Symptoms :
pains of the hip occurring with walk ;
a reduction in articular mobilitie.

Diagnosis :
radiographies show a pinching of the articular line space by disappearance of the cartilage: the bone of the head of the femur is in contact with the cotyle (pelvis).
Several stages are described according to the importance of osteoarthritis.

Treatment :
The treatment must always be medical initially acting on the pain and the inflammation ; when
the drugs are not enough, physiotherapy (using devices such the infra-red type or ultrasounds
or laser acting on the pain and the inflammation) can be carried out.
If all these therapeutic did not generate improvement, the surgery can be discussed.

Principle :
To remove injured cartilage surfaces and to replace them by a prosthesis which is made up:
of a stem introduced into the channel of the femur after having removed the femoral head ;
of a ball coming to fix itself on the higher end of the preceding stem ;

of an implant being fixed on the articular slope of the pelvis, comprising a metal slope with a natural coating of hydroxyapathite, not requiring cement and receiving a polyethylene insert which will be articulated with the ball previously described :




Sight after the assembly

The size of these implants is defined rigorously according to the morphology of the articulation of each patient.

Advantages :

The implants profited from significant technical improvements these last years:
one of the ways initially surgical makes it possible to obtain more limited dissections and more reduced osseous removing, it is about the initially antОro-external way; immediate rehabilitation and the resumption of walk with a complete support after the intervention are possible; the duration of the hospitalization is shorter of approximately a week and rehabilitation can be carried out close to the residence ;
their implantation thus is facilitated of it making it possible to reduce the duration of the intervention; their implantation is also more precise and is adapted better to the anatomy of the patient thanks to a more powerful instrumentation ;
the prostheses of hip comprising a natural coating (the hydroxyapathite) are today posed without biological cement and have one longer lifespan, often avoiding the surgical recoveries for unsealing of the prosthesis, remotely of the first operation; they have a more satisfactory anchoring with the bone because this one is developing itself inside the pores of this coating around the prosthesis.

Limits : total ankylosis of the hip; associated neurological disease ; antecedent of chronic infectious processesЙ

Demonstration with a clinical file :


Osteoarthritis of hip with gaps
on the level of the femoral head


Radiograph hip after implantation of the prosthe




A few days after the operation,
the patient found a normal autonomy

Another more complex clinical example, comprising, in addition to the osteoarthritis of the hip, a deformation of the femur and pelvis :



The femur is the seat of an after-effect of fracture and the pelvis comprises a congenital deformity : the head of the femur left the articulation and is above the cotyle (congenital sub-dislocation of hip) right hip on the left of radiography. There it is thus necessary to find the normal axis of the femur to be able to place the femoral stem; for that, it is necessary to divide transversely the old fracture (osteotomy), to deliver a good axe to the femur and to insert there a longer femoral stem which will stabilize this zone:

One notes the femoral stem introduced into the femur, the head of the femur injured having been removed; it was necessary to rebuild the articular slope of the pelvis (cotyle) which being non-existent, by the implantation of a screwed metal ring.

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