Knee replacement under a quota: queue, where it is done and how to apply for a quota

It’s downright difficult to get in line at a hospital for knee replacement for free. The surgical intervention itself costs a lot of money - at least fifty thousand rubles (plus a prosthesis!), and it’s a rare family in our country that can afford it. The state program makes it possible for some people in need to receive services without financial compensation, but to do this they will have to collect the necessary documents confirming the need for surgery, take tests and wait their turn. There are restrictions on the number of people accepted into the government program each year. How to be among the lucky ones?

General overview

The cost of knee replacement is currently quite high - from 50,000 rubles only for the intervention itself, and, in addition, you will have to pay for the hospital stay, the medications used, all the studies that will be carried out, as well as the prosthesis. Many believe that the intervention is worth the money, because we are talking about an operation in which the damaged parts of the knee are successfully restored, and the person is able to move normally. The question is extremely relevant; many of our compatriots suffer from knee problems. For others, the cause is injury, for others it is age-related changes that have destroyed the joint tissue.

By waiting your turn under the quota for knee surgery, you can count on full compensation for the money spent on surgery or a partial refund of the amount. As can be seen from the responses of people who managed to get into the program, such an intervention restores the quality of life, and the state program gives hope to those whose financial capabilities would never allow them to accumulate such a significant amount on their own.

What to do?

Perhaps the most pressing question is how to apply for a quota for knee replacement. Bureaucracy in our country is one of the important enemies, and we have to fight it almost every day, especially in a situation when it comes to medical services. The legislation establishes a list of sequential actions that allow you to gain access to the desired program. It all starts with a full medical examination at the place of residence. The doctor’s task is to correctly complete the documentation and write a conclusion indicating the need for knee replacement. Based on such paper, you can already count on being included in the queue.

The documentation on the basis of which knee replacement is performed involves providing the medical institution with not only a medical opinion, but also a statement written personally by the patient, as well as transferring a copy of the passport, insurance policy, and identification number. It will be necessary to conclude an agreement with the institution. If a person has disabled status, a document confirming this fact must be provided.

Video “How the operation works”

Today, a quota for the manipulation in question, in accordance with the appendix to the Order of the Ministry of Health of the Russian Federation dated August 12, 2013 No. 565n, can be obtained for the following ailments:

1. Oncological diseases that cause damage to the musculoskeletal system in children/adults.
2. Joint defects that developed against the background of systemic connective tissue diseases.
3. Post-traumatic/postoperative changes in the structure of the limb (fractures, dislocations, subluxations, etc.), which are combined with deforming arthrosis of the knee, elbow, ankle, shoulder joints.
4. Von Willebrand's disease, other ailments associated with the quality of blood clotting, which affect the structure of joints and ligaments. This also includes cases of fracture of the neck of the femoral joint, when other types of surgical intervention, except total arthroplasty, are contraindicated.
5. Infection of the area in the area of ​​the installed endoprosthesis.
6. Wear, complete/partial destruction of the endoprosthesis, instability of some of its components.
7. Incorrectly fixed prosthesis.
8. Bone fractures near the installed endoprosthesis. This problem is especially relevant for older people: bone tissue loses its strength with age.

Joint endoprosthetics, or joint replacement, is a popular surgical procedure and joint treatment today. The procedure for replacing a joint is not cheap; most people do not have the opportunity to replace a joint at their own expense. At the same time, the current legislation in the Russian Federation in some cases allows for full or partial compensation of the costs of this operation.

Today we will talk about how you can replace a joint completely free of charge (or partially) under a quota, where and who to contact. At the bottom of the page we have selected interesting videos for you about the features of the operation, types of endoprostheses, how to choose an artificial joint that is optimal in terms of quality and cost of money.

According to the appendix to the order of the Ministry of Health of the Russian Federation dated August 12, 2013 No. 565n, today a quota can be obtained for the following diseases:

1. Oncological diseases that affect the musculoskeletal system in children and adults.
2. Joint defects developing against the background of systemic connective tissue diseases.
3. Post-traumatic/postoperative changes in the structure of the limb (fractures, dislocations, subluxations), combined with deforming arthrosis of the knee, elbow, ankle, shoulder joints.
4. Von Willebrand's disease, other diseases associated with the quality of blood clotting, which affect the structure of joints and ligaments. This also includes cases of fracture of the neck of the femoral joint, when other types of surgical intervention, except total arthroplasty, are contraindicated.
5. Infection of the area in the area where the endoprosthesis is installed.
6. Wear, complete/partial destruction of the endoprosthesis, or instability of its components.
7. Incorrectly fixed prosthesis.
8. Bone fractures near the installed endoprosthesis. The problem is relevant for older people, because bone tissue loses its strength with age.

In accordance with the above order and in accordance with Decree of the Government of the Russian Federation of November 28, 2014 No. 1273, quota hip replacement is possible in the following cases:

1. The patient is diagnosed with deforming arthrosis in combination with postoperative injuries.
2. Joint dysplasia against the background of deforming arthrosis.

In other cases, patients must have the financial resources to install an endoprosthesis.

These costs can be reduced in the following ways:

1. Make a choice when treating a joint in favor of a public clinic. You can save on paying for the services of the attending surgeon and for hospital stay. The costs will be covered by the compulsory health insurance policy (CHI), but you will have to pay for the prosthesis. Sometimes the patient does not have enough time to collect the documents necessary for the operation, then the administration of a public medical institution may refuse to assist the patient in a free operation. When a patient goes to a private clinic, he will be forced to pay for both the endoprosthesis and the operation.
2. Take advantage of an individual rehabilitation program.

The first person you need to contact is your local doctor. Most often this is an orthopedic traumatologist, but you can simply see a surgeon. He will prescribe a full medical examination, which will confirm the presence of complex joint pathology, which will make it possible to receive a quota for free treatment.

Based on diagnostic data, test results and medical history, the quota committee of the specified clinic will draw up a protocol.

Second. After receiving the quota decision protocol from a medical organization, the patient needs to collect the following set (package) of documents (copies):

1. Passport of a citizen of the Russian Federation.
2. Compulsory health insurance policy (CHI).
3. Pension insurance certificate (SNILS - insurance number of an individual personal account).
4. A document confirming disability (if there is a group - MSEC certificate).
5. Conclusion (including the original document) from the clinic that the person needs surgery. It should contain data on the state of health, diagnosis, and all diagnostic measures carried out to make a diagnosis.

Of the original documents, the patient needs to have with him:

1. Referral from a traumatologist-orthopedist (attending physician).
2. Quota decision protocol.
3. Written statement from the patient.

Third. With the collected complete package of documents, the patient or his authorized representative must contact the health department, where the received application is considered with the participation of a specialist in the field of “Traumatology. Orthopedics".

Often the patient himself is not present at these meetings, but if controversial situations arise, he may be called for an in-person consultation.

The entire process of considering the application, according to 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 that performs joint replacement surgery under a quota.

Any such clinic has a quota committee, which, after reviewing the received package of documents (within ten days), notifies the health department of the exact date of hospitalization.

Thus, the health department is informed about the decision made, and an employee of this department informs the patient about the appointed date by telephone.

It is not possible to say exactly how much time will pass from the moment you receive a coupon for high-tech medical care (HTMC) to the operation. Much will depend on the popularity of the medical clinic that performs joint replacement surgeries (workload of patients); settlement. In big cities, waiting in line can take several months.

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 whose right to receive endoprostheses in the IPR came before 01/01/2015. It does not matter in what year the operation will be performed: in 2021 or 2021. But there is a nuance: for this category of patients, a fixed amount is allocated for the operation and endoprosthesis (on average 160 thousand rubles).

If the IPR was received after December 31, 2014, endoprosthetics is carried out at the expense of compulsory medical insurance (compulsory health insurance policy). According to the order of the Government of the Russian Federation dated January 1, 2015 No. 1776-r (item from the list of rehabilitation funds that the state allocates to disabled people, endoprostheses are excluded.

An individual rehabilitation program makes it possible to receive certain rehabilitation equipment free of charge: walkers, crutches, diapers, etc. On the other hand, at present the procedure is not regulated for reimbursement of the cost of surgery under a compulsory medical insurance policy. There are many controversial issues that will take the patient a lot of time to resolve. Therefore, when an urgent operation is needed, people are forced to turn to charities and foundations for help.

The registration of an individual rehabilitation program for a disabled person is carried out on the basis of a medical and social examination (MSE). When undergoing the examination procedure at the ITU Bureau, the possibility of including technical means of rehabilitation in the IPR is considered.

First: the type of medical institution: in public clinics, a fee is more often collected for an endoprosthesis. In private hospitals, one treatment for a patient can cost at least 100 thousand rubles (without an endoprosthesis).

This price includes:

1. Operation.
2. Anesthesia.
3. Nutrition.
4. Hospital stay (4-5 days).

The cost will also be affected by the location and the qualifications of the surgeon.

Second: type of endoprosthesis, manufacturer.

1. If you take ceramic/ceramic and metal/metal friction pairs (from 170 thousand rubles) they will cost more than metal/polyethylene pairs (about 130 thousand rubles).
2. Prices for a total cement endoprosthesis range from 120-140 thousand rubles.
3. Cementless structures are 40-50 thousand rubles more expensive.

Third: the type of surgery.

1. For example, total arthroplasty costs twice as much as partial arthroplasty.
2. The most expensive manipulation is surgery on the hip joint (it is a large, supporting joint).
3. Surgical treatment of the shoulder joint is 5-7 thousand rubles cheaper, the knee joint is 10-15 thousand rubles cheaper.

Fourth: diagnosis. Before the operation begins, the patient undergoes a lot of tests and x-rays. State clinics are often referred to private medical organizations for these studies - this is an additional expense.

Knee replacement is a planned type of surgical intervention for which careful preparation is carried out. After all, this is the key to successful and effective treatment without unpleasant surprises during prosthetics.

Preparation

• Often the patient himself is not present at these meetings, but if controversial situations arise, he may be called for an in-person consultation.
• The entire process of considering the application, according to 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 that performs joint replacement surgery under a quota.
• Any such clinic has a quota committee, which, after reviewing the received package of documents (within ten days), notifies the health department of the exact date of hospitalization.
• Thus, the health department is informed about the decision made, and an employee of this department informs the patient about the appointed date by telephone.

Appearances and passwords

The described documents must first be submitted to a commission assembled by local government agencies responsible for healthcare and social protection of the population. The participants’ task is to determine to what extent a person needs urgent knee replacement and whether he should be given access to the program under a quota. The duration of the case consideration is 10 days. If the outcome is positive, the documentation is automatically redirected to the clinic responsible for providing the appropriate medical class=”aligncenter” width=”700″ height=”486″[/img]

The next stage of paperwork is the responsibility of the medical institution. Clinic managers study the received documentation and then decide how long to wait for the knee replacement quota. The facility usually already has a waiting list of patients who need such intervention. Data on a new person is analyzed to understand which date will be optimal for him. As the decision is made, information about it is officially transferred to the medical commission, which notifies the citizen who has requested help about when and where endoprosthetics will be performed, and what additional measures need to be taken to prepare for the intervention.

So, where are knee replacements done on a quota basis? Medical institutions in Moscow are listed below:

• City Clinical Hospital No. 67.
• KB MSMU im. Sechenov.
• Hospital named after N. Semashko.
• Medical and Surgical Center named after. N. Pirogova

Current questions and answers

• Question:
  How much will the operation cost on average if you pay yourself?

  Answer:

  Endoprosthetics costs about 210-300 thousand.

• Question:
  Instead of sending me to the clinic for quota surgery, they prescribe endlessly new examinations. That my new leg will grow? If I refuse these procedures, what will happen?

  Answer:

  If you refuse medical indications, including diagnostics, you will be denied your quota, with no options.

• Question:
  In which medical institutions can recovery be carried out?

  Answer:

  The list can include both state regional centers and institutes, and private clinics. Check the list for your region.

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About the timing. Who should

The laws establish that the waiting time in line is about a quarter of a year. In reality, the period increases significantly due to the high demand for participation in this program.

Currently, knee joint replacement is a quota for adults, children, and patients with cancer that negatively affects the capabilities of the musculoskeletal system. A person who is suffering from severe pain, and conservative treatment methods do not show effectiveness, can contact a medical commission. Those who have already received a prosthesis, but it has worn out or collapsed completely or partially, have certain opportunities. You should also try to get in line if a prosthesis was previously placed, but this area is inflamed.

There are certain opportunities for knee replacement under a quota for those who have suffered a fracture or experienced unsuccessful surgery. If the situation is complicated by rheumatism, arthrosis and other similar pathologies, or the limbs are subject to destructive changes, you should try to submit documents to be included in the queue.

Who will need surgery

There are no strict recommendations on how quickly surgery is required after the onset of the disease. The need for surgery is determined by the patient's condition. If a person has impaired joint function and constantly experiences pain that is not controlled by medications, surgery is recommended - even if the test results do not show significant changes.

By the way

20–30% of rheumatologists’ patients are people with depression that developed before the onset of the disease. Today it has been proven that depression is based on the same immune mechanism that causes joint pain.

Is it possible or not?

In some cases, knee replacement is not carried out under a quota (or without it, on a general basis). This applies to situations where doctors identify contraindications to intervention. In particular, a ban on surgery is established for patients suffering from cardiac disorders or vascular diseases, problems with the functioning of the nervous system. Surgery should not be performed on a person with diabetes.

In some cases, the indications are absolute, sometimes temporary. In each individual option, doctors tell you exactly why knee replacement is currently not possible under the quota, and also tell you whether the condition will change over time. There is a possibility that the operation will be allowed once the person’s position has stabilized, when the risk of negative outcomes is reduced. A good example: when blood glucose levels are stabilized in diabetes mellitus, surgery can be performed.

Where do they operate better - in Russia or abroad?

In Russia, these operations have been carried out for more than 40 years. During this time, not only the optimal technique was developed, but also the quality of artificial joints was improved (today it is possible to select a joint for each patient, depending on the nature of the disorders). Therefore, there was no reason to undergo surgery abroad (Germany is in particular demand among wealthy citizens of the Russian Federation. - Ed. ) neither before nor now. Another thing is that the operation is half the battle. No less important is rehabilitation, which is traditionally considered the Achilles heel of domestic medicine and the strong point of Western medicine, where more experience has been accumulated in the recovery of patients after joint replacement.

Article on the topic

The mouth did not open. Capital surgeons helped a patient with joint pathology. Fortunately, rehabilitation centers began to appear in Russia, and our specialists began to actively adopt the experience of foreign colleagues. For example, foreign patients began to come to our center for surgical treatment of joints. According to their reviews, the advantage of our medicine is its individual approach. In the West, the time frame for rehabilitation is strictly limited. Our doctors treat as much as needed.

What about the money?

According to reviews, knee replacement is an operation for which it is not easy to calculate how large the costs will be. This largely depends on the hospital chosen by the medical commission. If this is a government agency, then in most cases payment is due only for the prosthesis installed on the patient. If the choice fell on a private owner, then you need to pay for the intervention, and for the drugs and prosthesis used, and for being in the ward. Often the amount depends on the qualifications of the doctor performing the intervention.

Another important point related to financial aspects mentioned in reviews of knee replacement: the price of the prostheses used by doctors varies quite a lot. If this product is made in our country, it will cost relatively cheap, but imported models are many times more expensive. Additionally, the increase in price may be explained by special types of examination, if any are prescribed to the patient.

Will I be on the list?

Currently, the quota program involves providing the opportunity to receive relatively inexpensive medical care only to a strictly limited number of patients. From year to year, more and more people are turning to medical institutions in need of urgent surgery, but only a small percentage receive access to the state program.

Usually quotas are distributed at the beginning of the year. If the request, for example, to replace the meniscus of the knee joint was later, you will have to wait. As a rule, this drags on for a long time. There is a possibility that someone who has already been allocated a quota will refuse the operation. This doesn't happen often, but it is possible. Such an event somewhat shortens the waiting period for those who are in line after the refusenik.

What to do?

Two aspects are quite relevant for many: deadlines and which knee joints are placed according to the quota. The first one is clear: not everyone has the opportunity to wait their turn. If the approximate waiting period is years, during this time organic tissues can be destroyed very much, and the person himself will completely lose the ability to move. In such a situation, many try to find an alternative option, looking for funds to pay for the operation themselves. Timely medical care significantly increases the chances of restoring quality of life.

The second aspect is related to the prostheses that will be installed. It is usually assumed that those who go to the clinic at their own expense have a choice. People who get an appointment under a quota can only rely on those prostheses that are currently available in the institution. Of course, this is in any case better than nothing, especially for patients who objectively do not have the opportunity to pay for an operation that allows them to choose what and how to perform it. At the same time, no one can guarantee that at the right time, the doctors of the institution will actually have the best and most modern prostheses.

How soon can we return to normal life?

Due to the fact that today patients are lifted out of bed on the first day after surgery, and mechanical rehabilitation means (devices for developing the joint) and therapeutic exercises are actively used during recovery, the recovery process has been significantly reduced. As a rule, after 2–3 months a person feels healthy and can do without aids (in particular, without crutches). Patients with excess body weight (who are more likely to experience joint destruction) require the most recovery time.

However, the timing greatly depends on how conscientiously the patient follows medical instructions. If a person is lazy (in patients’ language this is called “taking care of the joints”), rehabilitation may take longer.

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Where can I read it?

To find out the current legal standards regarding the issue under consideration, you should study the order issued in 2013 by the Ministry of Health, issued under number 565n. It indicates all the features of the provision of quotas, as well as a list of persons eligible to participate in the program. Additional official information is also contained in the government decree issued a year later. This document was published under number 1273. It also discusses the features of inclusion in the waiting list, possible diagnoses with which you can get to the clinic for free (or partially free).

How to save money?

If you cannot find out for yourself how knee replacement surgery works under a quota, and you need to carry out the event entirely at your own expense, you can take advantage of several opportunities to reduce the cost of the event. The cheapest way available to our compatriots is to go to a state surgical clinic. In this case, you will not have to pay for hospital and surgical services - these amounts are covered by an insurance policy, which all citizens of the country must have. But the cost of the prosthesis will have to be reimbursed.

Sometimes the situation develops in such a way that the operation is required very urgently, and the person simply does not have the opportunity to collect all the documentation required by the rules. A public clinic does not always have the right to admit such a patient, so there is a high risk of refusing free care. If the circumstances are this way, the only option is to use the services of a private organization, where you will have to pay both the price of the prosthesis and the costs of the operation.

How is hip replacement performed in Moscow?

After visiting an orthopedic clinic, at the first consultation with the patient, the doctor describes the operation itself, its advantages and disadvantages, and possible complications. At this stage, he also selects the appropriate type of hip joint to replace. They differ in the materials from which the head and bowl (liner) are made:

• Metal
  – highly wear-resistant, but metal particles formed during friction of artificial articular surfaces can presumably negatively affect the general condition of the body;
• Ceramic
  prostheses are wear-resistant and completely safe for humans, but it is too early to accurately judge their durability, since they are just beginning to be used in endoprosthetics;
• Combined
  - in such prostheses, metal or ceramic heads are combined with inserts made of wear-resistant cross-linked polyethylene, which makes them more affordable, but less durable.

If the pathology has affected only the surface of the articular head and acetabulum, the doctor may suggest partial prosthetics. In this case, prostheses are inserted onto the head of the femur and into the pelvic cavity into which it is inserted, replacing cartilage tissue. This option allows you to preserve the patient’s natural bone tissue and reduce the rehabilitation period.

The operation itself takes place in a hospital hospital under general or spinal anesthesia. The procedure includes the following steps:

• The patient is placed on the surgical table on his side, while his leg is bent at the knee and fixed. The doctor makes an incision 15-20 cm long over the affected joint, after which he removes the damaged bone tissue and cartilage.
• A rod is inserted into the upper part of the femur, on which the head of the prosthesis is fixed, and a cup is inserted into the acetabulum. The implants are fixed using a cementing composition or a special orthopedic glue, which also stimulates the growth of bone tissue. The doctor selects the optimal length of the prosthesis, checks its mobility and stability.
• At the final stage, the orthopedist restores the ligaments of the hip joint, then washes the wound with an antiseptic, removes remaining blood and small fragments of bone and cartilage tissue. The disinfected wound is closed and stitches are placed on it.

The entire operation lasts on average 2-3 hours, immediately after it the patient remains in the surgical department until the anesthesia wears off. After this, he is transferred to the ward and the recovery period begins.

Disability and some features

The rehabilitation program after knee replacement, in accordance with current legislation, is intended for patients who have become disabled precisely due to the disease for which they were referred for prosthetics. IPR allows you to somewhat reduce the financial costs associated with surgery. The federal budget undertakes to reimburse the cost of prostheses if they were secured by rights that came into force before the beginning of 2015. It does not matter in what year the intervention itself will be carried out - in 2021 or later. True, there is a subtle point: the budget is ready to provide only 160,000 rubles, if the price of the prosthesis is higher, you will have to pay extra yourself.

If the patient entered the rehabilitation program after knee replacement after the end of 2014, then the prostheses are installed in accordance with the Compulsory Medical Insurance, and are guided by the decree issued under number 1776, signed by the government of the country. It provides a complete list of funds that the budget can provide to disabled people, and endoprostheses are not included in it. Using the IPR, you can get access to other rehabilitation devices - crutches, personal hygiene products, etc. At the same time, lawyers point out that many aspects are still not clearly regulated by laws, so it is likely that at the stage of reimbursement of expenses you will have to make a lot of effort to defend your interests.

Preparing for surgery

Before hip replacement surgery, the patient undergoes a comprehensive medical examination:

• blood and urine tests - clinical, biochemical, for infections (syphilis, HIV, hepatitis B and C), coagulability, etc.;
• instrumental studies - radiography of the affected joint, ECG, fluorography;
• consultations with an orthopedist, therapist, anesthesiologist, specialized doctors (infectious diseases specialist, ophthalmologist, dentist, etc.) if you have any diseases.

Since after the operation the patient will temporarily lose the ability to move independently, he needs to think about who will help him perform everyday activities. It is also necessary to provide in advance in the house the presence of handrails for support (especially on the stairs), a bench in the shower and other devices that make everyday life easier during the rehabilitation period.

After midnight on the day of surgery, you should refrain from eating or drinking water. It is also necessary to take medications that can be prescribed by an anesthesiologist or therapist as part of maintenance therapy.

What's in the future?

The prices are, of course, terrifying, but there is one aspect that scares many even more: the service life of the prosthesis. Modern systems are not eternal help. As the years pass, they gradually deteriorate. The service life is determined by several parameters. One of the most important is the method of attaching the artificial system to bone tissue. In some cases, the components of the prosthesis are literally driven into the bone, and gradually the objects grow together. In medicine this is called osseointegration. When using this technique, the joint elements are firmly fixed, so the system will last quite a long time.

This technique is not always feasible. Often, the quality of the bone simply does not allow for such prosthetics, but there may be other reasons. An alternative option is the use of bone cement, that is, a hardening mass that allows you to quickly fix the prosthesis.

Indications for endoprosthetics

• Prolonged pain in the ankle joint.
• Severe limitation of mobility in the joint, contracture.

The causes may be previous injuries, chronic diseases (rheumatoid arthritis, other systemic collagenoses, osteoarthritis deformans), and congenital anomalies. This is a serious, complex operation, which is resorted to when other treatment methods are ineffective (pharmaco- and physiotherapy, intra-articular injections of synovial fluid analogues, anti-inflammatory drugs, etc.).

Friction pair

This parameter of the prosthesis directly determines the length of its service life and the effect on the patient’s organic tissues. In fact, a joint is a joint whose components rub against each other. If in technology the process is smoothed out by the presence of lubricant, then in the human body there is none, so the components wear out significantly over time. The degree of wear is directly related to the survival of the joint. It is determined by the materials used and the number of movements made by a person.

In order for the joint to live longer, it is necessary to install systems with the most effective friction parameters, as well as reduce the number of motion cycles. The longest wear periods are typical for systems that use ceramics, but the price for such prostheses is the highest.

About the individual rehabilitation program

Often patients are not satisfied with the length of the waiting period.

There is another legal method to obtain government support for prosthetics. But to implement it, a serious amount of money is needed.

The essence of an individual rehabilitation program

1. The point of the event is that the citizen pays the clinic for the costs of manipulation and treatment from his own savings.
2. After completing all the necessary activities, the money spent is paid to him by the budget.

The benefits in this case are received by all parties to the process, they are as follows:

1. There is no need to wait for the government agency to pay for the purchase of a prosthesis.
2. The clinic has the necessary funds to purchase all materials and medicines.
3. Prostheses are purchased only from the most trusted suppliers and are of high quality.
4. The budget pays only for the assistance provided, so to speak, based on the actual services performed.

There is only one drawback of the program: a significant amount is required, which will be returned to the citizen after a certain time. The cost of a hip joint prosthesis varies from 120 to 190 thousand rubles. It depends on the design and material of manufacture.

Charitable organizations can finance the purchase of a hip replacement.

Who is eligible for the individual program?

Payment for a prosthesis from the budget is made in the following cases:

• if the person is disabled due to the disease in question;
• the right to receive a prosthesis was documented before 01/01/2015.
• others (individually).

Citizens who received the right to a quota before 01/01/2015 are allocated a fixed amount. It amounts to 160 thousand rubles. Additional expenses must be paid from your own funds.

What to choose?

Not every material is suitable for a particular patient. In some cases, polyethylene is the most profitable option; for others, ceramics will be the optimal solution. Sometimes doctors may recommend using metal prostheses. To choose the best option, you should seek advice from an experienced doctor. Only a qualified specialist can evaluate all the positive and negative aspects of different types of prosthesis in relation to a person’s specific situation, on the basis of which a reasonable decision will be made - both in terms of quality and financial investment.