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Arthroscopy, hip, surgical; with synovectomy

CPT4 code

Name of the Procedure:

Arthroscopy, hip, surgical; with synovectomy
Common name(s): Hip Arthroscopy with Synovectomy, Hip Scope, Minimally Invasive Hip Surgery

Summary

Hip arthroscopy with synovectomy is a minimally invasive surgical procedure where a small camera (arthroscope) and instruments are inserted into the hip joint to remove inflamed synovial tissue that causes pain and discomfort.

Purpose

This procedure addresses issues caused by synovitis, such as chronic pain, swelling, and reduced range of motion in the hip. The goal is to alleviate these symptoms by removing the inflamed synovial tissue, improving joint function, and preventing further damage.

Indications

  • Persistent hip pain not relieved by non-surgical treatments
  • Hip synovitis due to rheumatoid arthritis or other inflammatory conditions
  • Mechanical symptoms like catching or locking of the hip
  • Patients with confirmed synovial inflammation through imaging studies

Preparation

  • Pre-operative imaging such as MRI or X-rays to assess the joint
  • Blood tests to check for inflammatory markers
  • Fasting for 8-12 hours before the surgery
  • Adjustments to regular medications as instructed by the healthcare provider
  • Arrange for transportation and post-operative care

Procedure Description

  1. The patient is placed under general anesthesia or spinal anesthesia.
  2. The surgeon makes small incisions around the hip joint.
  3. An arthroscope is inserted through one incision to visualize the inside of the joint.
  4. Specialized surgical instruments are inserted through other incisions to remove the inflamed synovial tissue.
  5. The joint is irrigated and inspected for any additional issues.
  6. Incisions are closed with sutures or surgical tape and covered with a sterile dressing.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity.

Setting

The procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

  • Orthopedic Surgeon
  • Surgical Nurse or Technologist
  • Anesthesiologist
  • Recovery Room Staff

Risks and Complications

  • Infection
  • Bleeding or hematoma
  • Blood clots
  • Nerve or blood vessel damage
  • Stiffness or reduced range of motion
  • Rarely, worsening of symptoms

Benefits

  • Reduction in hip pain and inflammation
  • Improved joint function and mobility
  • Shorter recovery time compared to open surgery
  • Smaller incisions leading to minimal scarring

Recovery

  • Initial recovery in a recovery room followed by discharge the same day or after an overnight stay
  • Pain management with medications
  • Ice and elevation to reduce swelling
  • Physical therapy to restore range of motion and strength
  • Avoiding heavy lifting, high-impact activities, and prolonged standing for several weeks
  • Follow-up appointments to monitor healing progress

Alternatives

  • Non-surgical treatments such as physical therapy, medications, and lifestyle modifications
  • Corticosteroid injections for temporary relief
  • Open synovectomy for cases not suitable for arthroscopy
  • Pros: Less invasive options may involve less risk and no recovery from surgery.
  • Cons: Non-surgical treatments may not provide lasting relief and might not resolve the underlying issue.

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. After the procedure, some discomfort and swelling are expected. Pain management strategies will be employed to keep the patient comfortable. Gradual improvement in symptoms is anticipated over the weeks following the surgery.


By providing comprehensive information in layman's terms, this markdown description ensures that patients understand the hip arthroscopy with synovectomy procedure, preparing them adequately for what to expect before, during, and after the surgery.

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