Hip Hemiarthroplasty (Bipolar)

Hip Hemiarthroplasty (Bipolar)

Sometimes, when a person experiences a hip fracture, the head of the femur becomes separated from the shaft. This is called a femoral neck fracture and it can be very painful and needs immediate medical attention. In some cases, the head of the femur is either too damaged to be reattached, or a condition called avascular necrosis sets in. If this happens, the head of the femur needs to be replaced in a procedure called hemiarthroplasty. This is different from total hip replacement, as the socket portion of the joint, located in the pelvis, is not replaced. 

Causes of Hip Hemiarthroplasty

Many times, patients need hip replacement because of a hip fracture. These fractures most often take place as a result of a fall or of weakening bones. However, this does not mean that it is the only cause. Sometimes the head of the femur becomes weakened by other issues like osteoarthritis or wear and tear over time. It is more common for elderly patients to need a hip replacement after many years of use and mild injury, especially if the head of the femur has been damaged. 

Basics of Bipolar Hemiarthroplasty

It is recommended that each patient talk with their doctor to know what to expect before and after the surgery. Patient education is extremely important for any procedure. First, the patient is sedated and the area is prepped for the surgery. The surgeon makes an incision above the hip joint large enough to see the head of the femur. The leg is then manipulated to remove the hip joint from the socket, also known as the acetabulum. This is done very carefully so to not damage the surrounding tissues and cartilage. The head of the femur is then removed. If this was already separated, there may be some smoothing down of the femur to make the break more clean. 

Procedure

The upper part of the femur is hollowed out and a long implant called a “stem” is inserted into the femoral cavity. This stabilizes the femur bone and actual hip replacement. The stem is specially designed to hold the main portion of the implant, the “ball” portion of the ball and socket joint. This makes the ball able to turn in all different directions, which may help avoid damage in further wear and tear. The surgeon then carefully places the new ball implant into the socket, reassembling the hip joint. This is then tested for mobility. If the implant looks good and everything seems to be in place, the surgeon will then close the incision. 

Bipolar Hemiarthroplasty Implant

In specifically a Bipolar Hemiarthroplasty, the implant used for the “ball” portion of the implant is actually a metal ball fitted into a casing made of polyethylene. This is a form of plastic which will help cushion the metal implant, hopefully helping the patient experience more mobility and less wear on the pelvis.

Recovery After Hip Hemiarthroplasty

After the surgery has been completed, most patients can return home after a day or so. If there are any complications, that hospital stay may be longer. Almost immediately, the doctor will prescribe physical therapy to help the hip recover and regain mobility. Most patients are back on their feet and walking (with help) within a few days, but fully regaining movement can take up to six months. Most patients can go back to mild activity within 4-6 weeks. 

Long Term Effects of Hip Hemiarthroplasty

Some patients will have to make some adjustments to their everyday activities. Unfortunately, some people will not experience the best possible healing or they may have pain or discomfort during recovery. Some patients will have less mobility and use of their hip after the surgery and recovery. However, most patients do experience lessened pain and greater use of their hip after the procedure has been completed.

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