CPT® Code 27179

1. Indications

The open treatment of slipped femoral epiphysis using CPT® Code 27179 is indicated for the following conditions:

• Slipped Capital Femoral Epiphysis (SCFE) - This condition is characterized by the backward slippage of the femoral head due to displacement of the growth plate, which can lead to hip pain and limited mobility.
• Hip Pain - Patients may present with hip pain that is often exacerbated by activity, indicating the need for surgical intervention to correct the underlying issue.
• Limited Range of Motion - The presence of SCFE can result in a reduced range of motion in the hip joint, necessitating treatment to restore function.

2. Procedure

The procedure for the open treatment of slipped femoral epiphysis involves several critical steps:

• Step 1: Incision and Exposure - A lateral skin incision is made over the hip joint to provide access. The surgeon carefully dissects the soft tissues to expose the hip joint, ensuring minimal damage to surrounding structures.
• Step 2: Joint Capsule Incision - Once the hip joint is exposed, the joint capsule is incised to allow for direct visualization and evaluation of the femoral head and neck. This step is crucial for assessing the degree of slippage.
• Step 3: Evaluation of Slippage - The surgeon evaluates the extent of the slippage to determine the appropriate repair technique. This assessment is vital for planning the subsequent steps of the procedure.
• Step 4: Hip Motion Assessment - The hip is moved through a range of motions to identify any impingement caused by the bone prominence resulting from the slippage against the acetabulum.
• Step 5: Osteoplasty - The periosteum of the femoral neck at the site of the prominence is incised and elevated. The prominence is then carefully removed by smoothing and remodeling the bone to alleviate impingement and restore proper alignment.
• Step 6: Closure - After the osteoplasty is completed, the periosteum is repaired. The joint capsule is then closed, followed by a layered closure of the soft tissues and skin to ensure proper healing and minimize complications.

3. Post-Procedure

Post-procedure care following the open treatment of slipped femoral epiphysis includes monitoring for complications such as infection or improper healing. Patients are typically advised to limit weight-bearing activities for a specified period to allow for adequate recovery. Physical therapy may be recommended to restore strength and range of motion in the hip joint. Follow-up appointments are essential to assess the healing process and ensure that the hip joint is functioning properly.