Orthopaedic consulations, how does it work?

You can consult Dr van der Lugt and Dr Henkus at the Hospital Ceram in Marbella. During the first consultation, an interview and a physical examination will be conducted and research will take place like an X-ray of the hip or knee joint. During these consultations different treatments can be discussed: physiotherapy, medication, infiltrations in the joint, etc.

Do I have to pay for a consulation or operation?

It’s always possible to pay the consulations or operations by yourself if you don’t have a referral of your general practioner/home doctor.
But you do need a referral of your general practitioner/home doctor) to get it paid by your own insurance company.
In both cases don’t hesitate to contact Hospital Ceram if you have further questions.

What to do if an operation is needed ?

When a hip or knee operation is needed we will discuss the different surgical options and your expectations for the future. If you agree, we first ask permission to your insurance company. For this process we fill in a S2 form together (formely known as E112 form) and sent it to your insurance company. After a few weeks you’ll get permission and, in most cases, the insurance company will pay all the surgical costs. If they disagree, we will let you know which costs are for you own.

After this authorization we make an appointment with the anaesthesiologist for a preoperative screening.

Finally, we can give you an operation date, always in consultation with you.

Which surgeries are performed?

Primary hip prosthesis by the direct anterior approach (DAA)
Primary knee prosthesis
Arthroscopy of the knee

For all surgeries we use a ‘ fast track protocol’ for early rehabilitation.

Which prostheses are used?

Total hip prothesis uncemented (Actinia, Implantcast)


Total knee prosthesis cemented (ACS, Implantcast)

How long are you staying in the hospital after surgery?

Total Hip and Knee Prosthesis: 2 weeks: check wound and remove stitches, 6 weeks: last check.

Arthroscopy: 2 days: check wound 6 weeks: last check

If possible, these visits can be replaced by video consulting always in discussion with the patient.

Do you need physiotherapy?

Total hip prosthesis 2-4 weeks

Total knee prosthesis 4-6 weeks

Arthroscopy knee 1-2 weeks

Do I need antibiotics for dental procedures?

Patients with joint prostheses should alert their doctors and dentists that they have an artificial joint. These joints are at risk for infection by bacteria introduced by any invasive procedures such as surgery, infected dental or gum procedures, urological and endoscopic procedures, as well as from infections elsewhere in the body.
The treating physician will, in some cases, prescribe antibiotics before, during, and immediately after any elective procedures in order to prevent infection of the replaced joint.

What are the most common complications?

1. Wound infection 0,5 up to 1,0 %, depends on your general health. Infection with wound leakage is an indication for cleaning of the wound within 2 weeks. We give antibiotic prophylaxis pre-operatively to reduce these rates.
2. Dislocation 0,2 %, which requires reduction under anaesthesia. The physiotherapist will explane you the right excercises after the surgery.

Is there always a doctor at Ceram?

Yes, there’s an general doctor available, even during the nights and weekends. Your own orthopaedics surgeon stays in Marbella during your hospital stay.

Do I need painkillers after the surgery?

Most patients use painkiller for the first 6 weeks. After 2 weeks the amount of painkillers is reduced, always in discussion with you.

Do I need thrombotic profylaxis after surgery?

Total hip prosthesis: 4 weeks of Fraxiparine, subcutaneous injection
Total knee prosthesis: 4 weeks of Fraxiparine, subcutaneous injection
Arthroscopy knee: not needed

What happens when I get, for example, cardiac problems a few weeks after the surgery?

Please contact Ceram and we will refer you the a hospital in Marbella with a cardiology department.

When can drive a car again?

Total hip prosthesis 2 weeks
Total knee prosthesis 6 weeks
Arthroscopy knee 5-7 days

When are the postoperative checks at the out-patient clinic?

THP/TKP: 2 weeks for the  wound check and 6-8 weeks (last check)
This last checkcan be replace by video consulting.
ATK: 2 days and 6-8 weeks (last check)

For all orther questions, please contact Ceram