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Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)

CPT4 code

Name of the Procedure:

Incision, Bone Cortex, Pelvis and/or Hip Joint (e.g., osteomyelitis or bone abscess)

Summary

This procedure involves making an incision into the bone cortex of the pelvis or hip joint to treat conditions such as osteomyelitis (bone infection) or bone abscesses. It is typically performed to remove infected or dead bone tissue.

Purpose

The primary purpose is to treat serious bone infections or abscesses in the pelvis or hip joint. The goals include alleviating pain, removing infection, and preventing further damage to the bone and surrounding tissues.

Indications

Indications for this procedure include:

  • Persistent pain in the hip or pelvis.
  • Signs of infection (redness, swelling, fever).
  • Presence of a bone abscess confirmed by imaging studies.
  • Failure of non-surgical treatments (e.g., antibiotics).

Preparation

Preparation may involve:

  • Fasting for 8-12 hours before the procedure.
  • Adjusting current medications as advised by your healthcare provider.
  • Undergoing diagnostic tests such as X-rays, MRI, or CT scans to assess the extent of infection.

Procedure Description

  1. The patient is administered regional or general anesthesia.
  2. A surgical incision is made over the area of the pelvis or hip joint.
  3. Surgical tools are used to access and remove the infected or necrotic bone tissue.
  4. The area is thoroughly cleaned to remove any remaining infections or debris.
  5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 1-2 hours, depending on the extent of infection and complexity of the case.

Setting

It is performed in a hospital or a specialized surgical center.

Personnel

The procedure involves:

  • An orthopedic surgeon.
  • An anesthesiologist.
  • Surgical nurses and technicians.

Risks and Complications

Risks include:

  • Infection at the surgical site.
  • Excessive bleeding.
  • Damage to surrounding tissues or nerves.
  • Adverse reactions to anesthesia. Rare complications may include:
  • Deep vein thrombosis.
  • Chronic pain or impaired mobility.

Benefits

The expected benefits are:

  • Relief from pain and infection.
  • Improved bone and joint function.
  • Prevention of further complications.

Recovery

  • Post-procedure care involves pain management, antibiotics, and wound care.
  • Recovery time varies but may take several weeks for complete healing.
  • Physical therapy may be recommended to regain mobility and strength.
  • Follow-up appointments are necessary to monitor healing and address any complications.

Alternatives

Alternative treatments include:

  • Prolonged antibiotic therapy, which might not be effective for severe infections.
  • Less invasive drainage methods, which are not always sufficient. Pros and cons of alternatives depend on the severity and extent of the infection.

Patient Experience

Patients may experience:

  • Pain at the surgical site, managed by prescribed pain relief.
  • Limited mobility initially, improving with physical therapy.
  • Hospital stay of 1-2 days, followed by home recovery. Comfort measures include:
  • Adequate pain management.
  • Supportive care from the healthcare team to ensure a smooth recovery process.

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