CPT® Code 27295

Hip disarticulation is a surgical procedure that involves the complete amputation of the leg at the hip joint. This procedure is considered rare and is typically reserved for cases of severe trauma, such as crush injuries, or for serious infections like gas gangrene. Additionally, it may be indicated in situations where previous vascular procedures on the lower extremity have failed, or in the presence of malignant tumors, including Ewing's sarcoma, osteosarcoma, and chondrosarcoma, which affect the proximal femur. The procedure begins with careful marking of incision lines on the skin over the hip and thigh, ensuring precision in the surgical approach. The incision is initiated at the anteromedial aspect of the hip joint and is extended laterally over the greater trochanter, continuing over the posterior aspect of the hip joint. During the surgery, a myocutaneous flap may be created from the surrounding tissue to aid in wound closure. The surgical team will expose the femoral vessels, which are then ligated and transected to prevent excessive bleeding. The anterior musculature is cut at the level of the greater trochanter, followed by the transection of the adductor muscles at their origins on the ischium and pubic rami. The posterior musculature is also transected at the ischium, and the sciatic nerve is cut to facilitate the amputation. The gluteal vessels are ligated and transected, leading to the disarticulation of the femoral head and the complete removal of the leg at the hip joint. After the amputation, drains are placed in the hip region to manage any potential fluid accumulation, and the previously created myocutaneous flap is utilized to cover the surgical wound, promoting healing and reducing the risk of infection.