Hip hemiarthroplasty is an orthopedic surgical procedure used to treat hip fractures that is similar to a total hip replacement but only part of the hip is replaced. This procedure is typically used to treat a broken or fractured hip but can also be used to treat a hip damaged by arthritis. In this procedure, only one half (ball section) of the hip joint is substituted by a metal prosthesis, hence the name Hemi (half) arthroplasty. In this treatment certain femoral neck fractures where the femoral head is removed or replaced. However, in cases where the socket also needs to be replaced, you will need a Total Hip Replacement (THR). Hip fractures are frequently outside of the socket in the joint capsule, between the greater and lesser trochanter, or in the femur. Hip Hemiarthroplasty of a hip joint is not very commonly but after a rare disturbing accidents or injury to femoral head involved fractures. This may be due to dangerous events like a tumble or jerk where the hip has become displaced and fractured or because of degenerative conditions such as arthritis.

For patients suffering from serious hip arthritis or a fractured hip, a hemiarthroplasty may be required to restore healthy hip function. This procedure is usually advocated by the surgeons only when the femoral head is fractured, but the acetabulum is intact. Other medical conditions as listed below are also important to be considered before the hip hemiarthroplasty.

• Overall condition of your entire hip joint
• Your general health
• Your anticipated life expectancy
• Your physical activity levels

Your surgeon may recommend it when your arthritis does not get better with physical therapy and pain medications.

Some conditions can significantly damage the hip joint making partial hip replacement surgery essential. When you are suffering from significant pain, inflammation, and damage to your hip joint, your physician may recommend surgical intervention. Some of such damaging medical conditions are listed below.

• Osteoarthritis is the most common condition. It is also known as wear-and-tear arthritis, damaging the slick cartilage covering the ends of bones and helping joints move smoothly.
• Rheumatoid arthritis: This condition is caused by an overactive immune system, and produces severe inflammation that can erode cartilage and even underlying bone sometimes. This can result in damaged and deformed joints.
• Osteonecrosis (avascular necrosis): For some people, dislocation or fracture can result in less blood supply to the ball portion of the hip joint such conditions can result in bone collapse or deformities injuring the total hip joint.
• Damage such as hip fracture
• Tumor in the hip joint

Few of the symptoms listed below may also need surgery.

• Persistent pain despite taking pain medications.
• The pain worsens with walking, even with support.
• You cannot rest or sleep because of constant dull or severe pain.
• Affects your ability to use the stairs.
• Makes it difficult to rise from a seated position.
• Aching knee pain with stiffness.
• Severe pain in the hip or groin.
• Inability to put weight on the leg on the side of the injured hip.
• Bruising and swelling in and around the hip area.
• Shorter leg on the side of the injured hip.
• Outward turning of the leg on the side of the injured hip.
• Limping while walking to avoid pain.

Diagnosis is made by evaluating your symptoms, diseases or disorders, medical history, physical examination, and X-rays. Additionally, imaging tests such as MRI and CT scans may be needed to confirm the diagnosis. Accurate diagnostic evaluations play a crucial role in scheming an effective treatment plan and surgery.

The entire procedure will be performed under general anesthesia. Your surgeon will make an incision along the outer side of the affected hip. Once the surgeon gains access to the hip joint, the head of the femur is removed using surgical instruments and prepared to accept the prosthesis. The stem of the metal prosthesis will be placed inside the femoral bone. The surgeon will now connect the metal ball that forms the femoral head. For patients with strong, healthy bone structures, the stem prosthesis will be press-fit or cemented in cases of weak, osteoporotic bone. The method of implantation will depend on the age of the patient and the condition of the bone. After the surgery, the incisions are closed and covered with a bandage.

You will be prescribed medications to reduce pain and inflammation. After surgery, the post-procedural instructions to follow include:

• Crossing your legs should be avoided.
• Avoid lifting heavy weights.
• Avoid bending and twisting your hip.
• Avoid standing for long hours.
• Use an elevated toilet seat.
• Avoid sitting on low chairs.
• Exercises to strengthen your hip.

Your surgeon may recommend physical therapy to strengthen the joint and the muscles and to help restore mobility to the hip joint. You must take precautions to avoid any further fractures. Most patients can walk with the help within a few days, but fully regaining movement may take up to six months. Most patients can go back to mild activity within 4-6 weeks.

Complications of hip hemiarthroplasty include infection, dislocation, deep vein thrombosis, loosening of the prosthesis, and failure to relieve pain. Some other general complications can include, nerve injury, iatrogenic femoral neck fracture, infection at the surgical incision site or joint space, nerve damage which may cause numbness, tingling, pain, and excess bleeding into the joint (hemarthrosis), scarring, and complications from anesthesia.

Hemiarthroplasty is one of the highly-standardized quick operative procedures. The main advantages of hip hemiarthroplasty are freedom from pain, early recovery, and mobilization. It provides stabilization to the joint with minimal dislocation rates.