual payment plan is developed. Be sure to think about this point even at the stage of planning your treatment.

Additional costs that can increase the cost of hospital stay:

pain relievers;
injections of antibiotics and anticoagulants, designed to reduce the likelihood of complications, the development of infections and the formation of blood clots;
the use of additional computer or other technologies during the operation;
physiotherapy support;
consultations with a rehabilitation therapist.

Outpatient costs

A significant part of the cost of replacing the hip joint and other cartilaginous joints is inpatient treatment and hospitalization. However, keep in mind that you will also have to spend money on the outpatient part of the treatment.

These additional costs include:

pre- and postoperative consultations, laboratory tests;
planned visits to the orthopedic surgeon during the recovery period.

Post-surgical care

Experts recommend that the period of recovery and rehabilitation be carried out in specially equipped medical centers, where the patient will stay from 2 to 4 weeks. At the same time, he is placed in a ward equipped for all his needs, is under the vigilant supervision of junior medical personnel, and performs a set of exercises specially prescribed for him. As you can imagine, the services of such centers are far from free. Their average prices are about $ 250 per day, this amount may vary depending on the country and location, the level of equipment of the institution.

The indicated cost includes:

outpatient physiotherapy services;
instruments used during procedures;
ward (round-the-clock stay or day hospital);
three daily dietary or vegetarian meals;
adaptation and psychological assistance.

Additional expenses

The cost of treatment and the cost of adaptation are not all that you have to fork out for. Your doctor will most likely recommend purchasing special equipment, such as devices for passive movement (walkers, crutches). In some cases, their cost can be covered by insurance, but in general, such costs are borne entirely by the patient or his relatives.

Additional costs you can expect:

crutches, walkers, walking stick;
compression stockings;
shower bench;
toilet chair with removable bucket.

Depending on the condition of the patient and the ability of his loved ones to provide support and assistance in the postoperative period, you may still have to pay for the services of a nurse-nurse.

Average cost of hip arthroplasty

Procedure type	Prices for prosthetics
Procedure type	Germany, thousand euros	Israel, thousand USD	Canada, USD	USA, USD	Cuba, USD
Hip joint replacement, price	From 13.5	From 26	From 25	From 40	From 10
Knee prosthetics, price	From 14.5	From 23	From 22	From 35	From 7.8
Endoprosthetics shoulder joint price	From 15	From 20	From 20	From 35	From 8

Note that when using minimally invasive techniques, costs are somewhat reduced. So the price for total hip arthroplasty will be 20-25% more expensive than for partial. The fact is that with an incomplete replacement, recovery is faster, therefore, the costs of your stay in the hospital and painkillers will be reduced.

Also, keep in mind that purely hospital expenses are not the whole amount that you have to shell out from your pocket.

The total cost of total hip replacement or other cartilage joint replacement, in addition to the operation itself, includes the following pre- and postoperative costs:

preoperative doctor visits and tests;
the actual operation and the time you spent in the operating room, including the cost of anesthesia and other instruments used;
hospital stay;
postoperative visits to the doctor;
physiotherapy procedures;
services of rehabilitation and recovery centers.

The cost of prosthetics in Moscow

For joint replacement, it is not necessary to travel abroad; it can be performed in Russia with high quality and reliability. True, in Moscow it is much easier to find a medical facility with a good reputation, modern equipment and competent specialists than in the regions. And more quotas for free treatment, as well as partial compensation are given in the capital.

It is not always a good decision to be treated in Moscow, often for comparable funds it is possible to be treated with much better quality in other clinics, cities or even countries.

Each of the patients chooses a clinic based on the capabilities of their own wallet. Are you wondering how much does hip replacement cost in Moscow? Often the price of such procedures exceeds the cost of treatment in European clinics. In our country, unlike in Western countries, endoprosthetics has not yet been put on stream, it belongs to the category of the most complex, high-tech procedures. Accordingly, it cannot be cheap in any way. Moreover, the range of prices in the capital's clinics is very large, as is the difference in the quality of services.

Procedure name	From	Before
Unipolar hip arthroplasty, price thousand rubles	24,3	200
Complete replacement of the hip joint, price thousand rubles	23,2	410
Revision hip arthroplasty, price RUB	20,3	450
Reduction of dislocation of the head of the prosthesis (non-surgical)	5,1	25

To clarify the pricing policy of Moscow clinics, we will also answer the question, how much does knee replacement cost in Moscow.

Features of domestic insurance

The financing program for medical services in Russia is a one-channel program. That is, when performing an endoprosthetics operation under a compulsory medical insurance policy (MHI), it covers the treatment itself and the cost of the implant. And this means that you will not be able to buy a separate high-quality prosthesis that is more suitable for you when financing anesthesia, surgery and drugs under the compulsory medical insurance policy. All you have is a co-pay for non-medical services such as a more comfortable room, better nutrition.

Quota - on the one hand, it allows treatment for free, but on the other, it is not completely free. Or not at all free.

When concluding an agreement with the clinic for paid medical services, the full cost of prosthetics of the hip and other joints is paid by the patient or his relatives. But in this case, you will have to pay for the implant itself, the operation, the ward, anesthesia, medications, droppers and all other procedures.

In the presence of a voluntary insurance policy, the entire range of costs for endoprosthetics is usually paid by the insurance company. In some cases, but not always, she can pay for you and the cost of the prosthesis. Do not forget to clarify this point with your consultant.

Paid surgical treatment

This method of placing an artificial implant is the fastest. There are several options for the operation:

in a private clinic... You will need to pay for an operation to replace a shoulder or other joint, the price of which is prescribed in the price list, and each bed-day, the cost of the selected endoprosthesis, medication will be included in the costs;
in a public health facility... Treatment is carried out on the poles of compulsory medical insurance and voluntary medical insurance. However, in a number of clinics, additional payment for a number of services may be required.

Quota operation

Until recently, endoprosthetics procedures were carried out in Moscow in accordance with the budget quota program, when the state assumed all the costs for such high-tech operations. Unfortunately, since 2014, the volume of quotas has been significantly reduced, and it is becoming more and more difficult to obtain them.

The general sequence of actions looks like this:

provision of X-ray images of affected and healthy joints, all necessary extracts to the medical institution;
when the diagnosis is confirmed, if the selected medical facility has quotas available, you will be given a "Quota Decision Protocol";
taking the protocol, the compulsory medical insurance policy and documents confirming your identity, you must go to the city Ministry of Health, where, within the prescribed period, they will issue a coupon for the provision of medical care, and your personal information will be included in the operational plan;

then there are many months that must be waited until the date of the operation. Most often, it occurs after about a year (the exact time depends on the level of the clinic).

Such a long wait that you have to spend face-to-face with your ailment is the main drawback of the budget quota program. Also, before lying on the operating table, you should ask a few questions:

What kind of endoprosthesis is being installed according to the quota? It is chosen not on the basis of your individual anatomical needs, they establish those that are available at the time of the operation;
who is my surgeon: an experienced specialist or yesterday's student? The effectiveness of the operation depends largely on the experience of the orthopedist conducting it. Even if you get the best of the best prostheses, it is not a fact that a young doctor will be able to install it as needed.

Endoprosthetics according to IPR

By using an individual rehabilitation program as an alternative to quotas, which, as we have already mentioned, are now very problematic to obtain, you can significantly save money. You will be supplied with a high-quality biocompatible prosthesis in a qualified Moscow clinic at a budgetary expense.

Types of friction parts of the endoprosthesis from left to right: ceramics-polyethylene, metal-metal, ceramics-polyethylene, ceramics-ceramics, ceramics-polyethylene.

The bureau of medical and social expertise is engaged in the design of the program; in order to participate in the IPR program, you must have a disability. Within the framework of the IPR, the necessary measures and means are prescribed that can serve in favor of the patient's rehabilitation. For people with coxarthrosis and gonarthrosis, this is, in most cases, endoprosthesis replacement of the affected cartilaginous joint.

The porous surface of the endoprosthesis components allows the parts to be attached to the bones without cement. This is the most preferred method of implant placement.

If you have a valid IPR on your hands, you can get compensation for the installed prosthesis. True, initially, its cost will need to be paid to the current account of the manufacturing company from its own pocket. Later this money will be returned to you.

Outcome

As you can see, there are several ways to reduce the cost of prosthetics. Therefore, you should carefully study all aspects of the upcoming procedure, find out about what is included in the prices of the selected clinic, think about the equipment own home and how and where your rehabilitation period will take place.

Be sure to consult your doctor before treating diseases. This will help to take into account individual tolerance, confirm the diagnosis, make sure that the treatment is correct and exclude negative drug interactions. If you use prescriptions without consulting a doctor, then it is entirely at your own risk. All information on the site is presented for informational purposes only and is not a medical aid. All responsibility for the application lies with you.