Endoprosthetics of the joint, or its replacement is a popular surgical procedure and joint treatment at the present time. The procedure for replacing the joint is not cheap, most people can not replace the joint at their own expense. At the same time, the current legislation in the Russian Federation in some cases allows to fully or partially compensate for the costs of the operation.
Today we will talk about how you can replace the joint completely free of charge( or partially) by quota, where and to whom to contact. At the bottom of the page for you are selected interesting videos about the features of the operation, types of endoprostheses, how to choose an artificial joint optimally for quality and cost of money.
CONTENTS
Joint replacement: commercial operation
According to the annex to the order of the Ministry of Health of the Russian Federation dated August 12, 2013 No. 565n, today the quota can be obtained with the following diseases:
- . Oncological diseases in which the musculoskeletal system affects children and adults.
- Defects of joints that develop against a background of systemic ailments of connective tissue.
- Posttraumatic / postoperative changes in limb structure( fractures, dislocations, subluxations), combined with deforming arthrosis of the knee, elbow, ankle, shoulder joints.
- Von Willebrand's disease, other diseases associated with the quality of blood coagulation, which affect the structure of the joints, ligaments. This includes cases of fracture of the neck of the femoral joint, when other types of surgery, except total endoprosthetics are contraindicated.
- Infection of the site in the endoprosthesis setting zone.
- Wear, complete / partial destruction of the endoprosthesis, or instability of its components.
- An incorrectly fixed prosthesis.
- Fractures of the bone next to the established endoprosthesis. The problem is relevant for the elderly, because bone tissue with age loses its strength.
According to the above-mentioned order and in accordance with the Decree of the Government of the Russian Federation of November 28, 2014 No. 1273, endoprosthetics of the hip are possible in the following cases:
- The patient is diagnosed with deforming arthrosis in combination with postoperative trauma.
- Joint dysplasia in the background of deforming arthrosis.
In other cases, patients should have money to install an endoprosthesis.
These costs can be reduced in such ways:
- Make a choice when treating a joint in favor of a public clinic. You can save on paying for the services of the treating surgeon and for being in the hospital. The expenses will be covered by the compulsory health insurance( MHI) policy, but they will have to pay for the prosthesis. Sometimes the patient does not have enough time to collect the necessary documents for the operation, then the administration of the state medical institution can refuse assistance to the patient in a free operation. When a patient goes to a private clinic, he will be forced to pay for both an endoprosthesis and an operation.
- Use an individual rehabilitation program.
Where to go, what documents are needed: stages of obtaining a quota for an operation to replace the joint
The algorithm for obtaining high-tech medical assistance for joint replacement for citizens in the RF is as follows:
The first , to whom you need to contact - to the treating physician at the place of residence. Most often it's orthopedic orthopedist , but you can just go to surgeon .He will appoint a full medical examination, which will confirm the presence of a complex pathology of the joints, which will give an opportunity to get a quota for free treatment.
Based on the diagnostic data, test results and medical history, the quota committee of the specified clinic will compile a protocol.
The second .After receiving the protocol of the quota decision in the medical organization, the patient needs to collect such a package( package) of documents( copies):
- Passport of a citizen of the Russian Federation.
- The policy of compulsory medical insurance( CHI).
- Pension insurance certificate( SNILS - insurance number of an individual personal account).
- Document confirming disability( if there is a group - reference by the Ministry of Health and Social Development).
- Conclusion( including the original document) from the clinic that a person needs an operation. It should contain data on the state of health, diagnosis, and all diagnostic activities conducted to establish a diagnosis.
From the original documents, the patient should have at himself:
- The direction of traumatologist-orthopedist( treating doctor).
- Protocol of the quota solution.
- Written application of the patient.
Third .With the complete package of documents collected, the patient or his authorized representative must apply to the health department, where the application is considered with the participation of a specialist in the field "Traumatology. Orthopedics".
Often the patient himself is not present at these meetings, but in the event of controversial situations, he may be summoned to a full-time consultation.
The whole process of considering the application, according to the current legislation, takes no more than ten days.
When the commission meeting makes a positive decision, all the patient's documents are sent to the clinic, performing operations for arthroplasty of the joints according to the quota.
In any such clinic there is a quota committee, which after reviewing the received package of documents( within ten days) informs the Department of Health about the exact date of hospitalization.
Thus, the decision of the decision is informed by the health department, and the employee of this department by phone informs the patient about the appointed date.
It is not possible to say exactly how much time will pass from the moment of receipt of a coupon for high-tech medical care( VMP) before the operation, it is not possible. Much will depend on the popularity of the medical clinic, which carries out operations for arthroplasty( congestion by patients);settlement. In large cities, waiting for your turn may take several months.
To whom and how do they give quotas for a free operation?
Individual rehabilitation program( IRP) makes it possible to compensate for the cost of the endoprosthesis in such cases:
The patient has a disability for the disease in question.
Endoprostheses at the expense of the federal budget are provided only to those disabled people who have the right to receive endoprostheses in IPPs before 01.01.2015.It does not matter in which year the operation will be performed: in 2016 or 2017. But here there is a nuance: for this category of patients, a fixed amount is allocated for the operation and an endoprosthesis( on average 160 thousand rubles).
If the IPR was received after 31.12.2014, endoprosthetics is carried out at the expense of the MHI( compulsory medical insurance policy).According to the order of the Government of the Russian Federation dated January 1, 2015 No. 1776-r( item 8), endoprostheses are excluded from the list of rehabilitation facilities that the state allocates to the disabled. An individual rehabilitation program gives you the opportunity to receive free of charge certain rehabilitation aids: walkers, crutches, diapers and so on. On the other hand, at present, the procedure is not regulated normatively for reimbursement of the cost of the operation under the MHI policy. There are many controversial points, the solution of which the patient will take a lot of time. Therefore, when an urgent operation is needed, people are forced to seek help from charitable organizations and funds.
Registration of an individual rehabilitation program for a disabled person is carried out on the basis of medical and social expertise( ITU).When an examination procedure is completed in the ITU bureau, the possibility of integrating rehabilitation equipment into the IPR is considered.
Endoprosthetics of the joint in Russian clinics: how much is it?
The cost of the procedure depends on several factors:
First : type of medical institution : in public clinics, the fee is usually withdrawn for an endoprosthesis. In private hospitals, one treatment for a patient may cost at least 100,000 rubles( without an endoprosthesis).
This price includes:
- Operation.
- Anesthesia.
- Power.
- Stay in the hospital( 4-5 days).
The cost will also affect the locality, the qualification of the surgeon.
Second : type of endoprosthesis, manufacturer .
- If you take pairs of friction ceramics / ceramics and metal / metal( from 170 thousand rubles) will cost more than the metal / polyethylene pair( about 130 thousand rubles).
- The prices of total cement endoprosthesis fluctuate within 120-140 thousand rubles.
- Bezcementnye constructions for 40-50 thousand rubles more expensive.
Third : type of surgical procedure .
- For example, total endoprosthetics costs twice as much as a partial endoprosthesis.
- The most expensive manipulation is the operation on the hip joint ( it is a large, supporting joint).
- Surgical treatment shoulder joint is 5-7 thousand rubles cheaper, knee joint - 10-15 thousand rubles cheaper.
Fourth : diagnosis .Before the beginning of the operation, the patient undergoes a lot of tests, X-ray examination. State clinics for these studies are often referred to private medical organizations - these are additional costs.
Video
Joint replacement: lifespan of endoprosthetic replacement joints
The video presents the Multipurpose Clinic of CELT.
Is the operation of arthroplasty required? The life of the artificial prosthesis will be told by the doctor of medical sciences, the doctor of traumatologist-orthopedist of the Multipurpose Clinic of CELT.
Content of the video:
Another question that we would like to consider and which probably excites the patients when they come to consult a doctor, they are offered surgery to replace the joint with an artificial one, this is what the terms of functioning or survival of the joint, to what lifeperiod a person can count on having an artificial joint. .. Endoprosthetics of the joint.
The first aspect of the is the attachment of the artificial joint to the bone components. It is carried out in two main ways: it is a strong clogging of the components in the bone tissue, where, due to the porous surface that the implant has, a gradual ingrowth of the bone beams and the so-called process occurs, the process of osseointegration is formed.
Due to this process, the joint elements are very firmly fixed in the bone and, most importantly, for a long time. This is called the so-called biological fixation of the implant.
If the quality of the patient's bone tissue( osteoporosis or some other problems) does not allow such a biological fixation, then a one-stage fixation is carried out using a special solidifying mass called "bone cement".This is the doctor's choice, depending on the clinical situation that he has. .. Endoprosthetics of the knee joint.
The second aspect of endoprosthetics, with which we meet, is a pair of friction.
Each artificial joint is a hinge, where there are friction components. Here, in the absence of any lubrication, as occurs in the technical device, there is a coefficient of friction and the corresponding wear of the components between which the friction in the joint occurs. And the degree of wear of these components also determines the survival of the joint in the human body.
The degree of wear depends on both the materials used in the friction pair and the number of motor cycles performed by the person during the operation of the artificial joint.
The increase in the survival time of the joint is in two ways: firstly, the improvement of the quality of friction pairs and in some cases this may be a reduction in the cyclic activity of the joint that a person does not need in his everyday life and only leads to early wear of the joint. At present, in particular, for some joints such as the hip joint, such pairs of friction as the ceramic friction couple that already exist and are used, including in the CELT clinic, can exist in terms of their wear and tear capabilities at a time comparable topatient's life. .. Endoprosthetics of the hip joint.
Still exist in our practice of friction pairs, where a special ultra-high molecular weight polyethylene is involved. .. Endoprosthetics of the shoulder joint.
In order to choose an endoprosthesis of the required quality, adequate to the condition of the patient's bone tissue, its age, its functional capabilities, it is necessary to apply to very qualified specialists. .. Prosthesis of the knee joint.
Telephone for information -( 495) 788-33-88( multi-channel), for companies and insurance companies -( 495) 305-02-68.
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How to choose the endoprosthesis
On the video channel Mediagroup INFOX.
Several years ago, surgeons had in their arsenal only five types of endoprostheses. Today in Europe there are about seventy different options. For each patient, depending on the age, gender, body configuration, the endoprosthesis is selected individually.
Endoprosthesis: for which it is worth paying, for which there is no!
On the video channel Medinua Clinic.
MedinUa clinic & LAB is a multidisciplinary family medicine center, where only advanced technologies are used - invasive surgery, methods from the field of sports medicine, which contribute to the effect of early rehabilitation.