Hip Core Decompression (HCPCS: S2325)

Name of the Procedure:

• Common Name: Hip Core Decompression
• Technical Terms: Core decompression of the hip, Osteonecrosis decompression

Summary

Hip core decompression is a surgical procedure aimed at relieving pain and slowing the progression of osteonecrosis (avascular necrosis) in the hip by removing a portion of the inner bone.

Purpose

• Medical Conditions: Osteonecrosis (avascular necrosis) of the hip
• Goals: To reduce pain, improve blood flow to the affected bone, and delay or prevent the collapse of the hip joint.

Indications

• Symptoms: Persistent hip pain that does not improve with conservative treatments.
• Conditions: Early-stage osteonecrosis diagnosed via imaging studies.
• Patient Criteria: Typically younger patients or those whose osteonecrosis is detected early before the bone collapses.

Preparation

• Pre-procedure Instructions: Patients may be asked to fast for several hours before the surgery and to stop taking certain medications that could affect blood clotting.
• Diagnostic Tests: MRI or X-rays to assess the extent of bone damage.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A small incision is made near the hip.
3. Decompression: A surgical drill is used to create channels in the bone to relieve pressure and promote new blood vessel formation.
4. Completion: The incision is closed with sutures or staples, and a sterile dressing is applied.

Tools and Equipment:

• Surgical drill
• Imaging technology (for guidance)
• Standard surgical instruments

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Hip core decompression is performed in a hospital operating room or a surgical center.

Personnel

• Surgeon: Typically an orthopedic surgeon.
• Nurses: Operating room nurses.
• Anesthesiologist: Responsible for administering anesthesia.

Risks and Complications

• Common Risks: Pain, infection, bleeding.
• Rare Complications: Fracture in the treated area, progression to hip replacement if decompression is not successful.

Benefits

• Relief from hip pain and improved joint function.
• Prevention of further bone damage and delay in the need for hip replacement.
• Benefits are typically realized within a few months post-procedure.

Recovery

• Post-Procedure Care: Patients may need crutches or a walker for initial mobility.
• Recovery Time: Typically within 2 to 4 months, with physical therapy possibly required.
• Follow-Up: Regular follow-up appointments to monitor healing progress.

Alternatives

• Non-Surgical Options: Medications, physical therapy, lifestyle modifications.
• Surgical Alternatives: Total hip replacement or other salvage procedures.
• Pros and Cons: Hip core decompression is less invasive but may not be suitable for advanced osteonecrosis.

Patient Experience

• During the Procedure: The patient will not feel anything due to anesthesia.
• Post-Procedure: Some pain and discomfort are expected, managed with pain medications. Physical therapy and gradual return to activities are part of the recovery plan.