Osteotomy and transfer of greater trochanter of femur (separate procedure)
CPT4 code
Name of the Procedure:
Osteotomy and Transfer of Greater Trochanter of Femur (Separate Procedure)
Summary
An osteotomy and transfer of the greater trochanter of the femur involve surgically cutting the bone and repositioning the greater trochanter to improve hip function and alleviate pain. This procedure is often performed when there are structural abnormalities in the hip joint that cause significant discomfort or mobility issues.
Purpose
This procedure addresses hip deformities or abnormalities that result in pain, limited range of motion, or gait disturbances. The primary goal is to reposition the greater trochanter to enhance hip function, reduce or eliminate pain, and improve overall mobility.
Indications
- Hip dysplasia or developmental deformities
- Osteoarthritis of the hip with misalignment
- Abductor muscle weakness due to improper trochanter positioning
- Previous hip surgeries that resulted in malalignment or non-union
- Chronic hip pain unresponsive to conservative management
Preparation
Patients may be instructed to:
- Fast for 8-12 hours before the procedure
- Stop certain medications, especially anticoagulants, as directed by the physician
- Undergo preoperative imaging studies such as X-rays or MRI
- Complete a pre-surgical medical assessment including blood tests and physical examination
Procedure Description
- The patient is administered general anesthesia to ensure comfort and immobility.
- An incision is made over the hip area to access the femur.
- The surgeon performs an osteotomy, cutting the bone at a specific location to separate the greater trochanter from the femur.
- The greater trochanter is repositioned to the desired location and secured using screws, plates, or other fixation devices.
- The incision is closed with sutures or staples, and a bandage or dressing is applied to the site.
Duration
The procedure typically takes 2 to 3 hours, depending on the complexity of the case.
Setting
The procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection at the surgical site
- Blood clots
- Nerve damage
- Improper bone healing or non-union
- Continued pain or discomfort
- Need for additional surgeries
Benefits
- Improved hip function and alignment
- Reduced pain and discomfort
- Enhanced mobility and ability to perform daily activities
- Potential for improved quality of life
Recovery
- Hospital stay of 2-4 days post-surgery
- Use of crutches or a walker for 4-6 weeks to offload weight from the hip
- Physical therapy to regain strength and mobility
- Follow-up appointments to monitor healing and remove stitches
- Full recovery can take 3-6 months, with some restrictions on activities during this period
Alternatives
- Physical therapy and exercise programs without surgery
- Pain management strategies, including medications and injections
- Other surgical options like hip replacement if osteotomy is not suitable
- Pros and cons of alternatives should be discussed with the orthopedic surgeon
Patient Experience
Patients may experience:
- Postoperative pain managed with medications
- Swelling and bruising around the hip
- Initial difficulty in moving the hip and walking
- Gradual improvement in pain and function over weeks to months
- Comfort measures include icing the area, pain relief medications, and adequate rest