0SR9039
Replacement Hip Joint, Right to Cemented with Synthetic Substitute, Ceramic, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | S Lower Joints |
| Operation | R Replacement |
| Body Part | 9 Hip Joint, Right |
| Approach | 0 Open |
| Device | 3 Synthetic Substitute, Ceramic |
| Qualifier | 9 Cemented |
Operation Definition
Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part
Procedure Overview
Joint replacement in the lower extremities involves removing damaged or arthritic surfaces of a hip, knee, or ankle and implanting an artificial device that takes over the joint's function. Surgeons turn to this once medications, injections, and physical therapy no longer control the pain or stiffness of advanced osteoarthritis, rheumatoid arthritis, avascular necrosis, or a joint destroyed by prior trauma. The goal is restoring the ability to walk, climb stairs, and move without bone grinding on bone.
Implants are made of metal alloys, ceramic, or high-grade polyethylene, and a case can replace an entire joint (total) or a single compartment (partial). Recovery centers on physical therapy to build strength around the new joint; most patients regain substantial function within a few months, though the device will eventually wear and may need revision decades later.
Anatomy & Axis Detail
Hip Joint, Right
The right hip joint is the ball-and-socket articulation between the femoral head and the acetabulum of the pelvis, a weight-bearing joint essential to walking, standing, and transferring load from the trunk to the lower limb. Osteoarthritis, avascular necrosis, femoral neck fracture, and inflammatory arthropathy are common reasons this joint deteriorates to the point that replacement becomes the most effective treatment for pain and lost mobility. Replacement of the right hip joint removes the damaged femoral head and acetabular surface and substitutes them with prosthetic components, which may be metal, ceramic, or polyethylene depending on the bearing surface selected and the patient's activity level and bone quality. Because hip replacement can be total, involving both femoral and acetabular sides, or partial, involving only the femoral head, the extent of the procedure and the specific components used should be clearly documented.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Device: Synthetic Substitute, Ceramic
Synthetic Substitute, Ceramic denotes an implant with both articulating surfaces made of ceramic material, valued for its hardness and low friction properties, most often used in hip arthroplasty. It differs from Ceramic on Polyethylene, which pairs a ceramic surface against a polyethylene liner rather than another ceramic surface, and from all-metal or metal-on-polyethylene substitutes made from different materials entirely.
Qualifier: Cemented
Cemented qualifies a joint replacement procedure by indicating that the prosthetic component was fixed to bone using bone cement rather than relying on bony ingrowth. It is distinguished from the Uncemented qualifier, with the choice affecting expected fixation strength, recovery timeline, and revision considerations.
Coding & Documentation
A coder assigns Replacement when the operative note documents removal of the native articular surface and insertion of a device meant to permanently substitute for it, not merely resurface it. Documentation should specify the joint, laterality, and whether the procedure was total or partial, since these drive qualifier selection. A common error is confusing partial resurfacing that leaves native bone intact with full Replacement, or missing that a revision arthroplasty swapping the entire prosthesis is still Replacement rather than Revision.