Hip hemiarthroplasty

Last revised by Henry Knipe on 28 Sep 2023

Citation, DOI, disclosures and article data

Citation:

Hacking C, Knipe H, Elfeky M, et al. Hip hemiarthroplasty. Reference article, Radiopaedia.org (Accessed on 23 Apr 2024) https://doi.org/10.53347/rID-37709

DOI:

https://doi.org/10.53347/rID-37709

Permalink:

https://radiopaedia.org/articles/37709

rID:

37709

Article created:

19 Jun 2015, Craig Hacking ◉ ◈

Disclosures:

At the time the article was created Craig Hacking had no recorded disclosures.

View Craig Hacking's current disclosures

Last revised:

28 Sep 2023, Henry Knipe ◉ ◈

Disclosures:

At the time the article was last revised Henry Knipe had the following disclosures:

Integral Diagnostics, Shareholder (ongoing)
Micro-X Ltd, Shareholder (ongoing)

These were assessed during peer review and were determined to not be relevant to the changes that were made.

View Henry Knipe's current disclosures

Revisions:

17 times, by 12 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Tags:

hip, fracture, orthopedic hardware, operations, orthopeadics, implants, rewrite

Synonyms:

Hip hemiarthroplasties

Hip hemiarthroplasty is an orthopedic procedure for the treatment of certain femoral neck fractures where the femoral head is removed and replaced. The prefix hemi (meaning half) refers to the fact that the prosthetic femoral head articulates with the native acetabulum.

Hemiarthroplasty is indicated for the surgical treatment of subcapital neck fractures that are displaced and at high risk of femoral head avascular necrosis, (Garden III and IV fractures) if treated with DHS internal fixation ¹. As the procedure is quicker and far less morbid than internal fixation, hemiarthroplasty is also routinely used in older, less active and co-morbid patients who would not be good surgical candidates for total arthroplasty. In younger or more active patients, outcomes are better with total hip arthroplasty ¹.

Procedure

Hemiarthroplasty is generally performed via one of the following approaches ⁴:

direct lateral (Hardinge)
anterolateral (Watson-Jones)
transgluteal
posterior (Moore, Southern, and true posterior)
anterior (direct anterior, Smith-Peterson)

The femoral stem is inserted similarly to total hip arthroplasty and can be cemented or non-cemented. When cemented, a plastic medullary cavity plug may be used to stop the inferior migration of the cement. Many organizations worldwide recommend the cemented technique as standard ^2,3. Cemented hemiarthroplasty have fewer prosthesis-related complications when compared to an uncemented hip prosthesis despite similar rates of mortality ⁴.

The prosthesis may be a bipolar hemiarthroplasty, which can be converted to a total hip arthroplasty in the future. The large prosthetic head can be removed and a smaller one attached to the femoral stem and an acetabular cup prosthesis is inserted. This is going out of fashion due to the added complication of osteolysis.