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The Endoprosthetics Centre treats advanced cases of arthrosis of the hip and knee joints by inserting artificial joints.

Many of our patients come to us for treatment with persistent complaints after accidents, or with chronic/degenerative joint complaints. Following a preliminary diagnosis by (special) X-ray, ultrasound or magnetic resonance imaging, arthroscopy (endoscopic examination of a joint) is an important operational measure. It is used for diagnosis, and in most cases for therapy, as a minimally invasive arthroscopic operation, for instance in meniscus surgery, in replacement of the cruciate ligament of the knee, or for cartilage smoothing in worn joints.

If a joint-preserving procedure – e.g. an operation to correct bowleggedness and eliminate the cause of arthrosis – can no longer be carried out, the advanced joint arthrosis is treated in the Endoprosthetics Centre of the Municipal Hospital of Pirmasens, and the patient is fitted with an artificial joint (endoprosthesis).

State-of-the art procedures are used, among them computer navigation via Orthopilot (as shown alongside, source: ©Aesculap AG), which optimises the fitting of the artificial knee.

This applies not only to optimal alignment of the prosthesis relative to the leg axes but also to achieving the optimal tension of the knee ligaments.

Both ensure good functioning of the joint replacement and extend what experts refer to as its ‘service life’.


After the surgery, X-rays of the knee joint are made from the front and side, showing the correct position of the fitted prosthesis. In this case, a complete surface replacement, the most commonly used knee prosthesis:

Cemented total knee arthroplasty from the front    Cemented total knee arthroplasty from the side


Depending on the requirements specific to the individual patient, sliding prostheses or axially supported special prostheses are implanted.

The artificial joint is anchored into the bone, either using bone cement or cement-free. The procedure applied depends upon the quality of the bone. Each approach has its own advantages – this is discussed in detail with the patient during planning for the surgery. Often, though, the final decision is not made until the operation begins.

Cement-free total hip arthroplasty                          
in pelvis overview
Cemented total hip arthroplasty in
pelvis overview

In addition to the usual cemented and cement-free prostheses, younger patients are treated with cement-free, implanted short-shaft hip prostheses; shown alongside: a cement-free short-shaft prosthesis with cement-free hip sockets on both sides, implanted at an interval of two years.

This special artificial joint ensures the preservation of as much natural bone as possible. Joint prostheses can become loosened after many years; if replacement surgery is required, it is easier to perform following implantation of a short-shaft prosthesis; it is also less stressful for the patient.



Artificial joints can be individually adapted to the patient, thanks to the wide variety of combinations of prosthesis components.

Shown here is a list of the components for the hip joint available for the implants we primarily use, which stem from the B. Braun Aesculap Company.

Even prior to surgery, thanks to digital prosthesis planning, a high-precision selection of the individual components of the prosthesis, their alignment and, via the location of the prosthesis, a determination of the expected result of the operation. This is obligatory in an Endoprosthetics Centre.

Naturally, a final decision is taken only during the procedure itself.

Digital prosthesis planning using the example of the knee joint, applying what is known as a ‘complete leg image in standing position’


Digital quality check after the operation

After the operation, a digital determination is also performed of the quality criteria relative to the fit of the joint prosthesis. Among others, these criteria include certain angular dimensions for the hip socket of the artificial joint. Measurement of the position of the hip socket following surgery is one of the many prerequisites that the Endoprosthetics Centre Pirmasens satisfies.

Measuring angular dimensions following
cement-free total hip arthroplasty



My questions for the Director of the Endoprosthetics Centre of Pirmasens

Chief Physician Dr. med.
Tobias Keßler


Contact the Endoprosthetics Centre

Katharina MüllerKatharina Müller




Stephanie SchlägelStephanie Schlaegel


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