Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft
CPT4 code
Name of the Procedure:
Conversion of Previous Hip Surgery to Total Hip Arthroplasty (with or without Autograft or Allograft)
Summary
This procedure replaces a previously operated hip joint with a new artificial hip joint. It can involve using the patient’s bone (autograft) or donor bone (allograft) to aid the procedure.
Purpose
The procedure addresses issues from previous hip surgeries that have failed or been problematic. The goal is to restore mobility, relieve pain, and improve hip function.
Indications
- Persistent hip pain and stiffness
- Failed previous hip surgery (e.g., insufficient healing, infection, prosthetic failure)
- Osteoarthritis or rheumatoid arthritis not relieved by conservative treatments
- Decreased hip function affecting daily activities
Preparation
- Fast for at least 8 hours before the procedure
- Adjust or stop certain medications as instructed by the doctor
- Undergo diagnostic tests like X-rays, MRIs, or blood tests
Procedure Description
- The patient is placed under general or regional anesthesia.
- An incision is made to access the hip joint.
- The old prosthesis or damaged bone is removed.
- The hip socket and femur are prepared for the new components.
- The new artificial hip joint is placed, and if needed, bone grafts are added for stability.
- The incision is closed with sutures or staples, and a drain may be placed.
- The patient is taken to recovery for monitoring.
Equipment used includes surgical tools, a new hip prosthesis, and imaging devices for guidance.
Duration
Typically takes 2-4 hours, depending on complexity.
Setting
Performed in a hospital operating room.
Personnel
- Orthopedic surgeon
- Surgical nurses
- Anesthesiologist
- Surgical technologists
Risks and Complications
- Infection
- Blood clots
- Dislocation of the new hip joint
- Nerve or blood vessel injury
- Leg length discrepancy
- Chronic pain or stiffness
Benefits
- Reduction in pain
- Improved mobility and quality of life
- Better hip function and stability
- Long-lasting results if proper care is taken
Recovery
- Hospital stay of 2-4 days
- Pain management with medications
- Physical therapy starting soon after surgery
- Avoid strenuous activities for several weeks
- Follow-up appointments for monitoring healing
Alternatives
- Non-surgical management (e.g., medications, physical therapy)
- Revision hip surgery
- Hip resurfacing
- Pros: Less invasive alternatives may reduce recovery time
- Cons: May not be as effective for severe cases
Patient Experience
During the procedure, the patient will be under anesthesia and won't feel pain. Post-surgery, there may be discomfort and swelling managed by medications. Physical therapy is essential to regain strength and mobility. Full recovery can take several months.
Overall, the procedure aims to enhance the patient's quality of life by reducing pain and improving hip function.