27090 Removal of hip prosthesis; (separate procedure)

Name of the Procedure:

Removal of Hip Prosthesis (separate procedure)

Summary

The removal of a hip prosthesis involves surgically taking out an artificial hip joint, which may be necessary due to infection, loosening, or mechanical failure of the implant.

Purpose

The procedure addresses problems associated with artificial hip joints, such as infections, mechanical failure, or severe pain and discomfort. The goal is to remove the faulty prosthesis to alleviate symptoms and prepare for either revision surgery or alternative treatments.

Indications

• Persistent pain or discomfort around the hip
• Infection in the hip joint
• Loosening or mechanical failure of the prosthesis
• Allergic reactions to the implant material
• Recurrent dislocation of the hip joint

Preparation

• Fasting for 8-12 hours before surgery
• Discontinuation or adjustment of certain medications (e.g., blood thinners)
• Pre-operative evaluations, including blood tests, imaging studies (X-rays, MRI), and possibly a pre-surgery consultation with an anesthesiologist.

Procedure Description

1. The patient is administered general or regional anesthesia.
2. The surgeon makes an incision over the hip area to access the prosthesis.
3. The surrounding tissues are carefully retracted to expose the implant.
4. The hip prosthesis is meticulously detached and removed.
5. If an infection is present, thorough debridement (cleaning out of infected tissue) is performed.
6. The site is closed using sutures or staples, and a drain may be placed to prevent fluid accumulation.

Tools and equipment: Surgical instruments, specialized retractors, debridement tools.

Duration

Typically, the surgery takes about 1 to 3 hours, depending on the complexity.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Infection
• Blood clots
• Nerve or blood vessel damage
• Fractures
• Pain or difficulty in walking
• Need for additional surgeries

Benefits

• Relief from pain and discomfort
• Removal of source of infection or mechanical irritation
• Improved function and mobility if followed by appropriate treatment or revision surgery

Recovery

• Hospital stay of a few days for monitoring and pain management.
• Use of crutches or a walker as needed.
• Physical therapy to regain strength and mobility.
• Follow-up appointments for wound inspection and progress evaluation.
• Full recovery might take several weeks to months, depending on individual health and any subsequent treatments.

Alternatives

• Non-surgical management with pain medications or injections
• Antibiotic therapy for infections
• Revision hip surgery involving the replacement of the old prosthesis with a new one
• Pros and cons: Non-surgical methods might not address the root cause, while revision surgery may offer a longer-lasting solution but comes with similar risks and recovery periods.

Patient Experience

During the procedure, patients will be under anesthesia and hence will not feel pain. Post-surgery, there may be discomfort and swelling at the surgical site. Pain management will include medications, and adherence to post-operative care instructions will aid in a smoother recovery.