CPT® Code 27134

The CPT® Code 27134 refers to the procedure known as the revision of total hip arthroplasty, which involves both components of the hip joint. This procedure is typically indicated when a previously implanted total hip prosthesis has failed, necessitating a surgical intervention to replace or revise the existing components. The revision process includes several critical steps: the removal of the old implants, addressing any bony abnormalities that may have developed, and the implantation of new or revised total hip components. Additionally, bone grafting may be performed using either autograft (bone taken from the patient's own body) or allograft (bone taken from a donor). During the procedure, the surgeon makes an incision along the previous surgical site on the lateral aspect of the hip, allowing access to the underlying soft tissues. The dissection may require extensive soft tissue release due to scar tissue formation, which can involve partial release of the psoas tendon, gluteus maximus insertion, and the head of the rectus femoris muscle. Once the hip joint is accessed, the femoral head prosthesis is dislocated to expose the acetabular component. The revision process is meticulous, as it involves excising the pseudocapsule and removing the acetabular cup, followed by the careful extraction of the femoral component. The procedure may also involve the removal of any bone cement used in the initial surgery, and the surgical sites are thoroughly cleaned with saline and/or antibiotic solutions. The evaluation of the acetabulum and femoral shaft for bone loss is crucial, as it determines the need for bone grafting to ensure proper support for the new components. Ultimately, the revised total hip components are implanted, restoring function and stability to the hip joint.