27138 Revision of total hip arthroplasty; femoral component only, with or without allograft

Name of the Procedure:

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

Summary

In layman's terms, this procedure involves replacing the part of a previously implanted artificial hip joint that connects to the thigh bone (femur). The surgery may also use donor bone tissue (allograft) if needed to secure the new component.

Purpose

This surgery addresses issues with a previously implanted artificial hip joint, such as loosening, infection, or wear and tear. The goal is to relieve pain, improve hip function, and ensure the longevity of the hip prosthesis.

Indications

• Persistent hip pain and dysfunction despite conservative treatments
• Mechanical failure or loosening of the femoral component of the hip implant
• Infection around the hip prosthesis
• Bone loss or damage surrounding the femoral component

Preparation

• Patients may need to fast for 8-12 hours before surgery.
• Adjustments to current medications, especially blood thinners, may be necessary.
• Preoperative assessments including blood tests, imaging studies (X-rays, CT), and a physical examination.

Procedure Description

1. Give anesthesia (general or spinal) to the patient.
2. Make an incision over the hip joint.
3. Remove the old femoral component and any loose bone or scar tissue.
4. Assess and prepare the femoral canal for the new component.
5. Insert the new femoral implant, securing it with or without an allograft.
6. Check for proper fit and function of the new component.
7. Close the incision with sutures or staples and apply a sterile dressing.

Duration

Typically, the surgery takes about 2 to 4 hours.

Setting

This procedure is usually performed in a hospital operating room.

Personnel

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

Risks and Complications

• Infection
• Blood clots
• Damage to nearby nerves or blood vessels
• Dislocation of the new hip joint
• Reaction to anesthesia
• Necessity for further revision surgery

Benefits

• Relief from chronic hip pain
• Improved mobility and function of the hip joint
• Enhanced quality of life Benefits can typically be observed within several weeks to months post-surgery.

Recovery

• Hospital stay of 2-5 days
• Pain management with medications
• Physical therapy to aid recovery and restore mobility
• Avoid strenuous activities and follow specific weight-bearing instructions
• Regular follow-up appointments to monitor recovery

Alternatives

• Non-surgical treatments including pain medications, physical therapy, and lifestyle modifications
• Total hip revision surgery (replacement of both femoral and acetabular components)
• Each alternative comes with its own risks and benefits; for example, non-surgical options may not provide lasting relief, whereas a total hip revision might be more invasive.

Patient Experience

• The patient might feel sore and experience swelling after the procedure, managed with pain medications.
• Gradual improvement in hip function and reduction in pain over time.
• Physical therapy sessions to support recovery and regain strength.
• Some discomfort during early stages of recovery but typically well-managed with proper care.