1) Proper proximal fixation of the femoral implant is crucial for the success of Austin Moore's prosthesis (AMP) surgery to provide mechanical stability and allow bone grafts to consolidate. 2) Inadequate proximal fixation is one of the primary reasons for painful failure of AMP, which can result in prosthesis subsidence, loosening, and loss of alignment. 3) Achieving good proximal fixation requires careful pre-operative planning, preservation of femoral neck bone stock, impaction grafting of the proximal area, and selection of an appropriately sized implant.

1. Austin Moore’s Prosthesis Technique Vinod Naneria Girish Yeotikar Arjun Wadhwani Choithram Hospital & Research Centre, Indore, India

10. Posterio-lateral incision in lateral decubitous position

12. Quadratus Gemeli Piriformis Sciatic Nerve Gluteus Maximus Cut the rotators close to the bone

13. Incise the capsule in “T” shape

14. Measure the size of the head

15. Superior lateral neck attched to Gr. Troch must be removed

16. Neck Cut

17. Piriformis fossa as entry point

19. Bone grafts harvesting

22. Prosthesis design: Proper Offset Stem Diameter Neck over hang Fitness at proximal part

23. Half inserted prosthesis

24. Packing of graft in the medial wall

26. Graft in the distal hole

27. Grafts in the proximal hole

28. Final setting

29. Trochanteric index

30. Reduction by gentle pressure

31. Capsular repair

32. Post Op X-ray

33. Bone growth on medial side and in the fenestrations