Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type)
CPT4 code
Name of the Procedure:
Acetabuloplasty
Summary
Acetabuloplasty is a surgical procedure aimed at reshaping and repairing the acetabulum, the cup-shaped socket of the hip joint. Techniques include methods such as Whitman, Colonna, Haygroves, or cup type, each tailored to address specific structural issues in the hip.
Purpose
The procedure is designed to correct deformities or damage in the acetabulum, improving hip joint function and relieving pain. It helps in cases where the hip socket is misshapen, shallow, or damaged due to conditions such as hip dysplasia or arthritis.
Indications
- Hip dysplasia
- Hip subluxation or dislocation
- Arthritic hip conditions
- Congenital or developmental hip deformities
- Chronic hip pain and mobility issues caused by structural irregularities
Preparation
- Fasting for a specified period prior to surgery
- Adjustment or cessation of certain medications (e.g., blood thinners)
- Preoperative imaging studies (X-ray, MRI) to assess the hip structure
- General health evaluations, including blood tests and a complete medical history review
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made near the hip to access the acetabulum.
- The deformed or damaged part of the acetabulum is reshaped or reconstructed using various techniques such as Whitman osteotomy, Colonna capsuloplasty, or Haygrove's method.
- If necessary, additional bone grafts or implants (cup type) are used to enhance the socket's shape and stability.
- The incision is closed with sutures, and a sterile dressing is applied.
Tools used: Surgical instruments for cutting, reshaping, and fixing bone, such as saws, osteotomes, and fixation devices. Bone graft materials may also be used.
Duration
The procedure typically takes 2 to 4 hours, depending on the complexity of the case.
Setting
Acetabuloplasty is performed in a hospital or specialized surgical center equipped for orthopedic surgeries.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
Common risks:
- Infection
- Blood clots
- Hip stiffness or limited range of motion
Rare complications:
- Nerve damage
- Non-union of bone (where operated bones do not heal properly)
- Implant failure or need for revision surgery
Benefits
- Improved hip joint function
- Relief from chronic hip pain
- Enhanced mobility and quality of life
- Reduced risk of hip dislocation
Benefits are usually noted within a few months post-surgery, following physical rehabilitation.
Recovery
- Hospital stay of 2 to 4 days post-surgery
- Use of crutches or a walker for several weeks
- Physical therapy to regain strength and range of motion
- Avoidance of high-impact activities for several months
- Regular follow-up appointments for monitoring progress
Expected recovery time is around 3 to 6 months, with gradual return to normal activities.
Alternatives
- Non-surgical management with physical therapy and pain medication
- Hip arthroscopy for minor corrections
- Total hip replacement if the joint damage is extensive
- Pelvic osteotomy for certain types of hip dysplasia
- Each alternative has its own benefits and drawbacks, depending on the severity of the condition and patient's overall health.
Patient Experience
During the procedure: The patient is under general anesthesia and will not feel pain or be conscious.
After the procedure:
- Postoperative pain managed with medication
- Initial discomfort and limited mobility
- Gradual improvement with physical therapy
- Restricted activities until the hip heals fully
Pain management includes prescribed pain relievers and anti-inflammatory medications, along with comfort measures such as ice packs and elevation of the operated leg.