Author: Medical Tourism Magazine
If you are interested in first-class medical care in Berlin, DRK Kliniken Berlin is the right place to go. At three hospitals situated in Berlin’s most attractive locations, we offer an optimum health care provision and provide you with the individual, highly specialized inpatient care you desire. The DRK Kliniken Berlin is characterized by many years of experience in high-performance medical treatment and by always placing the patient in the centre of our medical and nursing attention.
Our partner, the German Red Cross Nursing Corps, Berlin branch is a synonym in this city for a tradition of highly qualified nursing care, putting the patient first, in all activities and thoughts. Every year more than 58,800 in-patients put their trust in the DRK Kliniken Berlin. At the department for traumatology and orthopaedics, we offer the latest surgery techniques. Highly specialized and experienced doctors offer patients in need of orthopaedic surgery options on well-founded medical diagnosis combined with adequate therapy techniques. Our doctors use arthroscopic and minimally invasive techniques whenever possible. This reduces rehabilitation time significantly and obtains better results. Here are just a few examples.
Stability and Flexibility with Intervertebral Disc Endoprothesis
Intervertebral disc endoprothetics is a promising alternative to spinal fusion. In the past, degenerative conditions that needed surgical intervention were treated with a spinal fusion. However, technology has advanced to the point of creating a device that can mimic the role of an intervertebral disc and thus can help to keep the spine flexible and stable. The aim of this operation is to restore pain-free function of the spine.
Professor Dr. Dr. med. Burkhard Rischke is a specialist in surgery, orthopaedics and trauma surgery specializing in microsurgical nucleotomy, spondylodeses, at decompression of stenosis of the spinal canal and interkorporal vertebroplasty/kyphoplasty as well as the intervertebral disc endoprosthetics performing more than 200 procedures using Prodisc® prosthesis per year.
Since 2000 Prof. Rischke has gained experience in implanting artificial discs. As a surgeon undertaking clinical trials, he was involved in the approval of the PRODISC-L® Total Disc Replacement by the U.S. Food and Drug Administration for use as a treatment for functionally disabling pain from lumbar degenerative disc disease. Initially, only the surgeons who have been part of the Prodisc® clinical trials are trained to implant the Prodisc®.
“With the findings from clinical research and development we particularly favour preservation and restoration of stability and mobility of the spine and offer on the basis of evidence-based medicine effective and safe treatment options,” says Prof. Rischke.
With more than 7000 surgeries for intervertebral disc prosthetic implantation, he is one of the world’s most experienced surgeons.
Patients between 30 to 60 years with an active life style and a so-called degenerative spine loss in one or more segments of the spine are most suitable for this kind of surgery. It is particularly important that the bone is still intact and free of osteoporosis.
The insertion of an artificial disc takes about 90 minutes. Using a highly sophisticated surgery technique the surgeon inserts the artificial intervertebral disc between two vertebrae. Here the prosthesis works like a ball joint and keeps the spine, in contrast to a spinal fusion, flexible. After the surgery on the lumbar spine, the patient can already get up the same day.
Another advantage compared to spinal fusion is the conservation of adjacent spinal segments, because these segments do not have to cover the function of the decommissioned spinal section. Over-exposure and associated damage can be prevented and a revision surgery can be avoided.
The Synthes Prodisc® is the second artificial disc which in 2005 has been reviewed in a clinical study under the supervision of the U.S. FDA. The surgeon also stresses on the 15-years of clinical experience, on which doctor and patient can rely. Prodisc® has been successfully implanted more than 10,000 times.
Another option is the Freedom Lumbar Disc produced by Axiomed which has lately been CE-certified. It is currently the world’s only approved prosthesis with an elastic core. The viscoelastic disc replacement is designed to mimic the native function of the disc, including three dimensional motion, dynamic stiffness, load sharing capability, and proper maintenance of lordosis may provide a more promising alternative to fusion than first generation total disc replacements.
“I was lucky enough to make the necessary clinical trials in Germany as a Principal Investigator and being the only operator implanting this prosthesis regularly in a hospital in Switzerland. In Germany, the prosthesis is expected to be available this autumn,” adds Prof. Rischke. The clinical trials have been registered with the FDA.
Hip Resurfacing and the Birmingham-McMinn Technique
DRK Kliniken Berlin surgeon, Professor Dr. med. Michael Faensen perfected the hip resurfacing technique using the Birmingham-McMinn technique. He specialized in hip and knee joint arthroplasty for degenerative, congenital and inflammatory arthropathies, hip and knee joint injuries and posttraumatic arthritis. In 2000 he was tought this special hip resurfacing technique by Derek McMinn in Birmingham and subsequently introduced this method to Berlin. In 2003 he founded the Centre for Hip Resurfacing (Birmingham Hip Resurfacing) at the DRK Kliniken Berlin.
Joint replacement has changed completely with hip resurfacing, as it is a minimally invasive approach to hip joint surgery. With this method, in contrast to conventional prostheses, only the damaged surface parts of the hip joint are removed. The femoral head and femoral neck are conserved. The femoral head is capped with a metal cup which similar to the thin walled acetabular cup consists of a special cobalt-chrome-molybdenum alloy with a high carbon content, which in individual cases remained free from wear or signs of loosening over a period of thirty years.
The concept of hip resurfacing was first applied clinically from the mid-1970s into the early 1980s. The results were mostly disappointing as the high degree of wear of the synthetic acetabular cup through friction with the metal or ceramic head caused osteolysis and component loosening. The reason for these early failures was the polyethylene used for the acetabular cup. The poor results with hip resurfacing in the seventies were therefore due to poor hip resurfacing systems.
The recognition of this following clinical evidence meant that in 1989 the metal on metal pairings were reintroduced for conventional prostheses. It also meant that in 1990, McMinn began to develop a hip resurfacing technique based on metal- on- metal articulating surfaces. Because of past experience in general, the McMinn concept was slow to gain acceptance. However, after the first publications in 1996, other prosthesis manufacturers began to copy the concept so that today nearly all leading manufacturers offer hip resurfacing prostheses.
The resistance to wear through lubricated friction and the very low risk of dislocation means that patients can participate in many types of sport without experiencing adverse effects where conventional prostheses cannot be recommended. This is also true for occupations which cannot be pursued with a conventional prosthesis or only at great risk. Other advantages are that there is no noticeable change in leg length or leverage of the hip muscles and the “feeling” for the joint and the reflexes (proprioception) are retained, meaning that the natural load transfer between the pelvis and the femoral head and femur prevents change in bone structure or bone loss and increases bone density. Furthermore the proximal femur is conserved so that optimal conditions exist for all types of prosthesis stems where revision surgery is required.
For over sixteen years and with more than 70,000 patients, the original McMinn implants (Birmingham hip resurfacing) have given excellent results which have been confirmed through numerous scientific publications. This is consistent with our own experience with over 1600 implants.
The centre for hip resurfacing at the DRK Kliniken Berlin is a teaching centre for resurfacing according to the McMinn method. With over 2000 resurfacings and more than 200 mid-head-resections the centre has developed into one of the world’s most experienced institutions in this field.
A Minimally Invasive Approach to Total Hip Replacement
At the DRK Kliniken Berlin a new surgery technique for total hip replacement is applied. The minimally invasive hip surgery uses a small incision combined with a new operating table. It much resembles an operation through a keyhole.
Thus, Berlin is one of the clocks in Europe. The physician Etienne Lesur has developed this surgical technique in France in 1993 and brought it to Germany approx. 2 years ago. Only a few German hospitals have tested this method so far. In Berlin, Dr. Thilo John is specialized in hip surgery and hip arthroscopy. Since October 2009 he is the new Head of Department for Traumatology and Orthopaedics at the DRK Kliniken Berlin. His research focuses on tissue engineering and migration behaviour of hip prosthesis, where he received grants from the Charité.
Dr. Thilo John has gained professional experience within the recent years. And this experience is very positive, Dr. John says. So far he is the only one in Berlin implanting an artificial hip joint through such a small incision – with specially developed tools, but with the best in decade’s implants. “The progress of the new surgical method lies in a significantly lower blood loss,” says Dr. Thilo John. “Furthermore the pain after the surgery is considerably less, and the patient’s rehabilitation determined by the higher stability of the muscles is also achieved much faster.” Many patients can already get up the next day and walk some steps.
Apart from the small incision, another, more sophisticated way towards the hip joint is taken. Up to now, important muscles of the hip joint had been partially detached or cut off, now they are merely pushed apart. “This causes less damage to the muscles and the risk of vascular and nerve injuries is reduced,” says Dr. John.
In addition to the gentle intervention, a new operating table has been installed. Previously another doctor had to keep the leg in a stable position away from the body. This is now done with an “Extension Table”, which holds the leg in an optimal position and allows better results for the insertion of the artificial joint. “The new method shortens the hospital stay significantly and the patient will soon be independent again,” adds Dr. John.
Furthermore Dr. John is specialized in the technically challenging hip arthroscopy, which allows him to find out the real reason for hip complaints better than with MRI and CT-scans only. He further treats primary and secondary hip malpositioning and is a specialist for pelvic fractures.
With the know-how and abilities of these specialists, the DRK Kliniken Berlin are able to find and perform the most suitable treatment for each individual patient facing hip complaints. Besides being internationally accredited by the prestigious Joint Commission International based in the United States, the DRK Kliniken Berlin have attained the national “PAIN FREE“ Certification awarded by the German Association for Qualified Pain Therapy (Certkom e.V.). Physicians, nursing staff and physiotherapists are fully committed to this cause, so that NO patient shall fear pain in preparation of, during or after required treatment.
The DRK Kliniken Berlin are a non-profit network offering a total of 1,350 beds, over 3,200 staff members and 450 physicians in attendance. They have an outstanding national and international reputation for excellent health care and their contribution to medical research. The International Affairs Department is dedicated to co-ordinates all aspects of medical treatment for international patients.