Hip Hemiarthroplasty

Overview:

Hip hemiarthroplasty is a surgical procedure where only one half of the hip joint is replaced — usually the femoral head (the ball part of the ball-and-socket joint) — while the acetabulum (hip socket) is left intact. It is commonly performed for elderly patients with hip fractures, especially displaced femoral neck fractures.

Why It’s Done:

Hip hemiarthroplasty is typically recommended when:

• There is a fracture of the femoral neck that cannot heal properly with fixation.

• The patient is elderly or has limited mobility, making full hip replacement less beneficial.

• The hip joint is otherwise healthy and does not have significant arthritis.

It’s a faster surgery with less stress on the body compared to total hip replacement, especially important for frail or older patients.

How You Prepare:

Before surgery, patients will typically undergo:

• Medical evaluation: Blood tests, ECG, imaging (X-rays, sometimes CT/MRI).

• Medication review: Some medications like blood thinners may be paused.

• Fasting: Usually no food or drink for 6–8 hours before surgery.

• Anesthesia planning: General or spinal anesthesia is discussed.

• Consent: Patient signs consent after understanding risks and benefits.

What You Can Expect:

During surgery:

• The damaged femoral head is removed.

• A metal prosthetic head is inserted into the femur.

• The socket is not replaced.

• The procedure usually lasts 1–2 hours.

After surgery:

• Monitoring in a recovery room.

• Pain control with medications.

• Initiation of mobilization within 24–48 hours.

Physical Therapy:

Physical therapy is crucial to recovery and usually begins shortly after surgery:

• Day 1–2: Bed mobility, sitting, standing, and short walks.

• Week 1–2: Walking with walker or crutches, light strengthening.

• Weeks 3–6: Improved gait, increased endurance, stair training.

• Focus is on preventing stiffness, improving strength, and restoring function.

Precautions are taken to prevent dislocation, such as avoiding certain movements (e.g., crossing legs, bending hip past 90 degrees).

Results:

Most patients experience:

• Significant pain relief.

• Improved mobility compared to pre-surgery.

• Lower risk of complications in appropriate patients versus total hip replacement.

• Recovery time ranges from 6 to 12 weeks, depending on age, health, and physical therapy.

However, since only half the joint is replaced, long-term outcomes may not be as durable as total hip arthroplasty, especially in younger or more active individuals.