PMC4397524_01
Preoperative MRI, showing the aseptic femoral head necrosis
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F1
The patient had been treated with cortisone injections for 6 months as treatment for vertebral disk pathology. His symptoms (pain and dysfunction of the hip) had been occurring for 18 months before diagnosis (Fig. 1). The decision was made to treat with total uncemented hip arthroplasty, opting for the use of the Proxima short femoral stem prosthesis, with a ceramic implant.
The minimally invasive posterolateral approach
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F2
It was decided to use the minimally invasive posterolateral approach, with the patient in a lateral position, under spinal anesthesia (Fig. 2).
Surgical moment showing the impaction of the acetabular component
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F3
At this point the acetabulum was prepared, then, the final size was determined with trial cups and the acetabular component was impacted (Fig. 3).
Surgical moment showing the ceramic insert
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F4
After impacting the acetabular component the ceramic insert was introduced (Fig. 4).
Surgical moment showing the preparation of the femoral metaphysis with dedicated instruments
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F5
The femoral neck and the metaphysis were prepared with dedicated instruments (Fig. 5), then the final size was determined and the Proxima short femoral stem prosthesis was impacted (Fig. 6).
Surgical moment showing the ceramic femoral head
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F7
The femoral head size was determined and the adequate ceramic implant was impacted (Fig. 7), after which the prosthesis was reduced and tested with a range of motion maneuvers and impingement tests.
Postoperative X-Ray showing the implant
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F8
The wound was actively drained and each anatomic layer, including the articular capsule, was sutured. 24 hours postoperatively the drains were removed and an X-ray was taken (Fig. 8).