Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc)
CPT4 code
Name of the Procedure:
Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc.)
Summary
This procedure involves surgically replacing the femoral head into the hip socket (acetabulum) to treat hip dislocation. It may include cutting tendons (tenotomy) to facilitate proper placement.
Purpose
The procedure addresses spontaneous hip dislocation commonly due to developmental, congenital, or pathological factors. It aims to restore hip stability, improve mobility, and alleviate pain.
Indications
- Hip dislocation due to developmental dysplasia
- Congenital hip dislocation
- Pathological dislocations due to conditions like neuromuscular disorders
- Pain and limited hip function despite conservative treatment
Preparation
- Preoperative fasting typically for 8 hours
- Adjustment or cessation of certain medications (e.g., blood thinners)
- Preoperative imaging studies (X-rays, MRI)
- Physical examination and pre-surgical clearance by healthcare providers
Procedure Description
- Anesthesia: General anesthesia to ensure the patient is unconscious and pain-free.
- Incision: A surgical cut is made over the hip.
- Exposure: Muscle and tissues are carefully retracted to expose the hip joint.
- Reduction: The dislocated femoral head is guided back into the acetabulum.
- Tenotomy: If necessary, tendons are cut to facilitate proper joint positioning.
- Stabilization: The joint may be stabilized with sutures or implants.
- Closure: The incision is closed with sutures or staples.
Duration
The procedure typically lasts between 2 to 4 hours.
Setting
The procedure is performed in a hospital surgical suite.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technician
Risks and Complications
- Infection
- Blood clots
- Nerve injury
- Joint stiffness or instability
- Dislocation recurrence
- Anesthetic complications
Benefits
- Restored hip stability
- Improved mobility and function
- Pain relief
- Enhanced quality of life
Recovery
- Hospital stay of a few days
- Pain management with medications
- Physical therapy starting shortly after surgery
- Restricted weight-bearing on the operated hip for several weeks
- Follow-up appointments with the surgeon
Alternatives
- Non-surgical management (physical therapy, bracing)
- Closed reduction (non-surgical realignment)
- Hip replacement surgery
- Each alternative varies in invasiveness, recovery time, and outcomes
Patient Experience
During the procedure, patients are under general anesthesia and will not feel pain. Post-surgery, pain and discomfort are managed with medications. Patients may experience initial pain and limited mobility, but these symptoms typically improve with time and rehabilitation efforts.