Hip resurfacing is becoming increasingly popular, and the midterm results have been favorable in well-selected patients. The position of the femoral component has been of particular interest, and ensuring the center-center or mild valgus position of the femoral stem within the femoral neck is a chief concern during the procedure. There have been multiple studies that suggest an increase in the incidence of component failure when the components are malpositioned.
Many of the implant companies provide an aiming guide to assist with the placement of the femoral guide pin; but most of these devices are cumbersome, difficult to use, and sometimes inaccurate. Computer navigation may be used for accurate pin placement, but this adjunct adds to the cost of the procedure.
To address these concerns for femoral pin placement, we have developed a simple and reliable technique of placing the femoral pin using fluoroscopic assistance and a 2.8-mm terminally threaded pin placed in a retrograde fashion, similar to placing the guide pin for a dynamic hip screw. This retrograde pin creates a hole in the femoral head through which the actual pin for head preparation can be threaded once the exposure and hip dislocation are complete.