Joris van der Lugt, English speaking orthopaedist in Marbella, Spain

by Lorraine Williamson
orthopaedist Marbella

Joris van der Lugt takes the plunge. A leap from a comfortable and interesting existence in the Netherlands into the depths of an uncertain but exciting future in Spain. From September 2022, he will open his orthopaedist clinic in Marbella. 

 Dr. Joris van der Lugt, orthopaedist in Marbella

Dr Joris van der Lugt wanted to know more about the services that this experienced specialist will offer to English and Dutch-speaking patients in the south of Spain. We, therefore, and spoke to him in May on the Costa del Sol. Van der Lugt has been working for years as a hip and knee specialist in the Netherlands. With his expertise, besides providing many people with a new hip or knee, he gives them also a new life. A life in which after long times of pain and suffering they can move, walk and cycle again. 

A new method of hip surgery with a faster recovery 

Many mainly associate a hip operation with a major procedure and a long road to recovery. However, the operation which Van deer Lugt carries out is much less invasive. He applies the Direct Anterior Approach (DAA). That term probably doesn’t mean anything to a layman, so he explains it to us: “It’s a muscle-sparing approach. It’s not necessary anymore to make a big cut through the muscles. The people I operate on all go home on foot and can wean off the crutches after two weeks!”. 

The biggest advantage of the DAA approach (from the front) lies in the fact that no muscles need to be loosened and therefore not tightened. As a result, the patient recovers much more quickly. An additional advantage, according to Van der Lugt, is that the operation only takes an hour. 

Orthopaedist in Marbella with less invasive approach

The orthopaedist also points out that this approach to place a hip prosthesis is now gaining terrain in several countries, but is still rather unknown in Marbella. “A similar approach had never been done here before. When I first did it here in southern Spain, twenty people were watching.” He continues: “We started with this less invasive approach in 2008 in The Hague (The Netherlands). After doing it a lot, I started educating people all over the country. This is very necessary because the only drawback of this technique is the long learning curve. You have to do about a hundred operations before you get the hang of the approach. The old approach is much simpler because you get to the hip joint from the back much easier.”

Van der Lugt also wants to train doctors in Spain for this new approach. “In the Netherlands, I now have 16 assistants to train, which is great fun!” 

Hip surgery: small investment and major health gain 

According to Van der Lugt, many people postpone an operation out of fear. But that fear is unfounded, he says. “Such an operation is very rewarding and the chance of complications is just very small. There is less than a one percent chance of an infection, but you can usually resolve that with a clean-up operation and antibiotics. Of the three best operations in Dutch health care in terms of small investment and major health gain, hip surgery is in second place, right after cataract surgery. Of course, you can patch up such a hip or knee for a while with injections, but these are palliative measures that mainly represent a postponement of execution”. 

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Knee surgeries 

Progress has also been made in knee operations in this regard. Van der Lugt: “In the past, huge cuts were needed, but the cuts are getting smaller and smaller and it is now all done without glue. Instead of gluing the prostheses, nowadays it just grows on the bone and stays there. If in 20 years the plastic starts to wear out, then you just replace it and continue. It’s much less intense.” 

specialist clinic


Van der Lugt opens FlexClinics, his orthopaedic practice for hip, knee, and recovery operations, in the private clinic Hospital Ceram in Marbella. Patients can go to FlexClinics for plannable care. He carries out all other acute, unplanned care such as fractures or infection treatments under the banner of Hospital Ceram. “That private clinic was founded by Spaniards, but there is a lot of English-speaking staff working there. They specialise in plastic surgery and gynaecology and fertility treatments and mainly have international patients. Now they want to add orthopaedics to that as well.

The specialist plans to fly in other Dutch doctors affiliated with FlexClinics for other types of orthopaedic procedures, such as foot or shoulder operations, once his practice is up and running here. “And then I can do the do aftercare, for example, for someone who wants to have a big toe straightened, I can do the follow-up checks.” 

Does the insurance pay for knee or hip surgery in Spain? 

Speaking of insurance, we ask the specialist how this exactly works, because do they reimburse an operation abroad just like that? “Dutch insurers pay 70% of the rate in the Netherlands. Sometimes that is enough to have a large part reimbursed, you may have to pay another €2,000, but in any case, you have your operation here. We can arrange everything for people coming from abroad, hotel or apartment, physiotherapy. For this I also work together with a Dutch physiotherapist and the British physiotherapy practice Body Works in San Pedro.”  

Orthopaedic treatments

When asked what the situation is with people who live in Spain and have Spanish private insurance, Van der Lugt says that they do not yet have partnerships with Spanish private health insurers. “But that’s the plan. If everything goes well, we will talk to those insurers. Until then, people must check in advance with their insurer what they will be reimbursed, and bring a statement of this with them and advance the operation themselves.” The price in Spain for a new hip or knee is €12,500 and insurers in the Netherlands often reimburse around €10,000. The same goes for people from other countries who want to be operated on in Marbella. However, they first need to check with their insurer.  

Second opinion 

Another important function that Van der Lugt can have here in Spain for English speakers living on the Costa del Sol is to give a second opinion. “If you have been to a Spanish hospital and still have no idea what the specialist has said, I may be able to help you further.” 

If you want to know more or already want to make an appointment for coming September with Joris van der Lugt, you can contact him or visit his website. 

Also read: Medical tourism in the Balearics

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