Novosibirsk: knee and hip joint replacement clinics, doctors, rehabilitation, prices, quotas

Hip replacement involves replacing the damaged joint with an artificial endoprosthesis. Modern possibilities of endoprosthetics are the most important achievements in prosthetics of the 21st century. Constant improvement of surgical techniques and the emergence of progressive, unique materials have led to a high demand for total hip replacement surgeries.

At the Road Clinical Hospital, operations are successfully performed on patients with degenerative joint diseases of a dysplastic, post-traumatic or idiopathic nature, as well as various systemic diseases.

The key indication for surgery is severe wear of the joint. Surgical intervention is usually prescribed if it is impossible to restore full functionality of the hip joint by other means.

In the absence of diagnosed severe diseases and joint injuries, the need for endoprosthetics is indicated by the presence of the following symptoms:

• every step, even when walking on a flat surface, causes acute pain;
• climbing stairs is also accompanied by pain;
• the duration of absence of pain when walking is no more than half an hour;
• the joint hurts at night;
• the patient sits down and stands up with difficulty;
• Painful sensations accompany any daily activity.

Even if only part of these symptoms are present, hip replacement with a modern endoprosthesis may be prescribed. The operation is aimed at restoring quality of life and eliminating constant pain.

Research Institute of Traumatology and Orthopedics named after. Y. L. Tsivyana – Novosibirsk

St. Frunze house 17, tel., www.niito.ru:

• diagnostic and treatment center with great scientific and practical potential. Provides medical assistance for pathologies of the osteoarticular system. Endoprosthesis replacement of the knee and hip joints is performed, followed by rehabilitation.
• The Institute has highly informative medical equipment, diagnostic and laboratory departments. Reception and surgical interventions are carried out by highly qualified specialists, candidates of medical sciences, who are proficient in modern technologies in the treatment of joints, including the use of domestically produced implants and instruments.
• The department of hip joint prosthetics is headed by Vitaly Viktorovich Pavlov, Doctor of Medical Sciences, who has been working at the clinic since 1994. The department of knee replacement is headed by Vladislav Sergeevich Baitov, a candidate of medical sciences with the highest category and 20 years of work experience.

Pavlov V.V.

According to reviews from patients who have passed through these departments, the work of doctors, both doctors and nurses, is assessed at a high level.

Diagnosis of osteoarthritis as an indication for endoprosthetics

“Osteoarthritis is a heterogeneous group of diseases of various etiologies that have the same biological, morphological and clinical outcomes, in which the pathological process involves not only the articular cartilage, but also the entire joint, including subchondral cartilage, ligaments, capsule, synovial membrane and periatricu- lar muscles” (Cuettner & Goldberg, 1995).

OSTEOARTHROSIS

Prevalence:
20% of the world's population.
The predominant age is 40-60 years. The predominant gender is osteoarthritis of the hip joints - male, osteoarthritis of the knee joints - female. Pathogenesis is multifactorial, with many risk factors.

If the patient has been diagnosed and it is known that surgery cannot be done, it is necessary to contact an orthopedist at the regional clinical hospital, who is seen at the KKB clinic every day, except weekends. You need to have all x-rays, tests, and studies with you. The orthopedist at the regional clinic will put you on a waiting list for free prosthetics and determine the timing of the surgical intervention. If a patient has already been on the waiting list for several years, it is possible that he will be operated on in the near future under one of the existing high-tech programs.

The orthopedics department of the KKB has been performing operations under federal programs and FSS programs at the expense of the regional budget for seven years. For example, in 2007, 60 patients were operated on under these programs, and in 2008, more than 140 patients were operated on.

GBUZ NSO "GNOKB" Novosibirsk

St. Nemirovich-Danchenko, 130, tel., oblmed.nsk.ru:

• a multidisciplinary medical institution providing care to patients from all over Russia. In its structure it has doctors, both candidates and doctors of medical sciences;
• The endoprosthetics department is equipped with modern equipment. Nursing and junior medical staff are certified;
• the structure of the clinic includes diagnostic and laboratory departments, which are equipped with all the necessary tools for accurate diagnosis of joint diseases;
• The department is headed by Ivan Vasilievich Rybalko, a doctor of the highest category. The team consists of experienced doctors with extensive work experience ranging from 10 to 18 years. This is Border Danil Olegovich, Lepikhov Dmitry Alexandrovich, Kolesnikov Alexander Olegovich.

Rybalko I.V.

Patients’ positive assessment of the team’s work indicates professionalism and rich practical experience.

Medical

G. Novosibirsk, st. Uritskogo 2, tel. +7 (383) 249-70-07, www.avicenna-nsk.ru:

• a traumatology and orthopedics clinic, which has the most modern equipment for performing various operations, including endoprosthetics of large joints, total and minimally invasive surgical interventions;
• The institution has laboratory and diagnostic departments equipped with all the necessary equipment. The medical staff is highly qualified and has extensive practical activity.
• The clinic is headed by Egor Yurievich Dremov, a doctor of the highest category, candidate of medical sciences. The department employs: Igor Anatolyevich Pakhomov, a doctor of the highest category, Doctor of Medical Sciences, author of 7 patented inventions, Andrey Aleksandrovich Gerasenko, a doctor of the 1st category.

Dremov E.Yu.

Reviews from patients treated at the center are only positive, noting the high professional qualities and attentiveness of doctors, as well as nursing staff.

Surgical operation techniques

Knee replacement is performed in 2 options. This is a partial or complete replacement. The indication for a certain type of surgical intervention is the degree of degenerative changes in the joint. During a total joint replacement, the following steps are performed:

• removal of the distal femur followed by replacement of this component with a metal plate;
• the end of the tibia is replaced by an element, which is a platform with a polyethylene liner and a rod, which acts as cartilage.

If the patella is not damaged, then it remains intact. But if the destruction affected him, then he is also prosthetic with artificial material.

Comparison of X-ray techniques.

Knee replacement can be partial, that is, it involves replacing only one, right or left, condyle with a prosthesis, but provided that the ligamentous apparatus is preserved. After installing the prosthesis, it is fixed with bone cement. But sometimes, a cementless or hybrid method of securing the implant is used.

Total hip replacement is performed when the entire joint structure, that is, the head, neck and acetabulum, is replaced. With such a prosthesis, it adapts well in the body of both elderly and young patients leading an active lifestyle.

From smaller to larger implant.

The progress of the operation, in its classical execution, can be traced as follows:

• after giving the patient anesthesia, the surgical field and access to the joint are prepared;
• the femur is crossed and an internal channel is created where the wedge-shaped leg of the prosthesis is placed;
• a part of the spherical prosthesis is fixed to the upper area of ​​the leg;
• the acetabulum is prepared, where the implant cup is inserted;
• reduction of the head into the acetabulum;

At the end of the operation, a drain is inserted and the wound is sutured. Hip replacement surgery can be performed using a minimally invasive method, carried out in 2 ways:

• surgery through 1 incision - it is made on the outer part of the thigh and is from 8 to 15 cm. Next, the muscles are pulled apart to access the joint capsule. After opening it, a joint prosthesis is inserted;
• an operation with 2 incisions - 1 incision of 4-6 cm is carried out in the groin area to fix the connector. A second 3-5 cm incision is made on the buttock to position the femoral rod.

Fresh stitching with staples after a classic operation.

Due to the small amount of trauma with this type of prosthetics, patient rehabilitation is much faster. This type of surgery is more often used in elderly patients.

Knee replacement in the Czech Republic: guarantees, prices, rehabilitation, reviews and statistics.

Find out more

Minimally invasive endoprosthetics in the Czech Republic: doctors, rehabilitation, terms and prices.

Find out more

Recovery period

The specifics of postoperative recovery depend on the type of prosthesis: endoprostheses on cemented and cementless bases require different behavioral tactics.

• Cement base. Gradual loading is indicated after 24 hours.
• Cementless base. During the first time after surgery, loads are prohibited to avoid any disruption of the process of fusion of bone tissue with the prosthesis. Then, during the first 4-6 weeks, you must constantly use crutches when moving until the moment when it becomes possible to transfer all the weight to the operated side.

In any case, careful and regular exercise therapy under the supervision of a specialist during the rehabilitation period is paramount.

Endoprostheses and friction pairs

The medical industry produces various prostheses made of ceramics, metal, plastic, and polyethylene.

Orthopedic clinics use prosthetics from various companies, but mostly foreign ones. The most famous and frequently used are:

• endoprostheses from the American company Zimmer;
• prostheses from the English company Biomet have proven to have good survival rates, reaching up to 98% of cases. Convenient, cementless type of fastening allows for planned replacement of the prosthesis;
• German company Aesculap - has virtually no negative effect on muscle tissue, blood vessels and tendons;
• prostheses from the American company Stryker are more suitable for young patients, as they have cementless fastening. The product, growing into the bone, is not an obstacle to active life in the future;
• prostheses from the Italian company Lima - produces knee joint endoprostheses that are highly stable and not subject to deformation;
• products from the Swiss company Mathys - in this type of prosthesis, the elasticity of the hip joint cup implant is almost identical to the elasticity of cancellous bone. This property of the implant does not allow a difference in the stress of the joint and the prosthesis.

Cracked ceramic component.

All companies produce products that have been tested in practical use. The selection of an endoprosthesis from a particular company is made only by a specialist, taking into account the anatomical and objective changes in the joint.

There are practically no Russian-made prostheses on the medical equipment market that would be successfully used abroad, competing on equal terms with world leaders, so endoprosthetics of large joints is performed almost 100% by foreign products.

Initial choice of orthopedic center

The variety of private clinics, the emergence of the latest treatment and diagnostic methods, the prestige and experience of doctors play a significant role in compiling the characteristics of medical institutions. How to choose a suitable orthopedic clinic to fully satisfy the patient’s needs? You should carefully read the description of the services provided and reviews of leading orthopedic centers.

Determining factors

The criteria for choosing an orthopedic clinic are determined by numerous factors. Regardless of the type of medical institution (public or private), you need to pay attention to the following criteria:

• equipping with modern equipment;
• doctors' experience;
• cost of services;
• patient recommendations.

The technical equipment and ability of orthopedists to correctly use advanced equipment determine an accurate and timely diagnosis, as well as the required treatment. The qualifications of doctors and many years of experience in conducting orthopedic practice are an important criterion. The success of treatment directly depends on the experience of a certified orthopedist. Polite communication between both junior and senior medical staff has a beneficial effect on patients.

When choosing a center, the cost of the services offered must correspond to their quality. Unjustifiably inflated prices do not contribute to increasing the prestige of the institution.

Carefully studying the reviews of visitors will help to avoid the emergence of a number of questions regarding the service in a particular hospital. Initially, it would be appropriate to verify the reliability of the source and the comprehensiveness of the recommendation with reference to your own experience.

Additional recommendations

Before going to a traumatologist-orthopedic surgeon, it is advisable to read the information on the official website of the medical institution, study the price list, find out whether the clinic operates under compulsory medical insurance and how to make an appointment, as well as choose a convenient location and determine how to get there.

Rehabilitation in Novosibirsk

The operation for endoprosthetics of large joints is not very difficult to perform, but serious in terms of rehabilitation, which lasts up to six months. The result largely depends on the patient and how he will comply with all the doctor’s requirements.

The most important period in recovery after prosthetics is considered to be the early period, which the patient spends in the hospital where he had the operation. After discharge from the hospital, proper rehabilitation will depend entirely on the patient.

Rehabilitation centers in Novosibirsk will help you get through this period effectively and fully restore your health and ability to work. These institutions are equipped with all the necessary equipment and staff of medical professionals, including massage therapists and physiotherapy.

There are such centers in the city on a paid and free basis. In government institutions you can get a rehabilitation course under the compulsory medical insurance policy, but it is limited to 10-12 classes. In paid clinics, doctors select rehabilitation individually, which can be completed at any stage of the recovery period. The largest rehabilitation centers are:

City Clinical Hospital No. 1

St. Zalesskogo, 6, tel. +7 (383) 225-07-19, gkb1.mznso.ru:

• The department is equipped with all types of physiotherapeutic procedures, specialists in massage and acupuncture. The staff has a kinesitherapist who diagnoses muscle activity and prescribes a set of exercises;

Medical

St. Krasheninnikova 3 lane 12, tel +7 (383) 201-83-12, www.medtsentrsk.rf:

• The department has water treatments and baths, massage, acupuncture, exercise therapy, physiotherapeutic procedures, and exercise equipment for muscle recovery. There is a nutritionist on staff who can provide advice on proper nutrition during the recovery period after prosthetics;

Medical

St. Shamshin families, 90/5, tel. +7 (383) 285-52-97, alfaclinic-nsk.ru:

• The rehabilitation department has physiotherapy, massage, therapeutic exercises with a set of necessary exercise equipment, and shock wave therapy. The staff of the institution includes a nutritionist who assists patients with a balanced diet after surgery.

All patients undergoing rehabilitation courses in these institutions will be under the supervision of an orthopedic specialist, who, monitoring the dynamics of the effectiveness of the recovery period, makes recommendations.

Endoprosthetics – the possibility of restoring painless mobility in the joints

A.A. Shchukin, Head of the Department of Orthopedics , Regional Clinical Hospital, Krasnoyarsk
One of the most pressing problems in surgery of the musculoskeletal system of the human body is the problem of restoring painless mobility in the joints.

Limb dysfunction is usually progressive. At first, you can count on a relatively long-lasting effect from conservative treatment. But there comes a time when it becomes useless. As the process progresses, pain intensifies, and deformities develop, indications for surgical methods arise. The most effective of them is endoprosthetics.

Prices and quotas for treatment

You can undergo surgery for endoprosthetics of large joints free of charge under a quota that is provided for certain indications. To do this, you need to perform a number of actions, such as:

• consultation and initial treatment with a traumatologist-orthopedist at the place of residence, who gives a referral to a level 1 commission based on the results of the patient’s examination;
• Based on the application, a higher authority of the medical institution draws up a protocol that reflects all the information about the diagnosis and indications for prosthetics. A decision on the application is made within 10 days;
• if there are no contraindications to the operation, the package of documents is sent to the regional health department;
• at a commission in the presence of the attending traumatologist-orthopedist, the application for a quota is considered without the participation of the patient, followed by drawing up a protocol. If the issue is resolved positively, a package of documents with a copy of the decision protocol and a coupon is sent to the clinic where the endoprosthetics will be performed;
• A quota commission meets in the clinic and decides on the advisability of intervention in a particular case. The positive response of the quota commission, which is accepted within 10 days, is brought to the attention of the health department. Next, the patient is informed about the date of hospitalization.

If there are no indications for free endoprosthetics surgery, the patient pays for all services independently.

The total cost of the intervention will consist of:

• surgical techniques;
• nutrition;
• inpatient stay up to 7 days;
• expenses for painkillers.

The price of these services without the cost of a prosthesis in a private clinic will cost the patient about 100 thousand rubles. Depending on the composition of the product and the manufacturer, its price will be from 130 thousand to 170 thousand rubles and more.

The cost of a cementless prosthetic system also increases in price. The total price of knee or hip joint replacement, if paid for independently, will range from 210 thousand to 300 thousand rubles.

What to do if you decide to have surgery

In the event that the patient received an invitation to undergo an operation at the KKB, or the cost of the endoprosthesis was paid by the company or sponsors, or the person independently wants to purchase an endoprosthesis for his own money. Where to begin?

First of all, you need to stop taking anti-inflammatory drugs. Then call for a preliminary examination the head of the department A.A. Shchukin by phone 20-16-01 and after examination agree on the date of hospitalization.

But there may be a different situation. The person got on the waiting list in 20010-2011, and the wait for an invitation is still long, there are no sponsors, no personal savings. You still need to contact a KKB orthopedist. After all, it is possible to perform an operation outside the region - in Kurgan, Novosibirsk, and other clinics.

What does the Czech Republic offer?

Hip replacement in the Czech Republic is performed only using minimally invasive methods using high-quality prostheses from Biomet, Zimmer, and Lima. Czech specialists take a very correct approach to the physiological qualities of the patient, trying to injure the tissue as little as possible. When replacing hip or knee joints, extensive bone resection is not performed.

Clinics in the Czech Republic are equipped with their own rehabilitation centers, where recovery after prosthetics is very fast. Patients begin to move with support already on the 2nd day.

After discharge from the hospital, recovery continues in the conditions of sanatorium-resort treatment, which promotes a speedy recovery and an active lifestyle for the patient.