Hemiarthroplasty

Author:

Gezahegn Beakal

Abstract

Hemiarthrroplasty is a procedure in which the head and neck of femur are only replaced with prosthesis. Currently, almost exclusively used now for displaced intracapsular femur neck fracture in older adults and is the surgery of choice for hip fracture in patients who minimally ambulate or do not function at a very high level. This surgical procedure(arthroplasty) eliminates the risk of non-union, fixation failure, and reoperation in the treatment of femur neck fracture. There are two forms of HA: unipolar and bipolar, as well as conventional and dual-mobility THA. Both HA types have comparable results in terms of stability, but there is a danger of acetabular wear that may eventually need conversion to THA. HA is indicated in patients whose self-sufficiency and physical activity are limited. A unipolar implant should be used, as no evidence exist that bipolar implants provide additional benefits. THA is associated with better functional outcomes and a lower risk of revision surgery in self-sufficient, physically active patients. Instability is the leading complication of conventional THA and occurs with a higher incidence compared to HA. Because of the potential for instability, the posterior approach should be avoided while doing HA. In the hands of a skilled surgeon employing a dual-mobility cup, the posterior route is a solid alternative for THA. Cement fixation of the stem is advised to reduce the possibility of peri-prosthetic fracture.

Publisher

IntechOpen

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