Following anesthesia the patient is placed supine on the HANA or PROfx table. The unique capabilities of the table facilitate surgery through this smaller and less invasive approach. The carbon fiber spars that support the legs move appropriately and manipulate the operated leg during surgery. Additionally the table has a sterile robotic attachment that reaches inside the wound and lifts the femur to an accessible position. Not seen here are compression boots on the legs which prevent intra-operative blood clot formation.(Figure 3)

The hip is exposed by following a natural plane between muscles and without detachment of muscle or tendons from the bone. The femoral neck is cut and the arthritic femoral head and neck are removed. (Figure 4)

The arthritic acetabulum undergoes a procedure called reaming. A hemispherical shaped reamer rotates on the end of a shaft. Reamers of gradually increasing diameter accurately shape the bone of the acetabulum to accept the acetabular prosthesis. (Figure 5 and 6)

An acetabular prosthesis slightly larger in diameter than the prepared acetabular cavity is inserted with a "press" fit that produces initial stability. During insertion active X-ray control with the fluoroscope is used to position the prosthesis accurately. One or more screws can also enhance initial stability. Later, stability relies on the biologic process of growth of the bone onto the prosthetic acetabular surface. Following insertion of this titanium acetabular "shell," the bearing surface (polyethylene, metal, or ceramic) is inserted. (Figure 7)