Proxima Hip replacement – Less is Proxima Hip replacement – Less is MoreMore

Dr.A.K.Venkatachalam

MS, DNB, FRCS, MCh Orth

Consultant Orthopaedic surgeon

www.hipsurgery.in, www.kneeindia.com

Proxima- What does it meanProxima- What does it mean

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

Conventional Total Hip Conventional Total Hip replacements replacements Introduced in 1960’s by Dr.John Charnley,

an English Orthopedic surgeon. Upper end of the femur is resected

consisting of the head and neck portion . Socket of the pelvic bone is deepened Prosthesis is implanted with bone cement. Metal articulates with High density

polyetheylene. Risk of dislocation results in poor function Recovery takes upto three months

Surface hip replacementsSurface hip replacements

Developed in late nineties in UK by Dr.Derek Mcminn

Head of femur is sculpted and not chopped off to receive a cap or resurfaced.

Socket is deepened and a new socket banged in

Could survive for long term as bearings are made of metal on metal – Unknown at present

Recovery is faster. Function is better.

Proxima is a bone preserving hip Proxima is a bone preserving hip replacementreplacement

Neck portion of femur is preserved

Only head is removed.

The shaft of the femur is not entered or reamed, once again preserving bone.

Design features of Proxima hip.Design features of Proxima hip.

Designer- Italian surgeon Dr. F.Santori Ten year follow up of a similar implant. Implant is fixed in the spongy upper part of

the thigh bone. Large diameter head – less chance of

dislocation Metal on metal possible longer survivor ship Can be implanted by a small incision as less

bone is resected ( Minimally invasive surgery)

Advantages of ProximaAdvantages of Proxima

Less soft tissue dissectionLess bony resectionLarge diameter Head- less chance of

dislocationFluid film lubrication – leads to less

wear of the implantMetal on metal bearings- less wearHence less is More

Intelligent Hip surgeryIntelligent Hip surgery

Maximising survivorship Optimising function

Accelerating recovery

Indications for Proxima HipIndications for Proxima Hip

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.

Those patients with disease in the head which is more extensive making “ Resurfacing” unsuitable. For eg- Avascular necrosis

Minimally invasive Hip & Knee Minimally invasive Hip & Knee surgery - What is it?surgery - What is it?

Skin incisions are smaller than conventional surgery

It is not Key hole or arthroscopic surgery

Inside soft tissue dissection is less.More Bone, tendons, soft tissues are

preserved

Benefits of Minimally invasive Benefits of Minimally invasive surgerysurgery

Less Blood lossLess Post op painLess requirement for narcotic analgesiaShorter hospitalizationEarly functional recoveryCosmesis

Thank youThank you