ENProsthetics in Germany covers four fields with little in common: external limb prostheses, dental prosthetics, joint replacement, and prostheses placed inside the body, such as a heart valve or an intervertebral disc. Each is handled by different doctors and hospitals, so the search starts by working out which of the four fields a case belongs to.
This page outlines each field: who runs it, what the patient’s path looks like and how long it takes, with links to detailed pages.
Four different fields and who works in them
Prosthetics in Germany is split between four groups of specialists, and an external limb prosthesis is not made by a surgeon. It is built by an orthopaedic technician together with a doctor, usually an orthopaedic surgeon or a rehabilitation physician, who prescribes it and checks the result. Orthopaedic technology is a separate skilled trade in Germany: the apprenticeship lasts three years, and the top qualification is the master craftsman’s examination. The socket is made for the individual residual limb, and the components are chosen for the person’s level of activity.
Dental prosthetics belongs to dentistry: a dentist runs the treatment, a dental laboratory makes crowns, bridges and dentures, and implants are placed by a dentist trained in implantology or by an oral surgeon.
Joint replacement is an orthopaedic operation in which a worn joint is replaced by an artificial one; hips and knees are replaced most often.
Prostheses inside the body include heart valves, intervertebral discs and vascular grafts. This is the work of cardiac surgeons and cardiologists, spine surgeons and vascular surgeons, and the choice of device, such as a mechanical or a biological valve, is settled with the patient in advance. Each field is taken separately below.
Limb prostheses
A limb prosthesis starts with the residual limb, not with the device. How the wound heals and the shape and volume of the residual limb decide whether the socket, the rigid shell it sits in, will fit. So the first weeks after an amputation in Germany go on healing, on reducing swelling with bandages, compression stockings or soft liners, and on building strength, not on choosing hardware. The full path is on the page on limb prosthetics in Germany.
The first prosthesis is usually an interim, or training, one. It already has the main parts of the final prosthesis but is made for a limited time: as the residual limb shrinks, the socket has to be remade while the patient learns to stand and walk. A definitive prosthesis makes sense once the volume has stopped changing.
A prosthesis consists of a socket, a liner worn under it, connecting components and a foot or a hand, plus a knee joint after an above-knee amputation. Mechanical components use springs, friction or hydraulics and are adjusted by the technician to the person’s gait. In a microprocessor-controlled knee, sensors and electronics adjust the joint’s resistance during each step. A myoelectric arm prosthesis responds to muscle signals picked up by electrodes on the skin.
The device alone settles nothing: walking with a leg prosthesis has to be relearned. Rehabilitation builds strength and balance, teaches putting on the prosthesis and caring for the residual limb, and treats pain, including phantom pain felt in the amputated part. The socket is refitted several times, which is normal, not a mistake: the residual limb keeps changing. The process is set out in the guideline of the German Society for Orthopaedics and Orthopaedic Surgery (DGOOC) on rehabilitation after leg amputation, which is currently being revised.
Dental prosthetics
Dental prosthetics means single crowns, bridges, partial and full removable dentures, and implant-supported work. Fixed crowns and bridges stay in the mouth permanently and are cleaned along with the natural teeth. Removable dentures are taken out for cleaning at least once a day; a partial denture is held by the remaining teeth or by implants, for example with metal clasps, a full denture by light suction against the jaw, and it takes getting used to. For dental care as a whole, see dentistry in Germany.
Whether implants are possible depends on the bone. An implant, usually a titanium post, replaces a tooth root; the bone has to grow onto it before the permanent crown, bridge or denture is fitted. If bone is lacking, it is built up first, which adds a stage. So months usually pass between an extraction and the finished work, even when the implant is placed straight after the extraction, and this is planned from the start.
For a patient from abroad, the work splits into visits with gaps between them: extraction and healing, implant placement and healing-in, then fitting of the finished restoration. Treatment is therefore planned as two or three trips or one long stay. Prices are not quoted here: guide figures are on the price page for dentures, and the exact cost comes from the clinic’s estimate.
Joint replacement
A joint is replaced not on the strength of an X-ray but on the sum of severe pain, limits on daily life and non-surgical treatment that has failed. For the hip, German selection criteria require that painkillers, exercise therapy or weight loss have not given enough relief for at least three months; the X-ray is only one criterion. So a German orthopaedic surgeon usually starts with treatment without an operation. See joint replacement in Germany.
Two German systems help in choosing a hospital. EndoCert certification, created on the initiative of the German Society for Orthopaedics and Orthopaedic Surgery (DGOOC), is voluntary for hospitals; in a certified centre every surgeon has to perform a minimum number of joint replacements a year, and operations are led by particularly experienced surgeons. Certified hospitals also commit to taking part in the German Arthroplasty Registry (EPRD). The registry is voluntary but large: for 2024 it recorded 410,333 hip and knee operations, including revisions. An example is Prof. Yves Gramlich, chief physician of the Department of Orthopaedics and Trauma Surgery at the Agaplesion Markus Krankenhaus in Frankfurt, whose focus includes joint replacement. His department is certified as a maximum-care arthroplasty centre (EPZmax), and he sits on the board of the German Society for Endoprosthetics (AE).
After a knee replacement, early rehabilitation starts on the day of the operation or the day after. The main rehabilitation usually follows straight after discharge, no later than two weeks after it; as an inpatient it usually lasts three weeks, and it can also be outpatient. When the leg can take full weight depends partly on the type of prosthesis; people usually return to work two to three months after a knee replacement. Put plainly, an artificial joint does not last forever. It can loosen or wear, and then a revision operation is needed, which is why it is discussed before the first operation.
Prostheses inside the body: heart valve and intervertebral disc
A heart valve or an intervertebral disc is replaced when the body’s own no longer works, and in both cases there is more than one option. An aortic valve is replaced either in open-heart surgery, with a mechanical or a biological valve, or through a catheter without opening the chest (TAVI), using a biological valve. A mechanical valve lasts a long time but needs lifelong anticoagulants, medicines against blood clotting; a biological one does not need them long-term but wears out. So the choice depends on age, other illnesses and the willingness to take them for life. A heart team of cardiologists and cardiac surgeons weighs the options, and under the 2025 European guidelines the patient’s preference plays a central role. See aortic valve replacement.
A disc prosthesis is a mobile implant that takes the place of a worn disc, instead of the neighbouring vertebrae being fused. It is considered when non-surgical treatment has not helped, the disc still has adequate height and the bone is of good quality. Its purpose is to preserve movement and to reduce the risk of wear in the neighbouring segments. With severe changes in the spinal joints or a stiff spine, a mobile prosthesis is less suitable. See intervertebral disc replacement.
Both cases share one thing: a second opinion is worth more here than almost anywhere, because an alternative to the prosthesis often exists. For a valve, the choice may be between open surgery and TAVI, between a mechanical and a biological valve, and sometimes between intervening now and watching. For a disc, the alternatives can be non-surgical treatment or fusion. They are worth hearing before the operation, not after.
Frequently asked questions
Which doctor should I see if I need a prosthesis?
That depends on the field: an arm or leg prosthesis is prescribed by an orthopaedic surgeon or a rehabilitation physician and made by an orthopaedic technician. Crowns and dentures are the work of a dentist and a dental laboratory. A joint is replaced by an orthopaedic surgeon, preferably in a certified centre. A valve replacement is weighed by a heart team, a disc prosthesis by a spine surgeon.
How long does prosthetic treatment in Germany take?
It depends on the field. After a knee replacement, patients stay in hospital for about 7 to 10 days and then usually spend three weeks in inpatient rehabilitation. Implant-supported dental work takes months because the implant has to heal into the bone. A leg prosthesis also takes months: healing, then an interim prosthesis, then the definitive one. For a valve or a disc, the hospital gives the timeline after the examination.
How do I choose a hospital for prosthetic treatment in Germany?
Choose a department for the specific task rather than a hospital in general. For a joint, EndoCert certification and participation in the EPRD registry matter; for a valve, a heart team of cardiologists and cardiac surgeons. After an amputation, a rehabilitation clinic experienced with amputees is needed, plus an orthopaedic technician who can come quickly for refitting. No single hospital leads in all four fields.
How AlenMed arranges treatment
AlenMed starts with the documents: the reports and imaging show which of the four fields the case belongs to, and the request goes to a specialised department rather than to a general hospital. Reports and images are translated, and an interpreter attends the appointments. The network covers 86 partner clinics in 38 cities and 345 doctors; the company’s office is in Munich.
Then comes the practical chain: a written cost estimate (Kostenvoranschlag), an invitation for the visa, accommodation, and rehabilitation planned together with the operation. In prosthetics, much of the result depends on rehabilitation, so it is arranged in advance; see orthopaedic rehabilitation in Germany.
This material is for information only and is not an offer. Treatment is decided by a doctor at a face-to-face appointment.