Name of the Procedure:

Anesthesia for open procedures involving the hip joint; Hip Disarticulation

Summary

Hip disarticulation is a surgical procedure in which the hip joint is entirely removed. Anesthesia is used to ensure the patient does not experience pain during the surgery.

Purpose

This procedure is typically undertaken to address severe trauma, infections, or malignancies affecting the hip and surrounding areas. The goal is to remove the diseased or damaged hip joint to alleviate pain, control infection, or prevent the spread of cancer.

Indications

• Severe hip infections that do not respond to other treatments
• Extreme trauma to the hip area
• Bone cancers or tumors located in or around the hip joint
• Failed hip replacement with severe complications
• Intractable pain not relieved by other surgical interventions

Preparation

• Patients may need to fast for at least 8 hours before the surgery.
• Inform the surgical team about all medications being taken; some may need to be adjusted or discontinued.
• Blood tests, imaging studies, and a full physical examination will be done beforehand.

Procedure Description

1. The patient is brought to the operating room and connected to monitoring equipment.
2. An intravenous (IV) line is inserted for medications and fluids.
3. General anesthesia is administered to make the patient unconscious.
4. Once the patient is asleep, a catheter may be inserted to drain the bladder.
5. The surgical area is cleaned and sterilized.
6. The surgeon makes an incision around the hip joint and dissects the tissues until the joint is exposed.
7. The hip joint is carefully disarticulated and removed.
8. The surgical wound is closed with sutures and covered with a sterile dressing.
9. Anesthesia is gradually reduced, and the patient is brought out of unconsciousness.

Duration

The entire procedure usually takes between 3-5 hours, depending on the complexity of the case.

Setting

This surgery is performed in a hospital operating room equipped for major surgical procedures.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurse
• Scrub Technician
• Circulating Nurse

Risks and Complications

• Infection
• Blood loss
• Blood clots
• Adverse reactions to anesthesia
• Nerve damage
• Postoperative pain
• Healing complications

Benefits

The primary benefit is the removal of a diseased or damaged hip joint, which can significantly alleviate pain, treat infections, or remove cancerous growths. Recovery and improved quality of life can be expected after a successful surgery and rehabilitation.

Recovery

• Hospital stay of 1-2 weeks for initial recovery.
• Pain management with medications.
• Physical therapy to aid in mobility and adapting to the absence of the hip joint.
• Follow-up appointments to monitor healing and address any postoperative issues.
• Use of assistive devices such as crutches or prosthetics may be necessary.

Alternatives

• Limb-sparing surgeries if applicable.
• Amputation at a lower level (e.g., above-the-knee amputation) if the condition allows.
• Non-surgical treatments like radiation or chemotherapy for cancer.
• Advanced infections may sometimes be managed with prolonged antibiotic therapy alone.

Patient Experience

• Patients will be under general anesthesia and will not feel anything during the procedure.
• Postoperative pain is managed with medications, which will be adjusted as needed.
• There may be discomfort or pain at the surgical site, mild to moderate, lasting a few weeks.
• Physical and emotional support will be important for adapting to life post-surgery.