27156 Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip

Name of the Procedure:

Osteotomy, Iliac, Acetabular, or Innominate Bone; with Femoral Osteotomy and with Open Reduction of Hip

Summary

This surgical procedure involves cutting and repositioning the bones around the hip joint, including the pelvis and thigh bone (femur), to improve alignment and stability. It also includes an open reduction to properly position the hip joint.

Purpose

This procedure addresses hip dysplasia or severe hip deformities. The goals are to correct bone misalignment, alleviate pain, improve hip function, and prevent further degeneration or damage to the joint.

Indications

• Hip dysplasia
• Severe hip deformities
• Hip subluxation or dislocation not amenable to other treatments
• Persistent hip pain and dysfunction despite conservative treatments

Preparation

• Fasting typically required for at least 8 hours before surgery
• Adjustment or temporary discontinuation of certain medications, as advised by the physician
• Pre-operative imaging tests such as X-rays or MRIs
• Comprehensive medical evaluation and blood tests

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: An incision is made over the hip to expose the bones.
3. Osteotomy: The surgeon performs precise cuts on the iliac (pelvic) bone and the femur to realign the hip.
4. Repositioning and Fixation: The bones are repositioned to achieve better alignment, and fixation devices such as screws or plates are used to secure the bones in place.
5. Open Reduction: The hip joint is carefully realigned.
6. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes between 3 to 5 hours.

Setting

The surgery is performed in a hospital operating room.

Personnel

• Orthopedic Surgeon
• Surgical Nurses
• Anesthesiologist
• Surgical Assistants

Risks and Complications

• Infection
• Blood loss
• Nerve damage
• Blood clots
• Non-union or malunion of bones
• Need for additional surgeries

Benefits

• Improved hip alignment and function
• Pain relief
• Enhanced mobility
• Prevention of joint degeneration

Benefits are typically realized gradually, with full improvement expected within several months.

Recovery

• Postoperative hospitalization for monitoring
• Pain management with medications
• Physical therapy to restore movement and strength
• Use of crutches or walker for several weeks
• Follow-up appointments to monitor healing and remove sutures or fixatives

Full recovery may take 3 to 6 months, with activity restrictions advised during this period.

Alternatives

• Non-surgical treatments such as physical therapy and pain management
• Less invasive procedures like arthroscopy
• Total hip replacement for severe cases

Each option has its pros and cons related to invasiveness, recovery time, and long-term outcomes.

Patient Experience

Patients may experience pain and discomfort post-surgery, managed with medications. Initial immobility requires assistance with walking aids. Gradual improvement is expected with ongoing physical therapy, leading to enhanced hip function and reduced pain.