OPERATION IN DETAIL: The patient was brought to the operating room and laid supine on the OR table. After general anesthesia was induced, the patient was turned to the left lateral decubitus position. The patient was on a bean bag. Next, the left lower extremity was prepped and draped in the usual sterile fashion. Approximately, a 15 cm incision was made directly overlying the greater trochanter. A direct lateral approach to the hip joint was performed. The gluteus medius and minimus were elevated off the greater trochanter in separate layers. The capsule was opened and retractors were positioned. The femoral head was then removed using a corkscrew. Next, the femur was then prepared for the implant. The canal finder was used followed by the lateralizing reamer. Then, broaching was initiated and the size 14 broach was determined to be the appropriate size. Next, trials were performed for the femoral head size and a size 52 hemiarthroplasty head was chosen. Next, a trial reduction was performed and excellent range of motion and stability was noted with a 52 head and the standard femoral neck. Next, the broach was removed and the canal was then prepared for cementing. A cement restrictor was placed. The canal was then irrigated with pulsatile lavage. Next, cement was injected in retrograde fashion into the femoral canal. Next, the implant was positioned in neutral into the medullary canal. Next, a standard femoral neck size with a 52 head was then positioned and the hip was reduced without any difficulty. This was done after the cement had hardened. Once the hip was reduced, excellent range of motion and stability were noted. Next, the joint was thoroughly irrigated with normal saline. Next, the gluteus medius and minimus were reattached to the greater trochanter in their respective positions. The iliotibial band was closed using figure-of-eight suture of 0 Vicryl. A Hemovac drain was placed and the subcutaneous layer was closed with 2-0 Vicryl suture in an inverted fashion. Staples were used to close the skin. Sterile dressings were applied. The patient was awoken from anesthesia and was then transferred over to the bed and an abduction pillow placed. The patient will be sent to the MICU for further care.
