Total hip arthroplasty / Top clinic in Germany, Friedrichshafen

Total hip arthroplasty

What is total hip arthroplasty?

The hip joint is made up of the acetabular cup (socket) within the pelvis and the femoral head (ball) of the thigh bone. In total hip arthroplasty (total hip endoprosthesis or TEP), both parts of the joint are replaced by synthetic implants made of metal, ceramic or plastic. Total hip arthroplasty by means of a TEP or a femoral head prosthesis is performed over 150,000 times annually in Germany, making it one of the most common forms of surgery.

Total hip arthroplasty (TEP) is a joint replacement surgery that is used to correct serious damage to the joint that has occurred due to various disorders that affect the mobility of the patient, placing limitations on his lifestyle. Before a total hip arthroplasty, a decision must be made as to whether a femoral head prosthesis, a shaft prosthesis or an acetabular prosthesis should be used. If both the femoral head and the acetabular cup are replaced, it is referred to as total hip arthroplasty (TEP). If only the femoral head is replaced, it is called a hemi endoprosthesis (HEP). There is a friction pair, consisting of two components, between the shaft and the cup of the synthetic joint. The ball-shaped head is mounted on the shaft. This head is able to rotate in a spherical synthetic acetabular cup in such a way that there is no significant difference in the movement of the synthetic joint and the natural joint. The acetabular cup can be made of metal, ceramic or plastic.

Total hip arthroplasty

Total hip arthroplasty is a significant therapeutic option for the treatment of disorders such as coxarthritis (non-inflammatory arthritis), coxarthrosis or a rheumatic disorder such as rheumatoid arthritis. Besides these very common causes, there are also several rare bacterial infections that play a significant role in the occurrence of inflammatory damage to the joint. Examples are Chlamydia, Borrelia and Campylobacter pylori. Inflammations due to other causes such as Psoriasis and existing tumours and necrosis of femoral head are also indications for TEP. Likewise, injuries to the joint, fractures and malalignment might necessitate a total hip arthroplasty.

The implantation of a complete synthetic joint is one of the most common orthopaedic procedures in Germany. In the last 20 years, hip-saving therapy options, for example in the case of coxarthritis, have been almost exclusively replaced by total hip arthroplasty.

Indications (areas of application) for total hip arthroplasty

  • wear and tear of the joint in the form of coxarthritis
  • inflammatory damage to the joint due to rheumatic disorders such as rheumatoid arthritis (and chronic polyarthritis) – the most common inflammatory disorders of the joints
  • inflammatory damage to the joint due to other auto-immune phenomena such as systemic Lupus erythematosus (SLE, a systemic auto-immune disease of the connective tissue)
  • necroses of the femoral head e.g. due to insufficient blood supply after an accident
  • subcapital fracture of the femur (femoral fracture below the femoral head)
  • comminuted fracture of the femoral head or the acetabular cup
  • malalignment of the joint
  • dysplasia (deformity) with secondary arthritis (wear of the joint)

Contra-indications in respect of total hip arthroplasty

  • the general condition of the patient is poor
  • low level of tolerance with regard to the anaesthetic required for arthroplasty

Cement-free total hip arthroplasty

A synthetic joint (total arthroplasty) can also be inserted without the use of cement, by anchoring the prosthesis directly into the bone. The surgeon screws or jams the synthetic acetabular cup and the prosthetic shaft into the prepared bone. After cement-free total hip arthroplasty, the bone grows onto the especially designed porous surface of the prosthesis over time, resulting in a firm, permanent bond.

Cemented TEP

A cemented prosthesis is also possible. This involves the use of special surgical cement that hardens exceptionally quickly. The orthopaedic surgeon cements both the acetabular cup and the femoral shaft into the existing bone, thereby providing a firm bond between the bone and the acetabular and the femoral components. Both the cemented and the cement-free methods are very effective in the long term, although the cement-free method requires a longer healing period before the joint is able to bear the full weight of the patient.

Hybrid prosthetics

Besides the cemented and cement-free methods, the so-called hybrid prosthesis presents another option. The hybrid total arthroplasty is a combination between a cemented and a cement-free prosthesis. The orthopaedic surgeon fixes the acetabular cup component of the prosthesis without the use of cement. The femoral component, on the other hand is cemented.

Why should I choose the Friedrichshafen clinic for my coxarthritis surgery?

All TEP procedures are performed according to the very latest methods in modern total hip arthroplasty procedures. Due to the large number of procedures performed every year, our orthopaedic surgeons have a great deal of experience in this field.

Besides the superb professional competence of our surgeons and the other medical staff, you will also be pleased with the exceptionally good atmosphere at the clinic.

Total hip arthroplasty

4.7/5 (761 votes)

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Medical Staff

Prof MD Eugene Winter

Prof MD Eugene Winter
Head of the Orthopedic Department of Clinical center of Friedrichshafen

MD Norbert Heuer

MD Norbert Heuer
Head physician assistant

MD Christoph Kaiser

MD Christoph Kaiser
Senior physician

MD Rainer Schnell

MD Rainer Schnell
Senior physician

Ingrid Glauss

Ingrid Glauss
Medical secretary








Facts and Figures

  • 12000 outpatient
  • 2523 inpatients
  • 2500 surgeries
  • 735 arthroplasty of the joints of the hip, knee and shoulder
  • 1500 hand surgeries

+49 163 59-51-511


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