27137 Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft

Name of the Procedure:

Revision of Total Hip Arthroplasty; Acetabular Component Only, with or without Autograft or Allograft

Summary

This procedure involves the replacement or repair of the acetabular component (the cup section) of a previously placed hip prosthesis. It may include the use of the patient's own bone (autograft) or donor bone (allograft).

Purpose

This surgery addresses issues like loosening, wear, or infection of the acetabular component in a previously performed total hip arthroplasty. The goal is to relieve pain, restore function and mobility, and ensure the stability and longevity of the hip joint.

Indications

• Persistent hip pain due to loosening or failure of the acetabular component.
• Radiographic evidence of acetabular component wear or malposition.
• Infection around the hip prosthesis.
• Osteolysis or bone loss around the acetabular component.

Preparation

• Patients may be instructed to fast after midnight on the day of surgery.
• Medication adjustments might be necessary, such as stopping blood thinners.
• Pre-operative imaging and blood tests are typically required.
• Pre-operative consultation with the surgical team and anesthesiologist.

Procedure Description

1. Anesthesia: The patient is given general or spinal anesthesia.
2. Incision: An incision is made over the hip to access the prosthesis.
3. Removal: The damaged acetabular component is carefully removed.
4. Preparation: The acetabulum (hip socket) is prepared for the new component.
5. Grafting (if needed): Autograft or allograft bone may be used to fill any defects.
6. Placement: The new acetabular component is implanted.
7. Closure: The surgical site is closed with sutures or staples.

Duration

The procedure typically takes around 2 to 3 hours, depending on complexity.

Setting

This surgery is usually performed in a hospital operating room.

Personnel

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

Risks and Complications

• Infection
• Blood clots
• Nerve damage
• Dislocation of the new component
• Fracture of the surrounding bone
• Pain and stiffness
• Need for further revision surgery

Benefits

• Relief from chronic hip pain
• Improved mobility and function
• Enhanced quality of life
• Increased longevity and stability of the hip joint

Recovery

• Hospital stay for several days post-surgery.
• Pain management with medications.
• Physical therapy to aid recovery and restore function.
• Limited weight-bearing on the affected leg for several weeks.
• Follow-up appointments to monitor progress and ensure proper healing.

Alternatives

• Conservative treatments like medication, physical therapy, and lifestyle modifications.
• Partial hip replacement focusing on the acetabular component.
• Non-surgical therapies such as corticosteroid injections.

Patient Experience

During the procedure, patients are under anesthesia and will not feel pain. Post-operatively, there may be discomfort managed by pain medications. Physical therapy and limited activities are essential for recovery, with a gradual return to normal activities over weeks to months.