27265 Closed treatment of post hip arthroplasty dislocation; without anesthesia

Name of the Procedure:

Closed treatment of post hip arthroplasty dislocation; without anesthesia
Common name(s): Hip reduction without anesthesia, Closed reduction of hip dislocation.

Summary

In this procedure, a dislocated hip joint that has previously undergone arthroplasty (artificial joint replacement) is manually realigned without the use of anesthesia.

Purpose

To correct a dislocated hip joint following a hip replacement surgery.
The goal is to restore the hip joint to its proper position to alleviate pain, improve mobility, and prevent further joint damage.

Indications

• Sudden hip pain and immobility following a hip arthroplasty.
• Physical examination or imaging (such as an X-ray) confirming the dislocation of the hip joint.
• Chronic or recurrent hip dislocations may also warrant this procedure.

Preparation

• No specific preparation is required due to the absence of anesthesia.
• Patients may be advised to avoid food and drink for a few hours, but this is typically not mandatory.
• An X-ray or other imaging studies are performed to confirm the dislocation and guide the procedure.

Procedure Description

1. The patient is positioned appropriately, usually lying flat.
2. The healthcare provider manually manipulates the leg and hip to guide the dislocated joint back into place.
   • This may involve specific movements and gentle traction.
3. No tools or anesthesia are used.
4. A follow-up X-ray is performed to confirm proper alignment of the hip joint.

Duration

The procedure typically takes 15-30 minutes, depending on the complexity of the dislocation.

Setting

Usually performed in a hospital emergency room or an outpatient clinic with radiology facilities.

Personnel

• Orthopedic surgeon or emergency room physician.
• Radiology technician for imaging support.
• Nurses may assist with patient positioning and provide comfort.

Risks and Complications

• Pain during the procedure.
• Potential for muscle or ligament injury.
• Rarely, nerve damage.
• Re-dislocation of the hip joint.

Benefits

• Immediate relief of pain and discomfort.
• Restoration of joint function.
• Avoidance of surgery or more invasive procedures.

Recovery

• Patients are often advised to rest and limit weight-bearing activities on the affected leg for a few days.
• Follow-up appointments to monitor healing and rehabilitation.
• Physical therapy may be recommended to strengthen the hip muscles and prevent future dislocations.

Alternatives

• Hip reduction under general or local anesthesia.
• Surgical intervention if closed reduction is unsuccessful or not appropriate.
• Pros: Less pain during the procedure with anesthesia, lower risk of complication for surgical methods.
• Cons: Anesthesia carries its own risks, and surgery may require longer recovery.

Patient Experience

• Patients may experience discomfort or pain during the procedure due to the lack of anesthesia.
• Immediate relief of pain once the hip is successfully reduced.
• Pain management may include oral analgesics post-procedure.
• It's normal to feel sore for a few days, with gradual improvement as healing progresses.