Revision of total hip arthroplasty; both components, with or without autograft or allograft
CPT4 code
Name of the Procedure:
Revision of Total Hip Arthroplasty; Both Components, with or without Autograft or Allograft
Common Name(s): Hip Revision Surgery, Total Hip Replacement Revision
Summary
Revision of total hip arthroplasty is a surgical procedure to replace both the acetabular (hip socket) and femoral (thigh bone) components of a previously implanted artificial hip joint. This may involve the use of bone grafts from the patient (autograft) or a donor (allograft).
Purpose
This procedure addresses issues with a failing or problematic hip replacement. The goals are to alleviate pain, restore function, and increase the longevity of the hip joint.
Indications
- Persistent pain or discomfort in the hip
- Loosening or wearing out of the prosthetic components
- Infection in the hip joint
- Fracture around the prosthetic components
- Dislocation of the hip joint
Preparation
- Pre-procedure fasting as instructed by the healthcare provider
- Adjusting or stopping certain medications (e.g., blood thinners)
- Preoperative imaging tests (X-rays, CT scans)
- Blood tests and a medical evaluation
Procedure Description
- Anesthesia: The patient is given general anesthesia or regional anesthesia (spinal or epidural).
- Incision: An incision is made over the hip to access the joint.
- Removal of Components: The existing prosthetic components are removed carefully.
- Bone Grafting (if needed): Autograft or allograft bone may be used to rebuild bone stock.
- Implantation of New Components: New prosthetic components are implanted.
- Closure: The incision is closed with sutures or staples.
- Dressings and Bandages: The wound is covered with sterile dressings.
Duration
This procedure typically takes 2 to 4 hours.
Setting
The operation is performed in a hospital's surgical suite.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Surgical Technicians
- Possibly a Physician Assistant or a Nurse Practitioner
Risks and Complications
- Infection
- Blood clots
- Nerve or blood vessel damage
- Hip dislocation
- Bone fracture
- Differences in leg length
- Need for further revision surgery
Benefits
- Reduced pain
- Improved mobility and function
- Enhanced quality of life Improvements can often be noticed within a few weeks after surgery, with continued progress over several months.
Recovery
- Hospital stay of 3 to 5 days
- Physical therapy beginning immediately post-surgery
- Pain management with prescribed medications
- Restrictions on weight-bearing and certain activities for several weeks
- Full recovery may take 6 months to a year
- Follow-up appointments for monitoring progress
Alternatives
- Non-surgical management with physical therapy and medications
- Partial hip revision (only one component replaced)
- Enhanced prosthetic options based on specific patient needs
Pros:
- Non-surgical options involve less risk and no recovery time from surgery.
Cons:
- May not adequately address the problem if the existing components are severely compromised.
Patient Experience
During the procedure, the patient will not feel pain due to anesthesia. Post-operatively, they may experience discomfort, swelling, and bruising, which is managed with pain medication. Physical therapy will aid in recovery, and adhering to care instructions will facilitate a smoother healing process.