Proxima Hip Replacement


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The Proxima hip replacement is one of the few short stem hip prosthesis that eliminate undesirable side effects of a total hip replacement. With the proxima hip, there is less bone loss, less risk of dislocation and no thigh pain. A variety of bearing options are also possible like ceramic, metal, polyetheylene. Dr. Venkatachalam offers this procedure at affordable costs at the Madras Joint Replacement Center ( MJRC)

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Proxima Hip Replacement

  1. 1. Proxima Hip replacement – Less is More Dr.A.K.Venkatachalam MS, DNB, FRCS, MCh Orth Consultant Orthopaedic surgeon ,
  2. 2. Proxima- What does it mean <ul><li>Proxima - refers to the anatomy in the proximal portion of the “Femur’ or thigh bone. It is shaped by the inner contours of the proximal femur </li></ul>
  3. 5. Conventional Total Hip replacements <ul><li>Introduced in 1960’s by Dr.John Charnley, an English Orthopedic surgeon. </li></ul><ul><li>Upper end of the femur is resected consisting of the head and neck portion . </li></ul><ul><li>Socket of the pelvic bone is deepened </li></ul><ul><li>Prosthesis is implanted with bone cement. </li></ul><ul><li>Metal articulates with High density polyetheylene. </li></ul><ul><li>Risk of dislocation results in poor function </li></ul><ul><li>Recovery takes upto three months </li></ul>
  4. 6. Surface hip replacements <ul><li>Developed in late nineties in UK by Dr.Derek Mcminn </li></ul><ul><li>Head of femur is sculpted and not chopped off to receive a cap or resurfaced. </li></ul><ul><li>Socket is deepened and a new socket banged in </li></ul><ul><li>Could survive for long term as bearings are made of metal on metal – Unknown at present </li></ul><ul><li>Recovery is faster. </li></ul><ul><li>Function is better. </li></ul>
  5. 7. Proxima is a bone preserving hip replacement <ul><li>Neck portion of femur is preserved </li></ul><ul><li>Only head is removed. </li></ul><ul><li>The shaft of the femur is not entered or reamed, once again preserving bone. </li></ul>
  6. 8. Design features of Proxima hip. <ul><li>Designer- Italian surgeon Dr. F.Santori </li></ul><ul><li>Ten year follow up of a similar implant. </li></ul><ul><li>Implant is fixed in the spongy upper part of the thigh bone. </li></ul><ul><li>Large diameter head – less chance of dislocation </li></ul><ul><li>Metal on metal possible longer survivor ship </li></ul><ul><li>Can be implanted by a small incision as less bone is resected ( Minimally invasive surgery) </li></ul>
  7. 9. Advantages of Proxima <ul><li>Less soft tissue dissection </li></ul><ul><li>Less bony resection </li></ul><ul><li>Large diameter Head- less chance of dislocation </li></ul><ul><li>Fluid film lubrication – leads to less wear of the implant </li></ul><ul><li>Metal on metal bearings- less wear </li></ul><ul><li>Hence less is More </li></ul>
  8. 10. Intelligent Hip surgery Maximising survivorship Optimising function Accelerating recovery
  9. 11. Indications for Proxima Hip <ul><li>Any patient with Hip arthritis for whom a total hip replacement is the permanent solution but Proxima will preserve more bone than a total hip replacement. Bone stock should be intact. </li></ul><ul><li>Those patients with disease in the head which is more extensive making “ Resurfacing” unsuitable. For eg- Avascular necrosis </li></ul>
  10. 12. Minimally invasive Hip & Knee surgery - What is it? <ul><li>Skin incisions are smaller than conventional surgery </li></ul><ul><li>It is not Key hole or arthroscopic surgery </li></ul><ul><li>Inside soft tissue dissection is less. </li></ul><ul><li>More Bone, tendons, soft tissues are preserved </li></ul>
  11. 13. Benefits of Minimally invasive surgery <ul><li>Less Blood loss </li></ul><ul><li>Less Post op pain </li></ul><ul><li>Less requirement for narcotic analgesia </li></ul><ul><li>Shorter hospitalization </li></ul><ul><li>Early functional recovery </li></ul><ul><li>Cosmesis </li></ul>
  12. 17. Thank you Thank you