Bipolar Hemiarthroplasty: What You Need to Know

If you're dealing with a hip fracture, bipolar hemiarthroplasty might be the solution you need. Recommended for older or less active individuals, it’s less invasive than total hip replacement.

In this article, we'll explore what bipolar hemiarthroplasty is, who it's for, how it works, and what you can expect during recovery.

What is Bipolar Hemiarthroplasty

Bipolar hemiarthroplasty (BHA) is a surgical procedure used to replace a damaged femoral head (the ball of the hip joint) due to fractures, particularly femoral neck fractures.

These fractures can interrupt the blood supply to the femoral head, making it necessary to replace the damaged part of the joint.

Unlike total hip replacement (THR), which replaces both the ball and the socket, BHA only replaces the femoral head, leaving the hip socket intact.

Bipolar hemiarthroplasty puts less stress on the joint than total hip arthroplasty. This leads to better stability and a lower risk of complications, like the prosthetic moving into the hip socket, compared to traditional hip hemiarthroplasty.

There are two main types of hemiarthroplasty procedure—unipolar and bipolar.

• Bipolar Hemiarthroplasty – This procedure uses a two-part prosthesis with an inner head and an outer cup, allowing the head to swivel within the cup, which reduces wear and tear. It provides better stability, especially for patients with arthritis or previous fractures.
• Unipolar Hemiarthroplasty: This procedure features a single-piece design, which provides movement between the hip socket, prosthetic, and hip.

BHA is often recommended for older patients with displaced femoral neck fractures, providing effective pain relief and improved mobility.

Who Needs Bipolar Hemiarthroplasty

Bipolar hemiarthroplasty is typically recommended for individuals who:

• Have sustained a displaced femoral neck fracture.
• Are independently mobile outdoors with minimal assistance.
• Are cognitively able to follow post-surgery instructions.
• Are healthy enough for surgery.

This procedure is often the best option for those who meet these criteria, offering a less invasive solution with quicker recovery.

Bipolar Hemiarthroplasty Procedure Overview

Before the surgery, you'll undergo a thorough evaluation to ensure you're fit for the procedure.

During the operation:

1. You'll receive anesthesia to keep you comfortable.
2. The surgeon will make an incision to access the hip joint.
3. The damaged femoral head will be removed.
4. The prosthetic implant will be inserted and secured by cement or acrylic bone cement.
5. The surgeon will assess the joint’s stability and range of motion.
6. The incision will be closed and you'll be moved to recovery.

The surgery typically lasts a few hours and you'll need physical therapy to help you regain mobility, and restore hip function, and strength in the joint.

Recovery After Bipolar Hemiarthroplasty

You will need to stay in the hospital for a few days. You'll likely begin sitting or standing with assistance within a day or two, and start walking with assistance typically within 4 to 5 days after the procedure.

Many people begin physical therapy the next day or as soon as they feel comfortable after surgery.

Doctors may also prescribe blood thinners to prevent deep vein thrombosis (a blood clot in the veins), which you may take from 12 hours before the surgery until up to 35 days afterward.

You will need to follow these certain precautions until your hip heals:

• Avoid twisting or bending your hips
• Prevent your affected leg from crossing the midline
• Keep your feet, shoulders, knees, and hips facing forward
• Use pillows to prevent the legs from crossing while sleeping
• Avoid sitting on low chairs
• Refrain from moving the hip beyond 90 degrees while seated
• Use crutches, elevated toilet seats, and grabbers to aid mobility during recovery

Additionally, be extra cautious when getting in and out of bed or a car. Imagine an imaginary line down the middle of your body and make sure your leg doesn’t cross it until you’re fully healed.

Most patients can expect to return to their daily activities by about 6 weeks after the surgery, though full recovery may take longer depending on individual circumstances.

Potential Risks and Complications

While bipolar hemiarthroplasty offers many benefits, it’s important to be aware of the potential risks, which include:

• Dislocation – Not common, but it can happen in some cases.
• Infection – You may need antibiotics before and after surgery to prevent infection.
• Blood clots – They can form in the deep veins of your leg after surgery, and blood thinners may be prescribed to reduce this risk.
• Injury to vessels or nerves – Although rare, nerves or blood vessels may be injured or stretched during surgery.
• Mortality – The mortality rate within the first year after hip fracture surgery ranges from 15–36%, with older age, male sex, and existing health conditions being predictive factors.

Though these complications are rare, it’s important to be aware of them. Make sure to discuss the risks with your surgeon to understand how they apply to your situation.

Frequently Asked Questions

How long does bipolar hemiarthroplasty last?

A successful bipolar hemiarthroplasty procedure typically lasts around 12.5 years.

What is the difference between bipolar prosthesis and total hip replacement?

Total hip replacement is better for extensive damage and offers better durability and range of motion, ideal for active individuals. Bipolar hemiarthroplasty is more suited for older or less active people, focusing only on replacing the femoral head.