Over the past 25 years, Ulrik Rebers has carried out over 5,000 hip replacements.Over the past 25 years, Ulrik Rebers has carried out over 5,000 hip replacements.

Malta could attract a considerable amount of medical tourism ­– but not without government help, according to a German surgeon who has set up practice in Malta.

Ulrik Rebers and his wife Xenia Lorenz Rebers have opened up the International Knee and Hip Centre – Malta at the Prince of Wales complex in Sliema, offering – as the name implies – knee and hip replacements, which will be done at Saint James Hospital.

Mr Rebers has over 25 years’ experience and has carried out over 5,000 replacements in all, now working at the rate of 200 a year.

So far, his clients are mainly residents of Malta, local and foreign, but he believes that citizens of other EU member states, particularly ones which have a long waiting time for orthopaedic surgery, would consider coming to Malta.

“I was already involved in marketing medical tourism from the Netherlands to our former base north of Dusseldorf,” Ms Lorenz Robers said, adding that they would be attending international fairs for medical tourism.

There is no doubt that Europeans feel more comfortable in a European jurisdiction

“But Malta is not branded overseas for medical tourism and it is not something that we could do alone – and it would take four to five years to achieve. It would require a coordinated thrust by the government,” Mr Rebers added.

Mr Rebers hopes that the name of the centre will raise awareness about Malta at the various conferences he addresses as a renowned expert in this field.

The Rebers were settled in Germany but after Saint James founder Josie Muscat came up twice to visit in an attempt to lure them to Malta, they decided to give it a try.

The centre opened a few weeks ago, and uses computers to create 3D images to ensure the most accurate surgery available, aligning the new joint across various axes such as left and right, leg-length and rotation.

“Research showed that almost a third of replacements did not achieve alignment for length and right/left tilt,” he said.

“And even a tiny difference can cause problems for life.”

In the office, a glass showcase has shelves of Swiss-made titanium and ceramic implants, whose lifespan is now considerably longer than the 15 years or so of the replacement joints used a generation ago. Custom-made joints are also available to ensure as perfect a match with the original joint as possible.

The computer used to generate the 3D images from a CT scan, only available since 2009, represents a considerable investment.

How will this be recouped? The centre will get a set fee for each operation, which will work out to about a fifth of the cost of the operation, usually in the range of €8,700.

However, success depends on the number of clients. And Mr Rebers is frustrated that they could do so much to help alleviate the waiting list at Mater Dei.

“The problem is that so few of those on the list have private insurance. But I am sure that if the government were to establish the cost of having the procedure done at Mater Dei and only charged the patient for any additional cost incurred if it were done privately – if any – many would be willing to pay.

“This would open up the waiting list for those who could not afford to pay the extra, making it a very equitable solution.”

The slots will eventually, they hope, be taken up by foreigners. Medical tourism is quite feasible for this type of operation, as it requires a consultation visit, and around two weeks’ stay in all: two days prior to the operation, five as an inpatient, and seven in a hotel, under the scrutiny of the centre.

“There will be a lot of interest from the UK and the Netherlands, the member states with the longest waiting lists,” she said. “But Russians would also be interested as it would be much cheaper for them to do here.

“And although there are medical tourism centres in places like Thailand and India, there is no doubt that Europeans feel more comfortable in a European jurisdiction. Apart from this, the flight connections are very good and nowhere is more than a few hours’ flight.”

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