CPT® Code 27111

1. Indications

The transfer of the iliopsoas muscle to the femoral neck, as described by CPT® Code 27111, is indicated for specific conditions that affect the hip joint. These include:

• Congenital Hip Dislocation This condition involves the improper formation of the hip joint at birth, leading to instability and potential dislocation.
• Paralysis of the Hip Adductor Muscles This condition results in the inability to properly control the movement of the hip, which can lead to functional impairment and instability.

2. Procedure

The procedure for transferring the iliopsoas muscle to the femoral neck involves several critical steps, each designed to ensure the successful relocation and stabilization of the muscle. The steps are as follows:

• Step 1: Anterolateral Incision An incision is made in the anterolateral region over the insertion site of the iliopsoas muscle on the lesser trochanter. This approach allows for direct access to the muscle while minimizing damage to surrounding tissues.
• Step 2: Division of the Iliopsoas The iliopsoas muscle is carefully divided at its insertion point. This step is crucial as it prepares the muscle for transfer and ensures that it can be repositioned effectively.
• Step 3: Creation of Notch in the Ilium A notch is created in the wing of the ilium, located between the anterior superior and anterior inferior iliac spines. This notch serves as a passageway for the iliopsoas muscle during the transfer process.
• Step 4: Splitting of Gluteus Medius and Minimus The gluteus medius and minimus muscles are split to allow for the iliopsoas muscle to be passed through. This step is essential for ensuring that the muscle can be properly positioned without obstruction.
• Step 5: Passage of Iliopsoas Muscle The iliopsoas muscle is then passed through the created notch in the ilium and through the split in the gluteus medius and minimus muscles. This maneuver is critical for relocating the muscle to its new attachment site.
• Step 6: Securing the Iliopsoas Finally, the iliopsoas muscle is secured to the femoral neck. This fixation is vital for restoring the function of the muscle and ensuring stability in the hip joint.

3. Post-Procedure

Post-procedure care following the transfer of the iliopsoas muscle to the femoral neck involves monitoring the surgical site for any signs of infection or complications. Patients may require physical therapy to regain strength and mobility in the hip joint. The expected recovery period can vary based on individual patient factors, but adherence to rehabilitation protocols is essential for optimal outcomes. Additionally, follow-up appointments will be necessary to assess the healing process and the effectiveness of the muscle transfer.