Using a box osteotome, the residual femoral neck is resected  (click here for more information) and the metaphyseal housing of the implant is prepared. The acetabulum is reamed (click here) such that the sub-chondral bone is retained to seat the cup.

Metaphyseal housing

By using the hollow chisel adapted to the size of the implant and fixed to the broach handle, a cylinder of cancellous bone is removed from the metaphysis taking care not to damage the calcar or the greater trochanter. The smallest broach, left or right, is then introduced to find the medullary canal, as shown below. If the pre-operative planning anticipates a possible contact between the prosthetic stem and the diaphyseal cortex, it is advisable to ream with flexible reamers up to the diameter corresponding to the chosen implant and shown on the template.