A New Joint for Many Years: From a Reliable Joint Prosthesis to a Successful Surgery
More than a thousand joint replacement surgeries are performed in Lithuania every month. For many patients, these procedures offer an opportunity to get rid of long-standing pain, improve mobility and return to their usual daily activities. Joint prostheses are expected to last not just for years, but for decades, which is why they must meet strict quality, safety and long-term reliability requirements.
The Health Insurance Fund Purchases Joint Prostheses
The National Health Insurance Fund (NHIF) centrally purchases hip, knee, shoulder, elbow, ankle and thumb joint prostheses, as well as revision joint prostheses and their accessories, using funds from the Compulsory Health Insurance Fund (CHIF).
Centrally procured joint prostheses enable the efficient use of the Fund’s resources. The aim is to purchase them at the most favourable prices while ensuring that the implants meet the established requirements.
The implants purchased by the NHIF are supplied by various international manufacturers based in Germany, the United States, Switzerland and France.
“The joint prostheses purchased meet the European Union’s safety and quality requirements for medical devices, as confirmed by the CE marking, and are supported by data demonstrating their long-term reliability. The quality of joint prostheses is assessed on the basis of studies published in international scientific journals, data from the Joint Replacement Register and other established evaluation methods,” emphasises Giedrius Baranauskas, Head of the Medical Devices Reimbursement Division at the National Health Insurance Fund.
One of the most important indicators assessed is implant survivorship. Under the established requirements, at least 90–95% of patients must still have the same joint prosthesis in place after 10 years, with no revision surgery having been required to replace it. For newer implants, for which 10-year survivorship data are not yet available, the available shorter-term survivorship results are assessed, and these are also very high.
“Ten years is more than just a statistical indicator. It means that a joint prosthesis must remain reliable over a long period without the need for replacement, allowing a person to lead as normal a life as possible. That is why, when assessing joint prostheses, it is essential to rely not only on information provided by manufacturers, but also on long-term data and patients’ experiences. This is what helps doctors make informed decisions about the most suitable implant for each individual patient,” says Prof. Dr Giedrius Kvederas, Head of the Centre of Orthopaedics and Traumatology at Vilnius University Hospital Santaros Klinikos.
According to a study conducted by researchers at the Lithuanian University of Health Sciences, the results of hip and knee replacement surgeries in Lithuania show very good implant survivorship: approximately 95% of joint prostheses remained in place over a 10-year period. This means that the prostheses remain functional for a long time in the vast majority of patients, without the need for revision surgery to replace them.
According to Prof. Dr G. Kvederas, such good results are achieved thanks to medical professionals’ experience, teamwork, stringent requirements for healthcare institutions and high standards applied to joint prostheses.
The Orthopaedic Surgeon Selects the Implant
Joint replacement surgery may be necessary for various reasons, including osteoarthritis, systemic inflammatory diseases such as rheumatoid arthritis, injuries and oncological diseases. Most of these conditions are initially treated conservatively, using analgesics, non-steroidal anti-inflammatory drugs and rehabilitation measures. If such treatment proves ineffective, surgery is considered. Replacing the joint with an artificial one is only a last resort.
Before the operation, the orthopaedic surgeon assesses the patient’s overall health, the condition of the joint and bones, the type of surgery planned and other individual needs. Based on this assessment, the operating surgeon selects the most suitable joint prosthesis for the patient from among the models centrally procured by the NHIF.
Patients who choose a joint prosthesis provided by the Health Insurance Fund do not have to pay anything extra for it. However, a healthcare institution may offer patients the option of choosing a different prosthesis purchased by the institution. If the selected prosthesis is more expensive than the one reimbursed by the NHIF, the patient must pay the price difference.
Such a choice is the patient’s right. However, it is important to consider not only the price of the prosthesis, but also the information provided by the doctor about the implant and its suitability for the patient’s specific needs.
“Medical professionals’ experience with a specific implant is extremely important,” says Prof. Dr G. Kvederas. “As in other fields, the introduction of a new joint prosthesis in surgery may initially be associated with a higher risk of complications. Only after gaining sufficient experience and developing a thorough understanding of all the implant’s characteristics can the best possible outcomes be expected. Therefore, the decision to switch to or start using a new joint prosthesis must be based on sound reasons and evidence.”
According to the professor, patients nowadays take a keen interest in their treatment and actively seek information online. Sometimes they arrive at a doctor’s office having already chosen an implant, convinced that it is the best option. However, the fact that a joint prosthesis is widely advertised or frequently discussed does not necessarily mean that it will be the most suitable choice for a particular patient. In such cases, it is important to find a doctor who has sufficient experience working with that specific implant.
Before making a decision, the patient must be clearly informed in writing about the option of choosing a different joint prosthesis, its price and the additional amount they will have to pay. It is therefore worth finding out how the proposed implant differs from the joint prosthesis purchased by the NHIF and discussing the choice with the operating surgeon.
Joint replacement surgeries are currently performed at 20 hospitals across the country. During the first eight months of this year, more than 10,000 such procedures were carried out, including approximately 8,600 primary hip and knee replacement surgeries.
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Last updated: 05-11-2026
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