Femoral Preparation

The table rotates the leg externally (foot pointed outward) and extends the hip, dropping the foot towards the floor to allow femoral access through this small approach. A broach is inserted into the femoral canal. Progressively larger broaches are then inserted. The broach size is limited by the hard outer cortical bone. (Figure 8)

Sizing

Following insertion of the final broach, the driving handle is removed. The broach is temporarily left in as a "trial" femoral prosthesis and its upper end is capped with a trial femoral head. The table repositions the leg to its normal position and the trial head is "reduced" into the acetabulum. Active X-ray control is now used for sizing. Side by side television monitors compare the X-ray image of the patient's opposite hip to the operated hip. This comparison gives immediate information regarding equality of leg length and femoral offset (horizontal distance of the femur from the pelvis). The leg and hip are moved by the table to check for stability (resistance to dislocation). If the initial trial shows undesirable leg length, offset or stability adjustments are made. (Figure 9)

The Femoral Prosthesis

A femoral prosthesis of specific size is accurately inserted to reproduce the sizing indicated by the trial phase. (Figure 10 and 11)

 
 
The Final Result

The prosthetic hip is reduced by moving the leg into its normal position as the femoral head is placed into the acetabulum. The wound is washed with antibiotic solution and closed. (Figure 12)

 
Figure 12