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2. InRomania,endoprosthetichipreplacements are performed as part of the , all interventions being recorded
in the . Citizens who have a medical insurance benefit from prostheses free of charge. However, because funds prove to be insufficient, patients are placed on waiting lists. Patients also have the possibility to pay for their prostheses.

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Endoprosthetic hip replacement is a recons-tructive surgery procedure for the prosthetic repla-cement of the joint components in this area of the body. The aims of endoprosthetic hip replacement are: to alleviate the suffering of the patient through the elimination of symptoms, mainly pain, to restore joint mobility and stability, and finally, to improve the patient’s quality of life.

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An endoprosthesis for the hip joint includes a head to fit in the acetabulum and a stem to fit into the medullary canal of the femur

The time for surgery has come once all conservative treatment options (physiotherapy, balneotherapy, massage, pain medication) have been exhausted, the pain has become too strong, and the X-ray confirms arthrosis. For arthrosis of the hip joint, both the ball and the socket of the joint have to be replaced with an artificial joint, known as a total hip replacement (THR).

Endoprosthetic hip replacement is a reconstructive surgery procedure for the prosthetic replacement of the hip joint components. The aim is to restore the joint mobility and normal function of all periarticular structures that control the joint motion, allowing operated patients to live a normal life. The paper aims to present the situation of endoprosthetic hip replacements in Romania from 2003 to the present, including the number of interventions performed (primary and revision surgery), their costs, the main types of implanted prostheses, the sex distribution of endoprosthetic replacements, the reporting and recording procedures of the interventions performed. All Romanian citizens who have a medical insurance benefit from prostheses free of charge. As the demand for endoprostheses is very high and the allocated funds are insufficient, patients are placed on waiting lists. Part of these, who can no longer wait, pay for their prostheses. There are no separate data on patients paying for their prostheses and those benefiting from them free of charge. The existing data only refer to the total number of endoprosthetic replacements performed.

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1. The paper presents the situation of endopros-thetic hip replacements performed in Romania,
in the period 2003–2010 (1st semester).

Hip replacement has become necessary for your arthritic hip: this is one of the most effective operations known and should give you many years of freedom from pain.

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Considering the fact that the joint under the greatest amount of stress and the most affected by degenerative diseases is the hip, the majority of the prostheses implanted in Romania and worldwide are hip endoprostheses, followed by knee endoprostheses. There are two types of hip prostheses: cemented and uncemented. Uncemen-ted prostheses are fixed directly to the bone, while cemented prostheses are fixed with cement.
The latter are indicated for elderly people, because these have a poorer bone quality, which does not allow direct fixation. The disadvantage of a cemented prosthesis is that it is very difficult to change (revise) after it wears out, which is why it is not recommended for young people, who need to have their prostheses replaced several times during the course of life. The price of a cemented prosthesis is lower than that of an uncemented prosthesis: 600–1000 euros compared to 1200–1500 euros.

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The most common cause of a hip joint disorder is increasing destruction of the joint cartilage, which can develop into arthrosis of the hip or coxarthrosis. A distinction is made between primary arthroses with largely unknown causes and secondary arthroses after certain basic disorders (congenital malformations, rheumatism, circulatory disorders, accidents or similar). The joint increasingly loses its fit, bony deposits are formed along the edges, and abrasion particles cause repeated pain. The loss of cartilage results in an increasing stiffening of the joint. At the same time, pains occurs, at first associated with initial movement after periods of inactivity and with stress, later also at night and at rest, resulting in an increasing limitation of the walking range and ultimately a reduction in quality of life.

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41. Durbhakula SM, Czajka J, Fuchs MD, Uhl RL. Spacer endoprosthesis for the treatment of infected total hip arthroplasty. 2004;19:760-7

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